Healthy Weight and Stress Management Study
Condition: Physical Disability; Obesity; Muscle Weakness; Anxiety; Depression
MeSH terms: Muscle Weakness
Study type: Interventional

Summary: 
      Approximately 1 in 10 mid-life (age 35-64) Americans have mobility impairing disabilities.
      People with mobility impairing disabilities are defined using the World Health Organization
      criteria: community living adults with mobility impairment (e.g., amputation, spinal cord
      injury). Women with mobility impairing disabilities often struggle with stress, abdominal fat
      (measured as waist circumference), lack of muscle tissue (measured as handgrip strength) and
      high cardiometabolic risk. This study investigates the usefulness, acceptability, and
      effectiveness of two strategies to reduce stress, improve health habits, reduce abdominal fat
      and increase muscle tissue in mid-life women with mobility impairments. These strategies
      involve either gentle stretching and strengthening exercises or watching informative videos.
    

Detailed description: 
      About 1 in 10 mid-life (age 35-64) Americans have mobility impairing disabilities, steadily
      increasing due to medical and technological innovations. People with mobility impairing
      disabilities (PMI) are defined using the World Health Organization criteria, as community
      living adults with mobility impairment (e.g., amputation, spinal cord injury). Mid-life is a
      critical time for people to improve their current functioning and enhance healthy aging, by
      improving emotional health and increasing physical activity (PA). A review showed PA improves
      emotional and physical health among PMI. PMI have unique challenges to meeting PA guidelines;
      innovative strategies are needed to achieve emotional and physical benefits for optimal
      health and aging.

      The higher prevalence of daily stress encountered by mid-life PMI is linked to emotional
      health and abdominal fat (cardiometabolic disease risk) that can lead to premature mortality.
      This is especially so for women with mobility impairment (WMI) who have higher prevalence of
      excess body fat, higher cardiometabolic risk, and are not eligible for most interventions
      that involve PA. PA interventions also increase muscle mass, which helps to prevent
      cardiometabolic conditions. Although vigorous PA may not be well-suited for WMI, lighter
      intensity PA such as Tai Chi, Qigong and Yoga-also called meditative movement-adapted for
      seated practice, are a possible solution.

      Tai Chi and Qigong have been tested in non-impaired populations. Our work combines these two
      forms of low-to-moderate PA meditative movement, Tai Chi and Qigong (TCQ), in a mind-body
      practice. Our research, and others', show that TCQ consistently shows strong improvement in
      women in depressive symptoms, anxiety, emotional eating, and sleep quality-all contributing
      to excess abdominal fat (measured as waist circumference), improved muscle tissue (measured
      as handgrip strength) and strongly associated with cardiometabolic risk. Conventional health
      assessment strategies do not always work well for PMI; recent innovations have yielded
      scalable, low-contact assessment. We have demonstrated robust recruitment, reliable
      questionnaire administration and strong intervention implementation expertise via social
      media, video sharing, and gaming platforms.

      Aim 1: Assess the potential efficacy of TCQ to reduce waist circumference and increase
      handgrip strength compared to controls from T1 to T2 and sustain this change to T3 and T4
      when compared to control.

      Aim 2: Assess the potential efficacy of TCQ to reduce stress-related behaviors (depressive
      symptoms, anxiety, emotional eating, and sleep) that impact abdominal fat and strength when
      compared to control.

      Aim 3: Evaluate the feasibility and acceptability of an online delivered TCQ intervention in
      women with mobility impairments.
    

Intervention name(s): Seated Tai Chi Qigong; Health Information Videos
Intervention type(s): Other; Other
Intervention description(s): Participants will receive seated Tai Chi Qigong videos.; Participants will receive videos of health information.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Mobility impairment; Tai Chi; Stress Management; Obesity