PTPilotJMIR rehabilitation and assistive technologies2025

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

Zijian Huang, Dan McCoy, Rosemarie Cooper and 3 others

PMID 40472238

WHAT IT FOUND

In manual wheelchair users with spinal cord injury, a program using an app, smartwatch, wheelchair sensor, and PT and trainer guided workouts did not significantly change sedentary breaks, but it increased moderate-to-vigorous exercise time.

Key findings

01Daily moderate to vigorous exercise time increased significantly, while sedentary breaks did not change significantly.

02Exercise self-efficacy scores were higher after the intervention than before it began.

0316 participants completed the study, and all attended every study meeting.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study had no control group, so it cannot show that WheelFit alone caused the changes. The intervention included several components at once: the app, smartwatch, wheelchair sensor, study phone and tablet, PT assessment, personal trainer guidance, prescribed workouts, and exercise bands, so the contribution of any single component cannot be separated. The study was a short single-group pilot, so durability after 4 weeks is unknown. Participants were recruited by convenience sampling and had high baseline exercise self-efficacy, so very sedentary people may be underrepresented. The smartwatch battery lasted about 10 to 11 hours, so mid-day charging was needed and could cause daily activity data loss. The sedentary break definition may have hit a ceiling because many participants approached the maximum possible breaks. 4 participants rated usability as poor, and some had low digital literacy or frustration with device connections. The study was conducted during the COVID-19 pandemic, and many dropouts were non-study-related. The minimal clinically important difference for exercise self-efficacy was not established, so the score change may not be meaningful. The app connected only to 1 wheel sensor and lacked quick attach and detach, limiting use with multiple wheelchairs.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that the app alone made participants more active. The study had no control group, was a short single-group pilot, and gave participants the app, smartwatch, wheelchair sensor, study phone and tablet, PT assessment, personal trainer guidance, prescribed workouts, and provided exercise bands together, so the contribution of any single component cannot be separated.

Read it on PubMed →