Functional Fitness for Overweight or Obese Adults With Mobility Disabilities

Body Composition

Fat free and fat-mass Dual Energy X-ray Absorptiometry (DEXA) will be performed at the KU Edwards campus to determine the fat-free mass, fat mass, and body fat percentage (Prodigy Advance Plus, GE, Madison, WI)

Time frame: Change from Baseline body comp at 6 months (post-intervention)

Waist Circumference

Waist circumference will be assessed with a calibrated tape. For those unable to stand, waist circumference will be measured in the seated position at the umbilicus. Three measurements will be obtained with the outcome recorded as the average of the closest 2 measures.

Time frame: Change from Baseline waist circumference at 6 months (post-intervention)

Blood Pressure

Blood pressure will be obtained with an automated sphygmomanometer (DinaMap ProCare 100, General Electric) using the NHANES blood pressure protocol and recommendations of the American Heart Association.

Time frame: Change from Baseline blood pressure (diastolic and systolic) at 6 months (post-intervention)

Glucose

Fasting glucose will be assessed following finger prick blood draw with 8 hours prior of fasting

Time frame: Change from Baseline fasting glucose at 6 months (post-intervention)

Cholesterol

HDL Cholestserol will be assessed following finger prick blood draw

Time frame: Change from Baseline HDL cholesterol at 6 months (post-intervention)

Triglycerides

Triglycerides will be assessed following finger prick blood draw

Time frame: Change from Baseline triglycerides at 6 months (post-intervention)

Body Mass Index

Weight will be measured in duplicate using a portable calibrated, digital scale to the nearest 0.1 kg. Height will be measured in meters, and body mass index (BMI) will be calculated with the following formula: kg/m2

Time frame: Change from Baseline BMI at 6 months (post-intervention)

Perceived Quality of Life

World Health Organization Quality of Life an internationally recognized and established short measure assessing quality of life. There are 26 items on this survey, with a minimum value of 26, and a maximum value of 130. The higher the score, the higher the perceived quality of life.

Time frame: Change from Baseline QOL at 6 months (post-intervention)

Perceived Life Satisfaction

the Satisfaction with Life Questionnaire will be used as an additional assessment of well-being. There are five items on this survey, with a minimum score of 5 and a maximum score of 35, higher scores indicate higher satisfaction with life.

Time frame: Change from Baseline life satisfaction at 6 months (post-intervention)

Flexibility

Back Scratch Test - 1 arm above the head, bent elbow, reach down across the back as far as possible. Simultaneously, the opposite arm bent at elbow and forearm is extended up along the back as far as possible to that the fingers of both hands meet or overlap. The distance of overlap or the distance between the tips of the middle fingers is measured in centimeters.

Time frame: Change from Baseline flexibility at 6 months (post-intervention)

Balance (Seated)

Participants who are non-ambulatory participants will complete the Function in Sitting Test. Minimum score is 0 and maximum score is 56, where higher scores indicate better balance.

Time frame: Change from baseline balance at 6 months (post-intervention)

Balance (standing)

Participants who are ambulatory will complete the Berg Balance Scale test. Minimum score is 0 and maximum score is 56, where higher scores indicate better balance.

Time frame: Change from baseline balance at 6 months (post-intervention)

Strength

Grip Strength with dynameter. Participants will be seated with elbow flexed at 90 degrees, forearm in a neutral position and write between 0 and 30 degrees of flexion. participants will use their dominant hand and the 5 second squeeze will occur in duplicate, with 15 second rest in between and the score averaged to the nearest 0.1 kg.

Time frame: Change from baseline strength at 6 months (post-intervention)

Mobility

participants who are ambulatory will complete the 6-minute walking test and the 10-meter walking speed test, both of which can be completed with the help of an assistive device as needed. Distance covered during the 6-minute walking test will be calculated with meters, and average walking speed will be calculated as miles per hour. Participants who are non-ambulatory will complete a 6-minute push test and the Timed Forward Wheeling (23-meters) test. Distance covered during the 6-minute push test will be converted to meters, and timed forward wheeling will assess average speed calculated as miles per hour.

Time frame: Change from baseline mobility at 6 months (post-intervention)

Sense of Community

The Sense of Community Scale will be used to assess perceptions of community among the administration, social spaces, other members and competition. Minimum score is 18 and maximum score is 72, where higher scores indicate greater sense of community.

Time frame: Change from baseline sense of community at 6 months (post-intervention)

Shoulder Pain - manual wheelchair users only

he Wheelchair User's Shoulder Pain Index will be used to assess self-report changes in shoulder pain during daily functional activities with a 10-point visual analog scale. Minimum score is 15 and maximum score is 150, where higher scores indicate greater pain.

Time frame: Change from baseline shoulder pain at 6 months (post-intervention)

Exercise self-efficacy

28-item Self-Related Abilities for Health Practices Scale to assess self-efficacy scores regarding exercise, nutrition, health practices and psychological well-being. Minimum score is 0 and maximum score is 112, where higher scores indicate greater exercise self-efficacy.

Time frame: Change from baseline self-efficacy at 6 months (post-intervention)

Sleep

Sleep Disturbance Short Form (PROMIS Health Organization, 8b) will be used to assess self-report sleep quality in the past 7 days. Minimum score is 8 and maximum score is 40, where lower scores indicate better sleep.

Time frame: Change from baseline sleep at 6 months (post-intervention)

Barriers to Health

The 16-item Barriers to Health Adapted for People with Disabilities will assess participant self-report of perceived motivational and external barrier to exercise. Minimum score is 18 and maximum score is 72, where higher scores indicate greater perceived barriers to health promoting activities.

Time frame: Change from baseline perceived barriers at 6 months (post-intervention)

Psychological Need Satisfaction

The Psychological Need Satisfaction in Exercise Questionnaire will be used to assess need satisfaction within the functional fitness environment. Include three subscale autonomy, competence, and relatedness. Minimum score is 18 and maximum score is 108, where higher scores indicate better need satisfaction.

Time frame: Change from baseline perceived need satisfaction at 6 months (post-intervention)

Self-determination

Behavioral Regulation in Exercise Questionnaire will assess changes to perceived behavioral regulation (autonomous vs. external regulation) with in the functional fitness environment. 19 items with 5 subscales (external, introjected, identified, and intrinsic). Minimum score is 19 and maximum score is 95, where higher scores indicate more self-determined motives for exercise.

Time frame: Change from baseline perceived need self-determination at 6 months (post-intervention)

Perceived Functional Performance

The Canadian Occupational Therapy Measure is a valid and reliable standardized assessment used to identify occupational performance problems experienced by a client. Performance areas report by the client as challenging or unable to do will be documented in a list. Then the client will rate the perceived importance of each problem area on the list. Only the most important performance areas (top five maximum) will be included in the COPM assessment. The client will then rate their current performance ability for each of these performance areas. The client's ratings of performance ability will be used to calculate the client's baseline average occupational performance ability. Baseline average performance scores are then used to determine if a client's occupational performance improvements occur over time. Range of scoring is 1-10, where higher scores indicate greater perceived performance.

Time frame: Change from baseline perceived performance in occupational activities at 6 months (post-intervention)

Perceived Functional Performance

The Canadian Occupational Therapy Measure is a valid and reliable standardized assessment used to identify occupational performance problems experienced by a client. Performance areas report by the client as challenging or unable to do will be documented in a list. Then the client will rate the perceived importance of each problem area on the list. Only the most important performance areas (top five maximum) will be included in the COPM assessment. The client will then rate their current satisfaction of their ability for each of these performance areas. The client's ratings satisfaction will be used to calculate the client's baseline average occupational satisfaction of their ability. Baseline average satisfaction scores are then used to determine if a client's occupational performance improvements occur over time. Range of scoring is 1-10, where higher scores indicate greater perceived satisfaction.

Time frame: Change from baseline perceived satisfaction in performing occupational activities at 6 months (post-intervention)