title: Exercise for everyone: a randomized controlled trial of project workout on wheels in promoting exercise among wheelchair users.
abstract: OBJECTIVE
  To compare the effectiveness of 2 home-based behavioral interventions for wheelchair users to promote exercise adoption and maintenance over 12 months.
  
  
  METHODS
  Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability.
  
  
  METHODS
  Exercise occurred in participant-preferred locations (eg, home, recreation center), with physiological data collected at a university-based exercise laboratory.
  
  
  METHODS
  Inactive wheelchair users (N=128; 64 women) with sufficient upper arm mobility for arm-based exercise were enrolled. Participants on average were 45 years of age and lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment.
  
  
  METHODS
  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.
  
  
  METHODS
  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 (∼17min/wk) than the self-guided group over the year (t=10.6, P=.00), with no significant between-group difference in aerobic capacity (t=.76, P=.45) and strength (t=1.5, P=.14).
  
  
  CONCLUSIONS
  Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant because 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.
authors.affiliation: University of Texas School of Public Health, Dallas Regional Campus, Dallas, TX. Electronic address: Katherine.froehlich-grobe@utsouthwestern.edu.
authors.forename: Katherine
authors.initials: K
authors.lastname: Froehlich-Grobe
authors.affiliation: Center for Research Methods and Data Analysis, University of Kansas, Lawrence, KS.
authors.forename: Jaehoon
authors.initials: J
authors.lastname: Lee
authors.affiliation: School of Nursing, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Lauren
authors.initials: L
authors.lastname: Aaronson
authors.affiliation: Research and Training Center on Independent Living, LifeSpan Institute, University of Kansas, Lawrence, KS.
authors.forename: Dorothy E
authors.initials: DE
authors.lastname: Nary
authors.affiliation: Center for Physical Activity and Weight Management, LifeSpan Institute, University of Kansas, Lawrence, KS; Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Washburn
authors.affiliation: Center for Research Methods and Data Analysis, University of Kansas, Lawrence, KS; Department of Psychology and Center for Research Methods and Data Analysis, University of Kansas, Lawrence, KS.
authors.forename: Todd D
authors.initials: TD
authors.lastname: Little
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology / Q000523:psychology; D011788:Quality of Life; D020377:Self Efficacy; D012959:Socioeconomic Factors; D034941:Upper Extremity / Q000502:physiology*; D014910:Wheelchairs
keywords: ACSM; AIC; Akaike information criterion; American College of Sports Medicine; Exercise; HR; Intervention studies; People with disabilities; Randomized controlled trial; Rehabilitation; SCI; SRAHP; Self-Rated Abilities for Health Practices Scale; THR; Wheelchairs; heart rate; spinal cord injury; target heart rate