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Current Trends in Exercise Intervention Research, Technology, and Behavioral Change Strategies for People With Disabilities: A Scoping Review

Lai, Byron MS; Young, Hui-Ju PhD; Bickel, C. Scott PT, PhD; Motl, Robert W. PhD; Rimmer, James H. PhD

American Journal of Physical Medicine & Rehabilitation: October 2017 - Volume 96 - Issue 10 - p 748–761
doi: 10.1097/PHM.0000000000000743
Original Research Articles

Abstract: This review synthesized physical activity and exercise intervention literature for the past 10 yrs for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes. Systematic searches yielded 132 eligible studies. The major disability groups were multiple sclerosis (41%), stroke (15%), and spinal cord injury (12%). Research designs primarily involved randomized controlled trials (61%) versus quasi-experimental designs (39%). Approximately 20% of the interventions used some form of the following technology: information and communication technology (48%), interactive technology (37%), or electronic gauges (30%). Eighteen percent of studies used intervention strategies based on behavioral theory, which was typically combined with technology to promote activity and increase adherence in generally larger study samples. The three prevailing theories included social cognitive theory (58%), supportive accountability theory (21%), and transtheoretical model (21%). Upon completing the intervention, studies reported primarily significant outcomes (80%). Exercise research for PWD has grown in both quantity and quality, but several gaps remain. Study findings provide a roadmap for future exercise trials on understudied populations and highlight technology and behavior change theory as drivers of future intervention research.

From the University of Alabama at Birmingham/Lakeshore Research Collaborative, Birmingham, Alabama (BL, H-JY, RWM, JHR); and Department of Physical Therapy, Samford University, Birmingham, Alabama (CSB).

All correspondence and requests for reprints should be addressed to: Byron Lai, MS, University of Alabama at Birmingham/Lakeshore Research Collaborative, 4000 Ridgeway Dr, Birmingham, AL 35209.

Partial funding of this article was provided under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90RE5009-01-00). The NIDILRR is a center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

This manuscript is not underreview and has not been presented in any format elsewhere.

We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated, and if applicable, we certify that all financial and material support for this research (e.g., National Institutes of Health or National Health Service grants) and work are clearly identified in the title page of the article.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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