Telehealth Exercise Training and Monitoring Home Exercise
R2:TExT-ME: Telehealth Exercise Training for Monitoring and Evaluation of Home-Based Exercise in People with Neuromuscular Disability
What is TExT-ME?
TExT-ME (Telehealth Exercise Training for Monitoring and Evaluation of Home-Based Exercise in People with Neuromuscular Disability) is an exercise training and monitoring system using a customized platform to conduct high-fidelity, safe and effective training studies. The platform consists of a “coach’s station” website that connects to a customized application on an Android tablet operating system. This allows the coach and participant to communicate via live-time video conferencing as well as text message. Additionally, TExT-ME utilizes a BioharnessTM 3 physiological monitor that sends live heart rate and respiratory rate data to the tablet and coach’s station to allow for safe and effective monitoring of the exercise session. Each training session is stored on the website and can be exported for further data analysis. Exercise protocols and participant and coach information is also stored on the coach’s website.
The published exercise training literature on people with spinal cord injury (SCI) 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 (1-3).
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 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 hard-to-reach populations by eliminating the barrier of transportation, offering participants the flexibility of exercising at their preferred time of day, and conserving energy and time associated with travel.
- 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).
- Conduct a feasibility study to test the fidelity and efficacy of the TExT-ME system.
We worked with collaborators at Innovare Care and the University of Alabama at Huntsville to finalize the customized Android application and coach’s website. We then tested the usability of the system in three individuals with SCI during a single bout of aerobic exercise on the arm ergometer in a fitness facility.
TExT-ME will compare adherence rates, quantitative data, and qualitative data among 3 groups: 1) Remotely delivered exercise group with a telecoach 2) Exercise at home group without the coach 3) Exercising at a typical fitness facility without a coach. All groups will exercise three times per week on an arm ergometer using the same progressive training protocol. Participants in the 2 home-based groups will be provided with an Android tablet, arm ergometer, and BioharnessTM. Group 1 will be trained under the supervision of a remote telehealth coach, while Group 2 will be educated on the equipment and protocol but will not receive coaching during the exercise sessions. Group 3 will have a 2 month paid membership to an accessible facility with the needed equipment. All groups will undergo pre-post assessments including VO2 peak, fasting blood glucose, and 3 questionnaires (Quality of Life Index, Satisfaction with Life Scale, and the Physical Activity Scale for Individuals with Physical Disability). We hypothesize that participants in the home-based telehealth program with telecoaches will experience higher adherence to the exercise prescription and hence greater improvements in aerobic capacity compared to the onsite exercise group.
Development of the TExT-ME remote telehealth training and monitoring system which will allow coaches to monitor real-time physiologic data such as heart rate, blood pressure, respiratory rate, and EKG. This system will allow personal interaction and the ability to give instructions related to adjustments required in order to perform the exercise correctly and effectively.
For more information on TExT-ME, check out the products page.
If you have any questions about the development or use of this system, please free feel to contact the Project Director Dr. C. Scott Bickel at firstname.lastname@example.org. This work is supported by the RERC on Interactive Exercise Technologies and Exercise Physiology for Persons with Disabilities (#H133E120005) funded by the National Institute on Disability and Rehabilitation Research (NIDRR).
- Rimmer JH, Chen MD, McCubbin JA, Drum C, Peterson J. Exercise intervention research on persons with disabilities: what we know and where we need to go. American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 2010;89(3):249-63. Epub 2010/01/14. doi: 10.1097/PHM.0b013e3181c9fa9d. PubMed PMID: 20068432.
- Ginis KA, Hicks AL. Exercise research issues in the spinal cord injured population. Exercise and sport sciences reviews. 2005;33(1):49-53. Epub 2005/01/11. PubMed PMID: 15640721.
- Ginis KA, Hicks AL. Considerations for the development of a physical activity guide for Canadians with physical disabilities. Canadian journal of public health = Revue canadienne de sante publique. 2007;98 Suppl 2:S135-47. Epub 2008/01/25. PubMed PMID: 18213944.