Physical activity and sedentary behavior in people with spinal cord injury: Mitigation strategies during COVID-19 on behalf of ACSM-EIM and HL-PIVOT

Association of mobile health (mHealth) use with health status and COVID-19-related concerns by people with mobility impairments

PURPOSE

Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates.

METHODS

PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals).

RESULTS

Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models.

DISCUSSION

PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.

Ability to detect history of falls among individuals with spinal cord injury using upper limb loading during a seated push-up test

BACKGROUND

A history of falls is an important risk factor for future falls, including for individuals with spinal cord injury (SCI) who often experience falls and subsequent injuries. This may be even more pronounced during the current COVID-19 pandemic because of the extreme shortage of hospital admission and restricted access to important services. Therefore, the ability of detecting a history of falls that can be applied to wheelchair users and ambulatory individuals with SCI in various settings are essential.

AIM

To investigate the discriminative ability of three clinical measures-the handgrip (HG) test, Spinal Cord Independence Measure (SCIM) III and Upper Limb Loading During a Seated Push-Up Test (ULL-SPUT)-in discriminating individuals with SCI with and without a history of falls over the past six months.

DESIGN

A 6-month retrospective observational cohort study.

SETTING

Inpatient tertiary rehabilitation center.

POPULATION

One hundred and fourteen wheelchair users and ambulatory individuals with SCI.

METHODS

The participants were interviewed and assessed for their demographics, SCI characteristics and fall data over the past six months, with data confirmation from related events, their caregivers and medical records. Subsequently, they were assessed using the HG test, SCIM III, and ULL-SPUT.

RESULTS

In total, 29 participants (25%) fell during the past six months (with the number of falls ranging from 1-20, with minor consequences after the falls). Among the three clinical measures assessed in this study, the ULL-SPUT data of faller participants were significantly higher than those of non-fallers (P<0.05).

CONCLUSIONS

The limited rehabilitation length and increased staying home and social isolation prompted by the COVID-19 pandemic may have reduced the fall rates of the participants. The findings suggest a higher likelihood of falls among wheelchair users and ambulatory individuals with SCI who have good mobility as determined using ULL-SPUT data.

CLINICAL REHABILITATION IMPACT

Apart from being an important rehabilitation strategy, the present findings suggest an additional benefit of ULL-SPUT to identify individuals with SCI with a likelihood of future falls. The measurement can be done easily using digital bathroom scales placing over a flat and smooth surface. Therefore, it would enable the timely initiation of fall prevention strategies in various clinical, community, home and research settings; particularly in this COVID-19 pandemic of limited beds and hospital services for these individuals.

COVID-19 vaccination in individuals with spina bifida: A national survey

PURPOSE

This study aimed to conduct a national survey of individuals with spina bifida (SB) and their care partners to assess COVID-19 vaccination behaviors and vaccine uptake.

METHODS

A survey instrument was designed to assess current vaccination status, general perceptions towards vaccinations, and barriers to vaccination within the SB community. Surveys were administered to individuals with SB or their representing care partner. Chi-squared and independent-samples t-tests were used to analyze the relationship between vaccine uptake and demographics. Multivariable logistic regression modeling was used to test which predictors impacted the odds that a participant received a COVID vaccine.

RESULTS

A total of 1,412 participants completed the questionnaire, and 1,145 participants reported their COVID-19 vaccine status. The most common reason for not getting vaccinated was a concern about vaccine safety and efficacy. Overall, healthcare professional recommendations played a significant (OR 2.77 p < 0.001) role in whether to get vaccinated.

CONCLUSION

About one in five individuals with SB have not received any COVID-19 vaccine. Actionable and modifiable factors were identified which may help increase vaccine uptake. Importantly, health providers play a critical role in COVID-19 vaccination messaging and should emphasize vaccine safety and efficacy.