IMPLEMENTING STANDARDIZED OUTCOME MEASURES IN SA ADAPTIVE & MEDICAL FITNESS PROGRAMS

https://youtu.be/nd4NflLnlqs BACKGROUND: Sheltering Arms (SA) houses three unique fitness programs; Power Ex (PX), Adapt2Fit (A2F) and NeuroFit (NF). PX is a semi-supervised exercise program designed to transition individuals of any diagnosis to independent exercise using evidence-based behavior change models. NF utilizes evidence-based practices, innovative programming and advanced technology to empower individuals living with neurological conditions, such as stroke, spinal cord injury, and traumatic brain injury to achieve their fitness and recovery goals. A2F is a one-on-one program offering a holistic approach and versatile exercise programming to meet many needs and goals, regardless of function or diagnosis. Early success of programs was reflected through client testimonials; however, testimonials do not produce quantitative, replicable results. Standardized outcomes were implemented to support testimonials, increase replicability, and analyze impact. Based upon collective goals of clientele and unique program purpose, the following outcomes were identified to understand impact: Exercise Self Efficacy Scale (ESES) - PX: a self-report measure of confidence with independent exercise relevant to PX goal and purpose. 1 rep max row (1 RM row) - NF: a performance measure of upper extremity strength and function relevant to NF participants. 5 times sit to stand (5xSTS) - A2F: a performance measure of lower extremity (LE) strength relevant to most A2F participant goals (MDC: 3.6). Patient specific functional scale (PSFS) – all programs: a self-report measure of functional progress in selected activities when participant goals are not easily measured through quantitative tests (MDC: 2). METHODS: Exercise physiologists (EPs) implemented the above outcome measures and collected data over a 6-year period. Paired two-tailed t-tests were run, alpha 0.01, to analyze 6 independent data sets: PX ESES, A2F 5xSTS, NF 1RM row, and PSFS-all programs. RESULTS: PX and A2F PSFS scores improved by 2.9 (p-value 0.0001) and 1.4 (p-value 0.0002) points respectively. PX ESES improved by 5.6 points (p-value 0.0007). NF 1RM row improved by 13.9 lbs (p-value 0.008). No change in NF PSFS or A2F 5xSTS. CONCLUSIONS: Standardized outcomes were implemented to support testimonials, increase result replicability, and analyze program impact relevant to purpose. Statistically significant improvements were observed in 4 data sets (PX and A2F PSFS, PX ESES, and NF 1RM row) supporting positive impact related to program purpose. PX PSFS results held clinical significance, exceeding established MDC. NF 1RM row revealed high data variability, lack of established MDC and low application for manual wheelchair and assistive device mechanics. Researchers believe a submax chest press provides more applicable results for functional impacts and ability to compare against established MDC. Further research is required to establish ESES MDC. Consistent LE strength programming will be reviewed in A2F.