Workout on Wheels Internet Intervention (WOWii)

This study will gather empirical evidence of the effectiveness of WOWii intervention in
promoting changes in exercise behavior, fitness, and perceptions of exercise over the 16 week
intervention as well as 2 months later for individuals living with SCI. The study staff will
assess effectiveness by measuring participants (a) time spent each week doing aerobic
exercise by self-report and objective monitoring, (b) aerobic capacity to assess fitness
changes, and (c) self-reported perceptions of exercise barriers and self-efficacy at
baseline, 4 months, and 6 months.

Participants will be randomly assigned to an experimental (WOWii) or a wait-list control
group in one of four cohorts over a two-year period. This was an effective strategy in our
previous trial in helping us achieve the full sample size. We will use a blocked
randomization procedure to assure equal distribution of those with paraplegia and
tetraplegia. Four cohorts will be enrolled over two years, with each having up to 36 people.
This allows for up to 18 participants in the experimental and control groups, which permits
us to offer two different time options for participants to attend the weekly meetings, as our
video conferencing software allows up to 10 people to participate in the group video chat.
Each cohort will be divided into two groups of 18 study participants as experimental and
wait-list control groups. The experimental group will be divided into two groups of nine
participants. Each cohort will begin the intervention at the same time and attend weekly
calls together. All participants will undergo a pre-screen assessment which includes
eligibility assessment. Participants will undergo 2 in-person fitness testing assessments at
baseline at the end of the 16 week internet intervention with online meetings, before or
during which they will complete an online survey and follow. A third follow up assessment
will be conducted as an online survey at 6 months, which is 2 months after the intervention
is complete, and an exit survey will be conducted individually over the phone after within
one week of completing the final online survey. The wait-list control group will be offered
the intervention at the end of the 6 month period. Due to low enrollment numbers, we will
likely add a 5th cohort for enrollment.

Inclusion Criteria:

- Between the ages of 18 - 70 years old;

- Have SCI > 6 months with the ability to use arms enough for arm-based exercise and
requires wheelchair use;

- Have access to a computer with internet access or if they do not have
computer/internet access, have experience using a computer and going online;

- Obtain physician signed approval to participate in the exercise study; and

- Not be currently physically active, based on responses to the 7-item Behavioral Risk
Factor Surveillance physical activity survey.

Exclusion Criteria:

- Not receive physician approval to begin an exercise program;

- Have participated in the previous pilot studies; and

- Unable to read the English language.