Improving Adherence to Spinal Cord Injury Exercise Guidelines Using Smartphone Technology and E-coaching
Spinal Cord Injuries
About this trial
This is an interventional treatment trial for Spinal Cord Injuries focused on measuring Exercise, Telemedicine
Eligibility Criteria
Inclusion Criteria: Phase 1
- Individual with diagnosis of SCI, formal or informal caregiver of an individual with an SCI, or clinician that regularly sees individuals with SCI
- 18-80 years of age
- English-speaking
- Willing to download the study apps
Exclusion Criteria: Phase 1
- Severe visual or cognitive problems that would affect the ability to complete the study
- Does not own, or is unable to use a smartphone
Inclusion Criteria: Phase 2 and 3
- Individual with diagnosis of SCI, complete (only paraplegia) or incomplete, cervical C5- C6 and below
- 18-80 years of age
- English-speaking
- Use a wheelchair as primary means of mobility or walk with or without assistive equipment
- At least 1-year post-SCI
- Not adhering to SCI-specific exercise guidelines as ascertained by self-report or during structured phone interview
- Interested in increasing exercise levels
- Ownership of a smartphone that can be used for the study and has a data plan
- Willing to download the study apps
Exclusion Criteria: Phase 2 and 3
- Trauma or surgery in the past three months
- An active stage 3 or 4 pressure ulcer
- Medically unstable to perform the home-based exercise as determined by Dr. Chen and his team
- Unable to use at least one set of extremities to exercise
- Enrolled in a structured exercise program over the past three months
- Severe visual or cognitive problems that would affect the ability to complete the study
- Does not own, or is unable to use a smartphone
Sites / Locations
- Shirley Ryan AbilityLabRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Stage-I: Self Monitoring Exercise Using a Health App
Stage-II: Strategy to Address Non-Adherence
Participants will be randomized into one of two groups: Group 1 (self monitoring using a non-interactive app), and Group 2 (self monitoring using an interactive app). Participants in both groups will be provided a customized exercise program to complete over the duration of the study. Within either app, participants will be able to view assigned exercises, log additional exercises completed, complete questionnaires as needed, and access additional resources. Participants will use their own smartphone to receive the health app. Participants will continue using their Stage-I app intervention for the entire duration of the study (weeks 1-24).
After 12 weeks, the participants will be categorized as adherents or non-adherents based on their rates of adhering to the SCI exercise guidelines during Stage-I. Non-adherents (those who met the exercise guidelines <50% of the weeks) will be randomized to receive an augmented intervention of motivational interviewing-based e-coaching (2x per month or 4x per month) in addition to their Stage-I assigned app for 12 weeks (weeks 13-24) to further increase rates of exercise. All non-adherents who will be assigned to the e-coaching interventions will be asked to complete at least daily EMA surveys. A coach who is trained in motivational interviewing will review the EMA data and work collaboratively with participants to identify barriers and facilitators and develop individualized strategies to improve exercise adherence. Adherents (those who met the exercise guidelines >50% of the weeks) will continue with only their Stage-I assigned app intervention throughout Stage-II.