Qualitative Evaluation of a Comprehensive Online Wellness Program (MENTOR) Among People With Spinal Cord Injury.

People with spinal cord injury (SCI) experience a plethora of health conditions that hinder their health and wellness. This qualitative retrospective evaluation describes the perceptions of 14 peoples with SCI, several months after they completed an eight-week telewellness community program (MENTOR-Mindfulness, Exercise and Nutrition To Optimize Resilience). The program offered daily online classes that covered three core wellness domains (mindfulness, exercise, nutrition) and one health coaching session to introduce participants to eight other wellness domains (sleep, self-care, core values, arts & leisure, outdoor time in nature; spiritual practice, relationships, contribution to others). Qualitative analysis resulted in 4 themes related to program benefits, likes, and improvement recommendations. First, participants valued the program for the social support provided by a sense of community and relationship building with peers. Second, self-regulation was facilitated by the comprehensiveness of the program components, easy online access, and shared lifestyle goals for self-improvement among peers. Third, participants reported improved psychological wellbeing and adopted healthy behaviors that were maintained long after the program. Last, future programs should include flexible class times, post-program support, specific exercise adaptations for people with limited arm function, and supplementary in-person meetings. These preliminary findings demonstrate that MENTOR may benefit the wellbeing of people with SCI and warrant further study.

Evidence-Based Classification in Powerchair Football: Determining the Determinants.

The purpose of this study was to initiate the development of an evidence-based sport classification system for powerchair football, a sport that serves athletes with physical impairments. Sport classification is designed to increase participation by minimizing the impact of impairment on competition outcome, and powerchair football lacks an evidence-based system of classification which is required of Paralympic sports. A number of approaches were used to build the theoretical model of sport performance (Step 2 of the International Paralympic Committee model). Key sport activities were identified through surveys of stakeholders and underlying determinants of those key activities were identified through game and database analyses. Current findings support drive control, ball control, communication, and adjustment to the ball as key activities in powerchair football with joint-specific strength and range of motion, sensory, and neurological variables identified as underlying determinants.

Teleassessments for Enrollment of Adults With Physical or Mobility Disability in a Home-Based Exercise Trial in Response to COVID-19: Usability Study.

BACKGROUND: The Scale-Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH) initiative is a large randomized controlled study that aims to overcome logistical barriers to exercise via telehealth for people with physical disabilities. However, at the start of the COVID-19 pandemic, enrollment was halted due to limited operations at the testing site, which included no onsite visits that involved participant data collection. In response to the limited operations, a modified data collection protocol was developed for virtual enrollment of study participants. OBJECTIVE: This paper presents feasibility data on using teleassessments to enroll people with mobility impairment into a home-based exercise trial. METHODS: The modified protocol replaced onsite enrollment and data collection visits with teleassessments using a computer tablet and testing equipment that was shipped to the participants' home address prior to the synchronous teleassessments conducted by an exercise physiologist through Zoom. The participants were mailed a teleassessment toolkit that included a digital blood pressure cuff, spirometer, hand dynamometer, mini disc cone, and measuring tape (to complete standardized testing). The teleassessment measures included resting blood pressure and heart rate, forced vital capacity, grip strength, Five Times Sit to Stand, and Timed Up and Go. Feasibility metrics included technological effectiveness, efficiency, and safety. The technological effectiveness of the telehealth assessment was determined by the percentage of sessions completed without technical issues with ≥90% criteria set a priori. Efficiency was measured by a session duration of ≤2 hours. Safety was measured by the number of adverse events related to the teleassessments reported. RESULTS: Data from 36 participants were included in this feasibility study, and 34 (94%) participants completed all teleassessments without technical issues. For efficiency, the teleassessment sessions were completed in a mean time of 65 minutes and a maximum session length of 110 minutes. There were no adverse events reported to indicate concerns with the safety of teleassessments. CONCLUSIONS: The modified teleassessment protocol, in response to COVID-19 restrictions, may be a feasible process for enrolling adults with mobility impairment into a home exercise trial who otherwise would have not been able to participate. TRIAL REGISTRATION: ClinicalTrials.gov NCT03024320; https://clinicaltrials.gov/ct2/show/NCT03024320.

Role of age and sex on dual tasking using a treadmill desk while performing cognitive tests.

BACKGROUND: Treadmill desks have been used extensively to increase physical activity and decrease sedentary time in the work environment. However, dual tasking, such as simultaneously walking and performing a cognitive task, may result in diminished performance in one or both tasks. RESEARCH QUESTION: Do age and sex impact ability to dual task while using a treadmill desk at a preferred walking speed?. METHODS: A total of n = 24 younger (range of 18-24 years, mean age = 21.1 ± 1.6 years) and n = 25 older (range of 45-65 years, mean age = 53.0 ± 5.1 years) adults self-selected a comfortable walking speed ranging from 0.5 to 2.0 mph and performed the Stroop Color & Word test (measuring Inhibition) and the Sternberg Test of Working Memory (measuring Working Memory) while walking at their chosen speed on a treadmill desk and while seated. Testing was performed in two separate sessions with the order counterbalanced. Step length, stride length, gait cycle time, and coefficient of variation (CV) for each were measured using OptoGait software, and both reaction time and accuracy for the two cognitive tests were assessed. Dual Task Cost (DTC) was calculated by using the formula (Single task score - Dual task score)/Single task score)*100. RESULTS: Younger adults had faster reaction time compared to older adults for both Working Memory and Inhibition tests (p < 0.05), and both males and females had slower reaction time for the Working Memory test when seated compared to walking (p < 0.05). For DTC, older adults had greater stride length CV during the Working Memory task (32.0 % vs 19.6 %), and regardless of age or sex, DTC for gait was greater than for cognition. SIGNIFICANCE: These data provide evidence that while aging does decrease reaction time while dual tasking, few age differences and no sex differences were found in dual task cost. However, dual tasking results in diminished gait DTC compared to cognition DTC regardless of age or sex.

Walking Cadence during Moderate-Intensity Physical Activity in Pregnant Women.

Evidence has established that a cadence of 100 steps/min is indicative of the moderate intensity threshold of 3 metabolic equivalents (METs), but this has only been described in non-pregnant individuals. As metabolic alterations are well established during pregnancy, the purpose of this study was to determine if the walking cadence equivalent to 3 METs in pregnant women is similar to non-pregnant populations. Pregnant females (n = 29; age = 30.3 ± 3.2 years, gestational age = 23.9 ± 6.6 weeks) in their second or third trimester (>12 weeks gestation) completed three stages of treadmill walking for 5 min at different standardized walking speeds: 2.5, 3.0, and 3.5 miles per hour (mph). Oxygen consumption (VO2) and heart rate (HR) were measured each minute and METs were calculated for each stage. Real-time continuous monitoring of walking cadence was evaluated by an OptoGait gait analysis system. Following the three standardized speed stages, participants completed an additional stage walking at a speed that elicited 100 steps/min; VO2 and HR were also collected. A one-sample t-test was used to compare MET values at each stage to the heuristic 3 MET cutoff, and Pearson correlation coefficient was calculated to evaluate the relationship between cadence and METs. Mean cadence increased linearly across the three stages (2.5 mph = 103.7 ± 4.5, 3.0 mph = 112.5 ± 5.3, and 3.5 mph = 120.4 ± 6.2 steps/min), as did METs (2.5 mph = 2.7 ± 1.7, 3.0 mph = 3.2 ± 0.8, and 3.5 mph = 4.3 ± 1.8 METs) regardless of trimester. The average treadmill speed at which women walked at 100 steps/min was 2.4 ± 0.4 mph which elicited an oxygen consumption of 9.5 mL•kg-1•min-1, or 2.7 ± 0.7 METs. There was no significant difference between METs at 3.0 mph and the conventional 3 MET cut point for moderate-intensity PA (p < 0.05). There was a moderate and significant relationship between METs and cadence (2nd trimester: r = 0.51; 3rd trimester: r = 0.42). Current data indicate for the first time that the traditionally used 3 MET cutoff for moderate-intensity activity is appropriate for pregnant women despite metabolic alterations associated with pregnancy. This may have important implications for exercise prescription in pregnant populations.