Lifestyle and health changes in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application

Abstract

Purpose The aim of this study was to determine changes in physical activity, nutrition, sleep behaviour and body composition in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application (app). Methods A 12-week pre-post intervention study was performed, starting with a 1-week control period. Physical activity and sleep behaviour were continuously measured with a Fitbit charge 3. Self-reported nutritional intake, body mass and waist circumference were collected. Pre-post outcomes were compared with a paired-sample t-test or Wilcoxon signed-rank test. Fitbit data were analysed with a mixed model or a panel linear model. Effect sizes were determined and significance was accepted at p < .05. Results Thirty participants completed the study. No significant changes in physical activity (+1.5 √steps) and sleep quality (–9.7 sleep minutes; −1.2% sleep efficiency) were found. Significant reduction in energy (–1022 kJ, d = 0.71), protein (–8.3 g, d = 0.61) and fat (–13.1 g, d = 0.87) intake, body mass (–2.2 kg, d = 0.61) and waist circumference (–3.3 cm, d = 0.80) were found. Conclusion Positive changes were found in nutritional behaviour and body composition, but not in physical activity and sleep quality. The WHEELS app seems to partly support healthy lifestyle behaviour. Implications for Rehabilitation Healthy lifestyle promotion is crucial, especially for wheelchair users as they tend to show poorer lifestyle behaviour despite an increased risk of obesity and comorbidity. The WHEELS lifestyle app seems to be a valuable tool to support healthy nutrition choices and weight loss and to improve body satisfaction, mental health and vitality.