Wearable-Enhanced mHealth Intervention to Promote Physical Activity in Manual Wheelchair Users: Single-Group Pre-Post...

Area of Science:

• Rehabilitation Engineering
• Digital Health
• Assistive Technology

Background:

• Physical activity (PA) monitoring via wearable devices and mHealth apps is growing, but underutilized in spinal cord injury (SCI) populations, particularly manual wheelchair users (MWUs).
• Limited research exists on technology-based PA interventions for MWUs with SCI.

Purpose of the Study:

• To develop the WheelFit mHealth app for monitoring and promoting PA in MWUs with SCI.
• To evaluate the feasibility and usability of the WheelFit app in free-living conditions.

Main Methods:

• The WheelFit app was developed using the Fogg Behavioral Model and stakeholder input, integrating with a smartwatch and wheel sensor to track upper extremity and wheelchair movements.
• A 4-week study (1-week baseline, 3-week intervention) assessed feasibility (attendance, device/app usage, action plan adherence) and usability (System Usability Scale).
• Preliminary effectiveness was evaluated by comparing pre- and post-intervention PA variables and SCI Exercise Self-Efficacy Scale scores.

Main Results:

• 16 participants completed the study with 100% session attendance and high device/app connection (14.2 hours/day).
• WheelFit demonstrated excellent usability (average System Usability Scale score of 81.8).
• Significant increases were observed in daily exercise duration (P=.049) and exercise self-efficacy scores (P=.043).

Conclusions:

• The WheelFit app shows potential for promoting PA in MWUs with SCI, exhibiting good feasibility and usability.
• Further research is warranted to explore integrating WheelFit into clinical practice for SCI rehabilitation.