Physical activity is a key component of rehabilitation for people with spinal cord injury (SCI) and has been shown to improve physical strength, psychological wellbeing, and quality of life. Unfortunately, few tailored exercise interventions for SCI have been made accessible in home and community settings, and, consequently, people with SCI report lower activity levels than people without disabilities and people with other types of disabilities
A recent study assessed the feasibility and effectiveness of an internet-based SCI exercise program called the Workout on Wheels internet intervention (WOWii). Recognizing that many people with SCI have limited access to formal clinic or exercise settings—especially during the COVID-19 pandemic—WOWii leverages the ease and availability of the internet to connect SCI patients to this virtually-delivered exercise intervention.
The 16-week WOWii program offers participants online access to exercise information and skill-building modules, a weekly group-based meeting with other SCI patients, and a package of exercise equipment. The equipment package contains three items that can be used by patients with limited lower-body mobility: resistance bands, a seated aerobics instructional DVD, and a tabletop arm pedal exerciser. Participants also received wearable devices that monitored and reported their physical activity, and they completed questionnaires to assess outcomes such as self-efficacy and goal-directed thinking.
The study included 168 middle-aged SCI patients who had sustained SCI 12 to 16 years prior on average. The research team found that WOWii participants who self-reported more weekly time spent engaging in high-intensity physical activity showed higher levels of self-efficacy and goal-directed thinking—including goals that did not involve physical fitness. The wearable monitors found that individuals who were most adherent to WOWii showed improved oxygen uptake and power output.
The researchers concluded that WOWii is an easily accessible, promising intervention to increase physical activity among people with SCI. Critically, adherence to the WOWii protocol not only improved participants’ physical fitness but increased their perceptions of self-efficacy and ability to overcome motivational barriers. Home- and community-based rehabilitation programs remain a key driver of positive outcomes following SCI, especially during the COVID-19 pandemic.
Froehlich-Grobe K, Lee J, Ochoa C, et al. Effectiveness and feasibility of the workout on wheels internet intervention (WOWii) for individuals with spinal cord injury: A randomized controlled trial. Nature. (April 2022).