Encouraging Exercise

Exercise behavior researcher Dr. Danielle Wadsworth knows that a good study includes participants from all walks of life, but over the years, the Auburn University professor has noticed how difficult it can be to recruit people who live in rural areas.

Now her newest study is looking at how researchers can easily include rural Alabamians by conducting virtual evaluations of physical fitness called tele-assessments.

“We are a land-grant institution,” Wadsworth said. “We should be able to roll out exercise intervention programs throughout the state of Alabama. If we really want positive health outcomes that are sustainable, we have to provide programs in the environments in which people live, work and play.”

Wadsworth, a professor in Auburn’s School of Kinesiology, and several colleagues at the University of Alabama at Birmingham (UAB) and the Lakeshore Foundation knew the first step in creating these intervention programs was establishing the feasibility and accuracy of tele-assessments. During COVID-19, many researchers unexpectedly found themselves working with participants who had to remain at home.

“We started doing fitness assessments via telehealth during COVID as a necessity, and although delivery of mobile health isn’t new, we did not have established protocols,” she said. “There are some standardized measures for cardiovascular health, muscular strength, endurance and body composition that are done within the physical fitness realm. The purpose of this study was to see if these measures were valid and reliable between in-person and telehealth settings and between different populations.”

Dr. Jennifer Kerpelman, then the associate dean for research in the College of Human Sciences, invited Wadsworth to an online meeting she was hosting for researchers interested in exploring telehealth. It was there that Wadsworth connected with Dr. Byron Lai and several of his colleagues at UAB who were interested in assessing fitness virtually. Lai researches ways to increase exercise for individuals with disabilities while Wadsworth does the same for women, children and families.

“We noticed synergy between our research goals and were able to use Spark Funding to develop a project,” Wadsworth said. “Our initial goal was to determine validity and feasibility of creating interventions for several different populations. If we only test people in person, we exclude large parts of the population.”

Wadsworth and her colleagues received funding from the National Institutes of Health by way of UAB’s Center for Clinical and Transitional Science. With very little existing data about virtual research in exercise science, there is a clear need for researchers to test the scientific rigor of studies that are already happening.

“Everybody has started doing it out of necessity, but not systematically with standardized protocols,” Wadsworth said. “I think COVIDreally drove stakeholders to see the value of telehealth programs.”

Wadsworth and Lai asked each participant to come to their labs to do the same fitness assessment twice, once in person with a researcher and a second time by live video from a different room in the lab. The fitness assessment included grip strength, which is an indicator of body strength, timed tests for sitting and standing and a six-minute walk in a circular track around a measuring tape.

Each participant completed measurements in person and on video. Some said the six-minute walk made them dizzy, but all other measurements were equally accurate in
both formats.

“Our preliminary results show that, with the exception of the six-minute walk, it is a valid and reliable tool,” Wadsworth said. “If these were rural interventions, we would be able to mail them this equipment and they would do the intervention within their own home. This was a very easy way to get a snapshot of what these interventions will look like in the future.”

Wadsworth is happy with the outcome of the study, not only because it is important for research, but because conducting interventions virtually means participants may be more likely to continue exercise routines if they started them at home.

“We have issues getting individuals who come to campus to maintain our interventions,” she said. “It’s more sustainable for them to develop the habits within the context of their own environment.”

Wadsworth is currently conducting a study on the benefits of yoga that requires participants to come to campus 18 times. She plans on transitioning those participants to a virtual version of the program to see if they have the same outcomes at home.

“We already know that exercise is good for us,” she said. “The question is how to deliver programs and interventions that allow individuals to be successful long-term and what psychological, environmental, social and physical characteristics help them to be successful.” Wadsworth added, “We want to take this information and begin to understand the feasibility of larger-scale telehealth initiatives that can improve access to exercise interventions for all Alabamians.”

Research reported here was supported by the National Center for Advancing Translational Research of the National Institutes of Health under award number UL1TR003096-03. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.