This is the author's accepted manuscript. Made available by the permission of the publisher.Objective
To compare the effectiveness of two home-based behavioral interventions to promote wheelchair users exercise adoption and maintenance over 12 months.
Design
Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability.
Setting
Exercise occurred in participant preferred locations (e.g., home, recreation center), with physiological data collected at the university-based exercise lab.
Participants
One hundred twenty-eight inactive wheelchair users (64 women) with sufficient upper arm mobility for arm-based exercise enrolled. Participants on average were 45 years old, lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment.
Interventions
Both groups received home-based exercise interventions. The staff-supported group (n= 69) received intensive exercise support, while the self-guided group (n= 59) received minimal support. Both received exercise information, resistance bands, instructions to self-monitor exercise, regularly-scheduled phone calls, and handwritten cards.
Main Outcome Measures
The primary outcome derived from weekly self-reported exercise. Secondary outcomes included physical fitness (aerobic/muscular) and predictors of exercise participation.
Results
The staff-supported group reported significantly greater exercise (~ 16 minutes/week) than the self-guided group over the year (t=10.6, p=0.00), with no significant between group difference in aerobic capacity (t=0.76, p=0.45) and strength (t=1.5, p=0.14).
Conclusions
Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant as they also exercised more frequently. The staff-supported approach holds promise for encouraging exercise among wheelchair users, yet additional support may be necessary to achieve more exercise to meet national recommendations
