Byron Lai, PhD – R21
Project Summary/Abstract
Due to alarmingly low rates of exercise participation, children with physical disabilities are at substantially high
risk for cardiovascular disease (CVD), related conditions, and CVD mortality as they age into adulthood.
Regular participation in aerobic exercise is an effective non-pharmaceutical method for preventing
cardiovascular disease and metabolic syndrome, but effective modalities such as walking, running, and cycling
are often not suitable for children with disabilities, who have impaired mobility. The growing availability of
internet access and acceptance of telehealth (due to the coronavirus pandemic) create an unprecedented
opportunity to engage large, underserved groups of children with disabilities in exercise behavior. However,
ensuring that they maintain regular participation over periods of time that are necessary to elicit changes in
cardiometabolic health will require enjoyable, accessible, and age-appropriate programs. This application
proposes a pilot project that builds upon our recent feasibility work. The project will pilot an evidence-based,
scale-up movement-to-music (M2M) program that has been newly revised for children with cerebral palsy who
have functional impairments. The program includes three novel components: 1) pre-recorded videos that are
stylized with visual graphics and enjoyable music to themes (e.g., superheroes, sports, pop music) that were
requested by our feasibility participants; 2) arm-based routines with sprint-intensity interval training (SIT),
based on principles from the latest exercise physiology research in the general population; and 3) replicable
cloud-based tele-monitoring procedures. Participants will be recruited from a children’s hospital and network of
community organizations. A total of 50 children with cerebral palsy will be randomized to one of two groups:
12 weeks of SIT-M2M or 12-week waitlist control that undergoes habitual activity before receiving SIT-M2M.
The SIT prescription will include 3 sessions per week of 30 repeated sequences of 4-s of maximal arm
exercise, with active recovery periods (~20-min sessions with a warm-up and cool down period). This study will
compare changes between groups in outcomes related to cardiovascular fitness and core indicators of
cardiometabolic health, namely, body composition, body weight, high sensitivity C-reactive protein, hemoglobin
A1c, triglycerides, cholesterol, and blood pressure. Additionally, the study will record implementation metrics
that will inform the design of a follow-up trial. Study findings will inform the development of a convenient
telehealth efficacy trial for implementation across various sites and settings to improve the health and well-
being of children with disabilities who cannot walk or stand for prolonged periods of time.