The published exercise training literature on people with spinal cord injury (SCI) and Parkinson Disease (PD) is limited by small sample sizes, high dropout rates, under-dosed training programs, and selection bias associated with enrollment of study participants who have transportation, are higher functioning, and are more motivated to spend the time and energy enrolling in a study and getting to and from an exercise site several days per week. One of the major challenges conducting dose-response exercise training studies in people with disabilities is recruitment and retention. Recruiting large enough samples of people with SCI or PD from any one community or city to achieve adequately powered studies is extremely challenging because of the low prevalence of the condition, difficulty with transportation, and the time commitment getting to and from the exercise site.
One of the most promising and rapidly developing areas of health care and rehabilitation is telehealth – the use of telecommunication technologies to provide health information, assessment, monitoring, and treatment to individuals with chronic conditions from a distance. Home-based telehealth holds promise as an effective method for conducting exercise trials on low incidence populations of people with disabilities. It eliminates the barrier of transportation, offers participants the flexibility of exercising at their preferred time of day, and does not involve as much energy or time getting to an exercise facility.
The specific aims of the study are to: 1) develop a remote telehealth training and monitoring system, referred as TExT-ME (Telehealth Exercise Training for Monitoring and Evaluation), that will provide safe and effective home-based training exercise in people with spinal cord injury (SCI) and Parkinson disease (PD); and 2) conduct a feasibility study to test the fidelity and efficacy of the TExT-ME system.The project will be conducted in three distinct phases with a total recruitment of 72 subjects. In Phase I, six subjects (2 exercise trainers, 2 SCI, 2 PD) will be convened to collect feedback from stakeholders on system features and usability design of TExT ME via focus groups/interview. In Phase II, six people (3 SCI, 3 PD) will be recruited to beta test the TExT ME system (usability study). In Phase III, 60 individuals with SCI and PD (30 in each group) will be recruited for the home-based vs. onsite exercise trial (feasibility study).