Research tests "virtual gym" technology in people with spinal cord injuries

People living with spinal cord injuries (SCI) often encounter barriers that can limit their ability to participate in traditional exercise and wellness programs on a regular basis. These challenges include the need for more wheelchair-accessible facilities and equipment, a shortage of trained and knowledgeable staff, the costs associated with program enrollment, and transportation issues.

Mayo Clinic Physical Medicine and Rehabilitation researchers recently conducted a feasibility study to test whether providing access to currently available in-home "virtual gym" technology could help patients with SCI overcome some of these barriers.

"We wanted to examine the use of the internet as a delivery model for exercise and wellness programs to our patients," says the study's principal investigator, Megan L. Gill, P.T., DPT, NCS, a physical therapist at Mayo Clinic's campus in Rochester, Minnesota.

Dr. Gill's team hypothesized that this tool could yield two benefits: an increase in their patients' confidence levels for participating in exercise on a regular basis, as reflected by the Exercise Self-Efficacy Scale; and an increase in their patients' quality of life. The Mayo research project included six specific aims:

  • To determine how often participants log in to the exercise sessions, both video and live
  • To evaluate how long people participate in each login session of an online exercise program
  • To determine the frequency of community interactions, via text conversations (logged within software)
  • To analyze trends related to Exercise Self-Efficacy Scale (ESES) in relation to participation in the virtual exercise program with pre- and post-survey
  • To determine effects of a video-based and peer-led exercise program on quality of life of people with spinal cord injuries via the Quality of Life Index Spinal Cord Injury Version-III
  • To evaluate overall experience of those participating in the intervention via qualitative assessment interviewing

To test their hypothesis, Mayo researchers enrolled 10 people with SCI from Mayo Clinic's spinal cord injury database. Eligible participants were people diagnosed with SCI (tetraplegia or paraplegia) whose injury occurred at least one year before study enrollment, and who had existing video/webcam access to the internet.

Study participants were asked to engage in two exercise sessions for six weeks, conducted by a facilitator with past experience leading exercise programs using an online platform. Training sessions included evidence-based strengthening, stretching and endurance exercises appropriate for those with SCI, performed in the participants' own homes.

Study results

The mean change in Ferrans and Powers Quality of Life Index (QLI) (M = -0.25, SD = 2.78, N = 10) provided evidence that this exercise program did not result in a significant change in participant QLI scores.

The mean change in the Exercise Self-Efficacy Scale (ESES) (M = 2.9, SD = 4.04, N = 10) suggests that this exercise program was effective in improving exercise self-efficacy.

There was no correlation of frequency of live attendance and frequency of website video use with Exercise Self-Efficacy Scale (ESES) or quality of life ratings.

Conclusions

This feasibility study suggests that individuals with spinal cord injuries can successfully log in to a virtual exercise program and participate regularly and effectively. The results also indicate that having access to an online program that is accessible from home with minimal associated costs can alleviate some of the barriers that exist for people with SCI and increase their confidence in their ability to engage in exercise.

Dr. Gill noted that participation in the online program also facilitated mentoring and socializing with others who successfully live with a spinal cord injury. "More research is needed to study whether these types of interactions could potentially provide additional benefits beyond those documented in this first study," says Dr. Gill.