mHealth Physical Activity Intervention for Individuals With Spinal Cord Injury: Planning and Development Processes

Lawrason, Sarah; Brown-Ganzert, Lynda; Campeau, Lysa; MacInnes, Megan; Wilkins, C J; Ginis, Kathleen A. Martin

doi:10.2196/34303

Cited by 5 publications

(4 citation statements)

References 63 publications

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“…[ 23 ]. The results of the present study showed that the levels of GAP43 and NF200 were significantly increased in the spinal cord tissues of rats after scaffold implantation, suggesting that the mechanism by which scaffold transplantation improves motor and neurological functions in the hind limbs of rats with SCI and promotes axonal regeneration may be associated with the upregulation of GAP43 and NF200 levels in the tissues at the site of spinal cord injury [ 24 , 25 ]. Furthermore, more pronounced alterations of GAP43 and NF200 levels in the CBD-NGF/PCL/GE scaffold group versus the PCL/GE scaffold group are indicative of the clinical value of NGF in the treatment of SCI.…”

Section: Discussionmentioning

confidence: 97%

Research on Polycaprolactone-Gelatin Composite Scaffolds Carrying Nerve Growth Factor for the Repair of Spinal Cord Injury

et al. 2022

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Objective. This study was to investigate the mechanism of action of polycaprolactone/gelatin (PCL/GE) composite fiber scaffold with nerve growth factor (NGF) in the recovery of spinal cord injury (SCI). Methods. Sixty female Sprague-Dawley (SD) rats were randomly assigned to the negative control group, the positive control group, the PCL/GE scaffold group, and the collagen-binding structural domain nerve growth factor (CBD-NGF)/PCL/GE scaffold group, with 15 rats in each group. Spinal cord transection was used to establish SCI models in rats. The negative control group received sham surgery, while the other three groups were given spinal cord transection at the tenth thoracic vertebra (T10) segment. The rats in the PCL/GE scaffold group were implanted with a 4 mm PCL/GE composite fiber scaffold, and those in the CBD-NGF/PCL/GE scaffold group were implanted with a CBD-NGF/PCL/GE composite fiber scaffold. The Basso–Beattie–Bresnahan (BBB) locomotor rating scale was used to evaluate the locomotor ability of the hind limbs of the rats, and the amplitude and latency of motor evoked potentials (MEP) were recorded by neurophysiological testing at 12 w postoperatively. The levels of growth-associated protein 43 (GAP43) and neurofilament protein 200 (NF200) in the spinal cord tissue of the injury site were determined using Western Blot at 12 w after surgery. Spinal cord tissues of 2 cm within the injury site, the thoracic segment above the injury site, and the lumbar segment below the injury site were collected from the measurement of axonal transport using fluorescent retrograde tracer fluorogold, and the integrated absorbance (IA) values of FC-positive cells were calculated. Results. After treatment, the negative control rats showed normal locomotion function of the hind limb with the highest BBB scores, while the positive control rats had the lowest BBB scores and showed paraplegia. The scaffold groups exhibited better locomotion function of the hind limb and higher BBB scores than the positive controls, with greater improvement observed in the CBD-NGF/PCL/GE scaffold group ( P < 0.05 ). Compared with the positive controls, the PCL/GE scaffold group and CBD-NGF/PCL/GE scaffold group exhibited significantly shorter latency and increased amplitude of MEP, with more significant changes observed in the CBD-NGF/PCL/GE scaffold group ( P < 0.05 ). Compared with the positive control group, the GAP43 and NF200 levels of spinal cord tissue were significantly elevated in both the PCL/GE scaffold group and the CBD-NGF/PCL/GE scaffold group, and the changes were more pronounced in the CBD-NGF/PCL/GE scaffold group ( P < 0.05 ). The differences in the IA values of FC-positive cells in the spinal cord tissue of the lumbar segment below the injury site among the four groups did not come up to the statistical standard ( P > 0.05 ). Compared with the positive control group, the FC-positive cell IA values of spinal cord tissue in the thoracic segment above the injury area were markedly increased in the PCL/GE scaffold group and the CBD-NGF/PCL/GE scaffold group, and the alterations were more significant in the CBD-NGF/PCL/GE scaffold group ( P < 0.05 ). Conclusion. PCL/GE composite fiber scaffold with NGF significantly improves motor and neurological functions in the hind limbs of SCI rats and promotes the recovery of axonal transport, and the mechanism may be associated with the upregulation of GAP43 and NF200 levels in spinal cord injury site tissues.

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Section: Discussionmentioning

confidence: 97%

Research on Polycaprolactone-Gelatin Composite Scaffolds Carrying Nerve Growth Factor for the Repair of Spinal Cord Injury

et al. 2022

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“…This is further highlighted by our assessment using the ABACUS, devised-by McKay and colleagues (86). Critically, Lawrason and colleagues (31) stress that behaviour change interventions need to target one or more of these core components (i.e., capability, opportunity, motivation) to change behaviour.…”

Section: Discussionmentioning

confidence: 90%

“…Given that smartphones are ubiquitous, it is estimated that there are now 3.5 billion users worldwide (28), mHealth interventions appear to be a favourable tool to support physical activity in people with SCI (29). Nevertheless, limited studies have concentrated on mHealth interventions to encourage physical activity in adults with SCI (30,31).…”

Section: What Is the Implication And What Should Change Now?mentioning

confidence: 99%

Applying the behaviour change wheel to assess the theoretical underpinning of a novel smartphone application to increase physical activity in adults with spinal cord injuries

Haley¹,

Rhind²,

Maidment³

2023

mHealth

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Background: People with spinal cord injuries (SCI) are physically inactive. Smartphone applications (or apps) may prove as one strategy to overcome this. This study examines the theoretical underpinning of a novel mHealth intervention that aims to improve physical activity in people with SCI, namely, the Accessercise smartphone app, using the behaviour change wheel (BCW).Methods: Accessercise was evaluated using the BCW in eight steps across the following three stages: (I) understanding the behaviour, (II) identifying intervention options, and (III) identifying content and implementation options.Results: Thirteen target behaviours were identified to improve physical activity and reduce sedentary behaviours in adults with SCI, including goal setting and monitoring, increasing self-confidence, interest and motivation for undertaking physical activity, improving the knowledge/awareness of available physical activity opportunities and resources, and reducing stigma and negative attitudes associated with physical activity. Accessercise incorporates the necessary components for adults with SCI to be physically and psychologically capable of undertaking physical activity, offering social and physical opportunities to reduce sedentary behaviours, and supports automatic and reflective motivation.Conclusions: This systematic approach of assessing the theoretical underpinning of Accessercise in the context of the BCW has revealed potential mechanisms of action for improving physical activity in adults with SCI. This serves as a blueprint to inform further intervention development, as well as high-quality effectiveness studies, namely, randomised controlled trials, assessing whether fitness apps can improve physical and psychological health outcomes in individuals with SCI.

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“…Logic models are graphic depictions of the relationships between resources, activities, outcomes, and impacts of a program or a system. They have been used in a variety of settings, for example, to inform the development of interventions such as a rehabilitation service for youth with concussion [ 7 , 8 ], mobile health support for physical activity in people with spinal cord injuries [ 9 ], and digital self-management in inflammatory bowel disease [ 10 ]. They have been used to understand how digital health interventions for self-management might be used to facilitate effective behavior change [ 11 ], how to design a plan to transform a health care system [ 12 ], and to capture complexities in systematic and scoping reviews [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Building Culturally Centered System Dynamics Logic Models for the Brown Buttabean Motivation Organization: Protocol for a Systems Science Approach

Savila¹,

Harding²,

Bagg³

et al. 2023

JMIR Res Protoc

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Background Brown Buttabean Motivation (BBM) is an organization providing support for Pacific people and Indigenous Māori to manage their weight, mainly through community-based exercise sessions and social support. It was started by DL, a man of Samoan and Māori descent, following his personal weight loss journey from a peak weight of 210 kg to less than half that amount. DL is a charismatic leader with a high media profile who is successful in soliciting donations from corporations in money and kindness. Over time, BBM’s activities have evolved to include healthy eating, food parcel provision, and other components of healthy living. A co-design team of university researchers and BBM staff are evaluating various components of the program and organization. Objective The purpose of this study is to build culturally centered system dynamics logic models to serve as the agreed theories of change for BBM and provide a basis for its ongoing effectiveness, sustainability, and continuous quality improvements. Methods A systems science approach will clarify the purpose of BBM and identify the systemic processes needed to effectively and sustainably achieve the study’s purpose. Cognitive mapping interviews with key stakeholders will produce maps of their conceptions of BBM’s goals and related cause-and-effect processes. The themes arising from the analysis of these maps will provide the initial indicators of change to inform the questions for 2 series of group model building workshops. In these workshops, 2 groups (BBM staff and BBM members) will build qualitative systems models (casual loop diagrams), identifying feedback loops in the structures and processes of the BBM system that will enhance the program’s effectiveness, sustainability, and quality improvement. The Pacific and Māori team members will ensure that workshop content, processes, and outputs are grounded in cultural approaches appropriate for the BBM community, with several Pacific and Māori frameworks informing the methods. These include the Samoan fa’afaletui research framework, which requires different perspectives to be woven together to create new knowledge, and kaupapa Māori–aligned research approaches, which create a culturally safe space to conduct research by, with, and for Māori. The Pacific fonofale and Māori te whare tapa whā holistic frameworks for interpreting people’s dimensions of health and well-being will also inform this study. Results Systems logic models will inform BBM’s future developments as a sustainable organization and support its growth and development beyond its high dependence on DL’s charismatic leadership. Conclusions This study will adopt a novel and innovative approach to co-designing culturally centered system dynamics logic models for BBM by using systems science methods embedded within Pacific and Māori worldviews and weaving together a number of frameworks and methodologies. These will form the theories of change to enhance BBM’s effectiveness, sustainability, and continuous improvement. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN 12621-00093-1875; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382320 International Registered Report Identifier (IRRID) PRR1-10.2196/44229

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mHealth Physical Activity Intervention for Individuals With Spinal Cord Injury: Planning and Development Processes

Cited by 5 publications

References 63 publications

Research on Polycaprolactone-Gelatin Composite Scaffolds Carrying Nerve Growth Factor for the Repair of Spinal Cord Injury

Research on Polycaprolactone-Gelatin Composite Scaffolds Carrying Nerve Growth Factor for the Repair of Spinal Cord Injury

Applying the behaviour change wheel to assess the theoretical underpinning of a novel smartphone application to increase physical activity in adults with spinal cord injuries

Building Culturally Centered System Dynamics Logic Models for the Brown Buttabean Motivation Organization: Protocol for a Systems Science Approach

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