Effects of a Virtually-delivered Activity Promotion Program on Lung Function in Individuals with Spinal Cord Injury – a Retrospective Study

Research Objectives: To examine the effects of the 16-week virtually delivered activity promotion program “Workout on Wheels Internet Intervention (WOWii)” on breathing strength and lung function in individuals with spinal cord injury (SCI).

Design: This is a retrospective study which analyzed a subset of data from its parent study of the 16-week randomized controlled WOWii study.

Setting: virtually delivered weekly program and the WOWii study website

Participants: There were 17 completed data set available post-16 weeks of virtually delivered group program and home-based exercise training (age: 43 ± 10 years, Body Mass Index: 26.3 ± 1.2 kg/m^2, Time since injury (years): 12 ± 1.9, ASIA category: A (n=7), B (n=5), C (n=1), D (n=4)), with 11 sets of data for the experimental group and 6 sets for the control group. The Institutional Review Board approved this study.

Interventions: In the parent study, participants met online weekly to discuss some barriers and facilitators in engaging in physical activities, moderated by a researcher trained in behavior sciences. Participants learned to set their own goals for improving their home-based exercise on an arm ergometer over 16 weeks. Local participants received testing on pulmonary function and this retrospective study analyzed this subset of data.

Main Outcome Measures: The main outcomes included: maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax)), and pulmonary function (i.e., FEV1, FEV1/FVC, and forced expiratory flow (FEF)).

Results: The experimental group showed: PImax (cmH2O) pre: 81.7 ± 32 (SD), post: 86 ± 30; PEmax (cmH2O) pre: 69.3 ± 6.3, post: 68.9 ± 7; FEF (%pred) pre: 47.8% ± 21%, post: 56% ± 17%. The control group showed: PImax (cmH2O) pre: 110 ± 22.6, post: 106 ± 20. PEmax (cmH2O) pre:81.5 ± 24.6, post: 91 ± 19.4. FEF(%pred) pre: 56% ± 29%, post 70% ± 25%. There were no significant differences in these outcomes between groups, which were likely due to the small sample sizes, large variabilities in the outcomes, and different levels of injury (thoracic vs cervical; complete vs. incomplete). Effect sizes for each outcome were calculated for future larger trials.

Conclusions: The virtually delivered 16-week interventions might help individuals with SCI address their barriers to exercise and supported them to exercise regularly, though this study did not show that their exercise participation significantly improved their breathing strength or lung function.

Acknowledgement: The previous WOWii study was funded by the NIDILRR (Grant #: 90IF0091, PI: K Froehlich-Grobe.).

Author(s) Disclosures: All authors have no conflicts of interests in any form.