Home Based Tele-exercise for People With Chronic Neurological Impairments

Study Overview
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Brief Summary
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To assess the impact of a 12-week virtual seated physical intervention on cardiovascular health and wellness in people with chronic neurological impairments (CNI).

Detailed Description
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This study aims to examine how effective seated Zoom exercise classes are for a person with CNI for addressing cardiovascular health, physical wellness and quality of life. If these classes prove to be effective, online platforms could be a viable avenue for those with CNI to exercise and increase/maintain wellness without having to leave their homes. The investigators are also attempting to determine if a class with a live instructor vs a pre-recorded class has an effect on motivation, compliance, exertion and modifications/safety. The entire process, including screening and consenting, will be done via Zoom and Redcap, potentially providing a blueprint for the future studies. This process can enable participants to participate in studies with minimal inconvenience, expense and effort of traveling for the consent process.

Official Title
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Home Based Tele-exercise for People With Chronic Neurological Impairments

Conditions
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Neurologic Disorder, Stroke, Spinal Cord Injuries, Cerebral Palsy, Hemiplegia, Hemiparesis, Multiple Sclerosis, Parkinson Disease, Trauma, Brain, Transverse Myelitis, Friedreich Ataxia

Intervention / Treatment
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* Behavioral: Seated exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants with chronic (>6 months) neurological impairments 18 to 75 years of age Participants who can provide a medical clearance to participate in the program Participants who can remain seated for at least one hour Heart rate/BP considerations, per each participant's MD Participants must be able to don/doff HR monitor without assistance, or have assistance if necessary Participants must maintain their current exercise/physical activity routine during the course of the study Clinically stable with no other neurological, medical or cognitive impairments Reliable Internet connection and ability to use Zoom platform Participants must speak and understand English No contraindication/limitations to exercise Currently exercising 2 days or less per week Exclusion Criteria: Participants with any cognitive impairment preventing safe and accurate participation in the program Medical issues preventing safe participation Other problems possibly contraindicating autonomous exercise at home if no supervision available.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: One group will attend live zoom classes with instructor feedback, and the other group will exercise using pre-recorded sessions.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Live zoom exercise classes<br>Participants will engage in a live zoom exercise session. Participants will undergo 45 minutes of aerobic exercise intervention, three times a week, for a period of 12 weeks. Exercise will include repetitive bouts of high intensity exercises with intermittent periods of rest or active recovery. circuit of moves like 'jabs', 'hooks' etc, and a strength and endurance class that promotes postural awareness. | Behavioral: Seated exercise<br>* Exercise will include repetitive bouts of high intensity exercises with intermittent periods of rest or active recovery. circuit of moves like 'jabs', 'hooks' etc, and a strength and endurance class that promotes postural awareness.<br>|
| Active Comparator: Recorded zoom exercise classes<br>Participants will undergo 45 minutes of aerobic exercise intervention, three times a week, for a period of 12 weeks, using a pre-recorded class that they can do according to their own schedule. Exercise will include repetitive bouts of high intensity exercises with intermittent periods of rest or active recovery. circuit of moves like 'jabs', 'hooks' etc, and a strength and endurance class that promotes postural awareness. | Behavioral: Seated exercise<br>* Exercise will include repetitive bouts of high intensity exercises with intermittent periods of rest or active recovery. circuit of moves like 'jabs', 'hooks' etc, and a strength and endurance class that promotes postural awareness.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in heart rate | Heart rate on last day of training compared to heart rate on first day of training | Within one week before the first intervention session to within one week after the end of intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived Wellness Survey | a 36-item instrument used to measure an individual's perceived health status in physical, psychological, emotional, intellectual, spiritual, and social wellness constructs | Within one week before the first intervention session to within one week after the end of intervention | 
| Physical Activity Enjoyment Scale | a self-assessment measure of enjoyment with their current physical activity | Within one week before the first intervention session to within one week after the end of intervention | 
| Short Form-36 Health Survey | measures physical health and mental health | Within one week before the first intervention session to within one week after the end of intervention | 
| Numerical pain rating | standardized instrument for pain assessment in clinical and research practice. It is an 11-point scale from 0 (no pain) to 10 (the most intense pain) at rest and during movement | Within one week before the first intervention session to within one week after the end of intervention | 
| Borg's Rating Scale of Perceived Exertion | standardized measure to evaluate perceived intensity of exertion, effort, and fatigue during physical exercise | Within one week before the first intervention session to within one week after the end of intervention | 
| Reason for exercise inventory | is a 24-item scale to assess the reason that motivates a person to exercise | Within one week before the first intervention session to within one week after the end of intervention |