Diseño y usabilidad de ParaSportAPP: una mHealth destinada a promocionar la actividad física en personas con lesión medular / Design e usabilidade do ParaSportAPP: uma mHealth para promover a actividade física em pessoas comlesões da medula espinal / Design and usability of ParaSportAPP: an mHealth aimed at promoting physical activity in people with spinalcord injury

Objetivo: Diseñar y evaluar la usabilidad de una mHealth destinada a aumentar los niveles de actividad física en personas con paraplejia usuarias de sillade ruedas manual. Método: En primer lugar, se diseñó la mHealth ParaSportAPP mediante un comité de expertos en ejercicio físico y lesión medular. Posteriormente, una vezcreada la mHealth, se instaló ParaSportAPP en los teléfonos inteligentes de 15 personas con lesión medular dorsal usuarias de silla de ruedas. 8 mesesdespués de la instalación de la mHealth, se citó de nuevo a los participantes del estudio y cumplimentaron la Escala de Usabilidad del Sistema. Resultados: Se creó una mHealth con 79 ejercicios físicos diferentes y con dos modos distintos de transmitirlos al usuario. Además, la aplicación es capazde registrar los ejercicios físicos realizados al margen de los proporcionados por la misma y ofrece un informe a modo de feedback sobre el ejercicio físicorealizado durante el día. Asimismo, los resultados hallados mostraron una puntuación media de 77.5 (18.85) en la Escala de Usabilidad del Sistema.Conclusiones: Se ha conseguido diseñar y crear una mHealth funcional y con buenos niveles de usabilidad centrada en promocionar la actividad física enpersonas con lesión medular dorsal.(AU)

Aim: To design and evaluate the usability of an mHealth aimed at increasing physical activity levels in people with paraplegia who use manualwheelchairs. Method: Firstly, the ParaSportAPP mHealth was designed by a committee of experts in physical exercise and spinal cord injury. Subsequently, once themHealth was created, ParaSportAPP was installed on the smartphones of 15 wheelchair users with dorsal spinal cord injury. 8 months after theinstallation of the mHealth, the participants were summoned again and completed the System Usability Scale. Results: An mHealth was created with 79 different physical exercises and with two different ways of transmitting them to the user. In addition, theapplication is able to record the physical exercises performed in addition to those provided by the application itself and offers a feedback report on thephysical exercise performed during the day. The results also showed an average score of 77.5 (18.85) on the System Usability Scale. Conclusions: It has been possible to design and create a functional mHealth with good levels of usability focused on promoting physical activity in peoplewith dorsal spinal cord injury.(AU)

Objectivo: Conceber e avaliar a usabilidade de uma mHealth destinada a aumentar os níveis de actividade física em pessoas com paraplegia que utilizamcadeiras de rodas manuais. Método: Primeiro, o ParaSportAPP mHealth foi concebido por um comité de peritos em exercício físico e lesões da medula espinal. Subsequentemente,uma vez criada a mHealth, o ParaSportAPP foi instalado nos smartphones de 15 utilizadores de cadeiras de rodas com lesão da espinal medula dorsal. 8meses após a instalação do mHealth, os participantes do estudo foram novamente convocados e completaram a Escala de Usabilidade do Sistema. Resultados: Foi criada uma mHealth com 79 exercícios físicos diferentes e com duas formas diferentes de os transmitir ao utilizador. Além disso, o pedidoé capaz de registar os exercícios físicos realizados para além dos fornecidos pelo próprio pedido e oferece um relatório como feedback sobre o exercíciofísico realizado durante o dia. Além disso, os resultados encontrados mostraram uma pontuação média de 77.5 (18.85) na Escala de Usabilidade doSistema. Conclusões: Tem sido possível conceber e criar uma mHealth funcional com bons níveis de usabilidade centrada na promoção da actividade física empessoas com lesões da espinal-medula dorsal.(AU)

Motivation to Physical Exercise in Manual Wheelchair Users With Paraplegia.

Background: Motivation could be considered as a critical factor for being and staying physically active in the spinal cord-injured population. Objectives: Our goals were (1) to describe motivation to exercise in people with paraplegia, comparing those who engage in regular physical exercise with those who do not and (2) to establish whether such motivation is related to the type of physical exercise practiced. Methods: This study was quantitative, cross-sectional descriptive research. One-hundred and six participants with chronic paraplegia completed the Spanish version of the Exercise Motivations Inventory (EMI-2). Participants were divided into the non-exerciser group (NEG) and the exerciser group (EG). EG was subclassified into sports players (SPs) and physical exercisers (PEs). Results: Participants in both EG and NEG presented a similar motivation toward physical exercise. The most important motive to practice or to adhere to exercise in participants with SCI was ill-health avoidance (mean, 8.45; SD, 1.33). Fitness was the second most important motive (ie, nimbleness, flexibility, strength, and endurance). Motives that distinguished EG from NEG included enjoyment and revitalization [t(41.9) = -2.54, p < .05, r = 0.36], competition [t(56.8) = 2.24, p < .05, r = 0.28], and health pressure [t(104) = 3.22, p < .01, r = 0.30]. Furthermore, we found that motivation was related to the type of physical exercise performed. SPs showed a statistically significantly higher score for competition and enjoyment and revitalization than PEs (p < .05). Conclusion: Ill-health avoidance and fitness are the key motivational factors to practice and adhere to physical exercise. Motivation is related to the type of physical exercise performed. Health providers need to understand these factors to promote and sustain long-term adherence to exercise in the SCI population.

Accelerometer assessment of physical activity in individuals with paraplegia who do and do not participate in physical exercise.

OBJECTIVE: Our main goal was to measure physical activity (PA) in people with paraplegia. Secondarily, we aimed to establish the relationship between being engaged in physical exercise (PE) and reaching the recommended moderate-to-vigorous physical activity (MVPA) level. We further analyzed the effect of being engaged in PE on the PA levels. DESIGN: Descriptive cross-sectional. SETTING: Spanish associations for individuals with spinal cord injury. PARTICIPANTS: Ninety-six manual wheelchair users with chronic paraplegia. INTERVENTIONS: Participants wore a wrist accelerometer for one week. OUTCOME MEASURES: Levels of PA and sedentary behavior. In addition, participants were classified into two groups, exercisers (EG) and non-exercisers (NEG) to analyze the effect of PE enrollment on the variables. RESULTS: For all participants, a mean (SD) of 5,341.70 (966.4) minutes per week were spent engaged in sedentary behaviors, 2,188.99 (723.9) minutes were spent engaged in light activity, and 206.24 (180.0) minutes were spent engaged in MVPA. There was a significant relationship between PE and reaching the minimum levels of MVPA recommended [x2 (1) = 25.03, P < 0.01]. NEG showed a greater number of minutes per week for sedentary behavior [t (94) = 2.50, P < 0.05, r = 0.25]. The EG spent more than twice as much time doing MVPA than the NEG (263.8 min vs 114.3 min, respectively). CONCLUSIONS: MVPA levels are low in manual wheelchair users who are not regular exercisers, but most of those who self-reported being regular exercisers reach the minimum levels recommended for health benefits. Sedentary behavior is a concern in this population.

Shoulder pain in cases of spinal injury: influence of the position of the wheelchair seat.

The objective of this study was to determine the relationship between shoulder pain and the position of the seat of a wheelchair relative to the ground and to determine the relationship between shoulder pain and structural damage. A transversal study of a patient cohort of 140 patients with grade A and B spinal cord injuries below the T1 vertebra, who were full-time users of self-propelled wheelchairs, was made. The main variables are angle of the seat of the wheelchair, nuclear magnetic resonance measurements, shoulder joint range, Spinal Cord Index Measurement scale value, Wheelchair User Shoulder Pain Index and visual analogue scale value. Of the 140 patients, 99 were males (70.7%), and 41 were females (29.3%). Of these patients, 78 (55.7%) used a wheelchair seat at a straight angle, whereas 62 (44.3%) maintained an acute angle. A total of 57 (40.7%) patients presented shoulder pain within the last 6 months, and 83 (59.3%) did not. Sixty-nine (49.3%) did not present any type of shoulder injury as determined by nuclear magnetic resonance, whereas 71 (50.7%) had pathological signs. Patients with the seat at a straight angle developed 1.86 times (P<0.01) more shoulder pain and 1.73 times (P<0.001) more structural injuries than those with seats at an acute angle. Patients with structural abnormalities suffered 6.3-fold greater shoulder pain (P<0.001) than those without abnormalities. Wheelchair seats positioned parallel to the ground may be a risk factor for pain and shoulder injury. Patients with structural injuries in their shoulders have a greater risk of shoulder pain.