Effectiveness of an Upper Extremity Exercise Device and Text Message Reminders to Exercise in Adults with Spina Bifida: A Pilot Study

Abstract

Obesity, deconditioning, cognitive impairment, and poor exercise tolerance are health issues concerning adults with spina bifida (SB). Our aim is to describe exercise participation and identify motivating tactics and exercise devices that increase participation. In a quasi-experimental randomized crossover design, the GameCycle was compared to a Saratoga Silver I arm ergometer. Personalized free or low-cost text/voice message reminders to exercise were sent. Nineteen young adults with SB were assigned to either the GameCycle or Saratoga exercise group. Within each group, participants were randomized to receive reminders to exercise, or no reminders, then crossed over to the opposite message group after eight weeks. Before and after a 16-week exercise program anthropometric, metabolic, exercise testing and questionnaire data, and recorded participation were collected. Miles traveled by the GameCycle group were significantly higher than the Saratoga exercise groups. No significant differences were found in participation between the message reminder groups. Low participation rates were seen overall. Those using the GameCycle traveled more miles. Barriers to exercise participation may have superseded ability to motivate adults with SB to exercise even with electronic reminders. Support from therapists to combat deconditioning and develop coping skills may be needed.

Keywords:

• arm ergometry
• cognition
• exercise
• exercise test
• hydrocephalus
• myelomeningocele
• physical activity
• spina bifida
• upper extremity

Acknowledgments

Funding provided by the National Institute of Child Health and Human Development-Training Rehabilitation Clinicians for Research Careers T32HD049307. We thank the following individuals: Ms. Erica Authier for exercise testing assistance and initial study design; Ms. Keyona Smith and Mr. Shiv Hiremath for exercise testing assistance; Mr. Zachery Mason for building the ramp for the Saratoga; Mr. Christian Nironkyu for statistical support, Dr. Mary Ann Sevick for educational support; Dr. Michael Boninger and the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh for personnel and equipment support; and we appreciate our study participants without whom this project would not have been possible. We honor Joel Lerich, who passed away in May 2010. And Mr. Lerich was the engineer of the Saratoga arm ergometer. He was instrumental in providing us technical support even while he was toward the end of his life, sharing with us his relentless dedication to improving the lives of individuals with disabilities.