Improving Adherence to Exercise Guidelines Using Smartphone-Based Technology and E-coaching: A Proof-of-Concept SMART-Design Study

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In this Spinal Cord Injury Model Systems (SCIMS) Site Specific Project, our research team will conduct a proof-of-concept project in which we use Sequential Multiple Assignment Randomized Trial (SMART) design to test an intervention to enhance adherence to exercise guidelines in individuals with spinal cord injury (SCI) by using smartphone technology, ecological momentary assessment (EMA) monitoring, and e-coaching.

EMA is a way to study people's thoughts or behavior in their daily lives by repeatedly collecting data in an individual's normal environment, at or close to the time they carry out that behavior. In this study, we use smartphone technology to gather this data. We believe strategically tailoring intervention components to users’ unique needs and preferences (based on information collected through EMA) will help improve and evaluate rehabilitation outcomes.

This study is currently recruiting participants for different parts of the study. You can participate in just one part, or both: 

Participants may be asked to be part of a focus group lasting up to 2 hours to discuss app preferences to guide future app development. Participants who have a spinal cord injury may also be asked to complete exercises and other tasks on a customized smartphone app for 2 weeks and then complete a virtual interview and questionnaires. All participants will receive compensation.

To participate, you must meet the following criteria:

• Have spinal cord injury diagnosis OR
• Be a caregiver to someone with a spinal cord injury OR 
• Be a clinician who regularly treats individuals with spinal cord injury
• Age 18-80 years
• English-speaking
• Willing to use study apps on a personal mobile device

​​​Participants will complete one in-person visit that may last up to 5 hours. Then they will be provided customized exercises to complete over the next 6 months using either the interactive or more traditional smartphone app (groups are assigned by chance, like a flip of a coin). Up to weekly video conference coaching sessions may be added in the last 3 months. Participation is expected to last 6 months. Participants will receive compensation.

To participate, you must meet the following criteria:

• Be at least 1-year post spinal cord injury diagnosis 
• Age 18-80 years
• Not meeting spinal cord injury exercise guidelines
• Willing to use study apps on a personal mobile device
• No surgery or trauma in past 3 months
• Not enrolled in a structured exercise program in the past 3 months

If you are interested in learning more, contact Sara Prokup at (312) 238-1355 or sprokup@sralab.org.

Co-principal investigators on this project are Alex Wong, PhD, DPhil, OT, CRC, Research Scientist in the Center for Rehabilitation Outcomes Research at Shirley Ryan AbilityLab and Associate Professor, Physical Medicine & Rehabilitation and Medical Social Sciences at Northwestern University and Arun Jayaraman, PT, PhD, Executive Director, Technology & Innovation Hub (tiHUB) and Director, Max Näder Center for Rehabilitation Technologies & Outcomes Research at Shirley Ryan AbilityLab. Co-directors are Allen Heinemann, PhD, Director, Center for Rehabilitation Outcomes Research at Shirley Ryan AbilityLab and
Professor, Department of Physical Medicine and Rehabilitation at Northwestern University Feinberg School of Medicine, and David Chen, MD, George M. Eisenberg Chair at Shirley Ryan AbilityLab. 

Improving Adherence to Exercise Guidelines Using Smartphone-Based Technology and E-coaching: A Proof-of-Concept SMART-Design Study, Site-Specific Research Project, Spinal Cord Injury Model Systems, National Institute on Disability, Independent Living,  & Rehabilitation Research (NIDILRR), USA (9/1/21-8/31/26, Total award: US$2,450,000, Award #: 90SIMS0015, Midwest Regional Spinal Cord Injury Care System (MRSCICS).

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Nataletti S, Banerjee A, Macaluso R, Prokup S, Jayaraman A, Wong AWK. Developing a mobile exercise program for individuals with Spinal Cord Injury: Stakeholder perceptions of app features and implementation determinants. Disabil Health J. 2024 Jun 28:101667. doi: 10.1016/j.dhjo.2024.101667. PMID: 38964938.