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Background: The Centers for Disease Control and Prevention (CDC) funds a quality improvement (QI) health promotion telewellness program for adults with physical disabilities., Objective: The nutrition component of the parent program, Mindfulness, Exercise, and Nutrition to Optimize Resilience (MENTOR) program, from 2020 to 2021, was evaluated to assess changes in nutrition knowledge of people with physical disabilities., Methods: This was a quasi-experimental program evaluation by pre-post survey of participating adults with physical disabilities. Participants attended weekly nutrition classes for eight weeks with optional one-on-one counseling with a Registered Dietitian. Participants completed pre-post General Nutrition Knowledge Questionnaire Revised (GNKQ-R) that were analyzed using paired t-tests. Participants were grouped into quartiles by pre-program GNKQ-R scores for additional comparisons. Program attendance and post-program feedback were also evaluated., Results: A total of 286 participants completed the MENTOR program, and 31% (n = 89) completed pre-post questionnaires for data analysis. Mean pre-program GNKQ-R scores were 58.4 ± 15.1 and post scores were 64.4 ± 11.3, which demonstrated a statistically significant improvement in nutrition knowledge (p < .001). Ancillary analysis revealed that participants with the lowest quartile of pre-program nutrition knowledge had the greatest improvements in their post-GNKQ-R scores (Mean change 16.4 ± 13.9). Questionnaire data revealed participants' subjective knowledge changes and their feedback on the nutrition component of the program., Conclusions: The eight-week MENTOR program effectively improved nutrition knowledge among people with physical disabilities. This demonstrates the impact the program can have on individual knowledge levels. Additionally, these results support the implementation of the program to the broader population of people with disabilities., Competing Interests: Declaration of competing interest All authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Substantial evidence supports therapeutic exercise for improving health and function in people with multiple sclerosis (MS). However, few studies have considered the patients' perspective., Objective: This study explored perspectives of adults with MS following participation in a 3-month clinic- and home-based exercise rehabilitation program., Methods: Twenty participants with MS were interviewed using a semi-structured interview guide on the design and implementation processes of the exercise programs as well as any perceived facilitators or barriers to exercise. Data analysis was conducted using a thematic analysis approach to generate themes from the transcribed interviews., Results: Key facilitators of exercise for people with MS included perceived improvements in physical health and function, activity participation, and psychosocial health. Mismatched level of exercise with their stage of post-diagnosis and/or functional ability and limited human interaction emerged as barriers to exercise., Conclusions: Participation in the exercise program was a positive experience for people with MS. Despite the provision of a high level of adaptation and tailored exercise plan and delivery, self-directed exercise continued to present challenges for people with MS. Additionally, the importance of seeking cost-effective ways to maintain motivational support was implicit in participant responses. The findings provided an improved understanding of personal experiences and exercise perspectives that can inform future intervention strategies aimed at promoting sustained exercise participation., Competing Interests: Conflicts of interest The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (Published by Elsevier Inc.)

Long-term exercise/rehabilitation is an integral component of the continual care for people with multiple sclerosis (MS). However, access to this care, which includes comprehensive exercise/rehabilitation services to people with MS, remains a significant challenge, especially in rural, low-income areas. Telerehabilitation, or what we refer to as teleexercise, can help fill service gaps for underserved MS populations in this region. This pragmatic, cluster randomized controlled effectiveness trial will compare a 12-week, 20 session complementary and alternative medicine (CAM) intervention composed of neurorehabilitative (functional) exercise, yoga and Pilates delivered at home, using pre-loaded tablets and Interactive Voice Response (IVR) system technology (TeleCAM), to the same intervention delivered in clinic by a therapist (DirectCAM). Eight hundred and twenty people with MS are being recruited across Alabama, Mississippi and Tennessee. Primary self-reported patient-centered health outcomes are: pain, fatigue, quality of life and physical activity. Secondary outcomes include four physical functioning measures: balance, endurance, gait, and strength. Each of these outcomes will be examined by age, race, sex, severity of MS and other demographics to determine if outcomes are beneficial across all groups (i.e., heterogeneity of treatment effect). The project is important to people with MS and/or caregivers because it aims to reduce their barriers to receiving exercise treatment and increases the convenience and appeal of such programs through technology. Clinical Trials.gov Identifier: NCT03117881., (Copyright © 2018. Published by Elsevier Inc.)

Background: Persons with multiple sclerosis (MS) have many health conditions related to overweight and obesity, but little is known about how body composition among those with MS compares to those without MS at the same weight., Objective: To compare differences in whole body and regional body composition between persons with and without MS matched for sex and body mass index (BMI)., Methods: Persons with MS (n = 51) and non-MS controls (n = 51) matched for sex and BMI. Total mass, lean mass, fat mass, and percent body fat (%BF) of total body and arm, leg, and trunk segments were assessed using dual-energy X-ray absorptiometry (DXA)., Results: Men with MS had significantly less whole body lean mass (mean difference: 9933.5 ± 3123.1 g, p < 0.01) and higher fat mass (mean difference: 6079.0 ± 2137.4 g, p = .01) and %BF (mean difference: 9.43 ± 2.04%, p < 0.01) than BMI-matched non-MS counterparts. Further, men with MS had significantly lower lean mass in the arm (p = 0.02) and leg (p < 0.01) and higher fat mass in the arm (p = 0.01), leg (p = 0.03) and trunk (p = 0.03) than men without MS. Men with MS had significantly higher %BF in all three regions (p < 0.01) than men without MS. There were no differences between women with and without MS., Conclusions: We observed significant differences in whole body and regional body composition between BMI-matched men with and without MS. Additional research is needed to further explore differences in body composition, adipose distribution, and the impact of these differences on the health and function of men with MS., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Individuals with disabilities are at higher risk of health conditions; thus, there is a need to provide hands-on opportunities for pre-healthcare professionals to interact with individual with disabilities as well as deliver wellness services to this population., Objective: Examine the feasibility and effectiveness of a student-led wellness program for individuals with disabilities., Methods: Thirty-two undergraduate student wellness coaches between the ages of 19-23 years, and fifteen participants with disabilities, ranging in ages from 28 to 74 years were included in this study. Every participant was assigned to at least 1 student wellness coach with the purpose of establishing an individualized wellness plan., Results: After 3 months (fall 2013 academic semester), all wellness coaches demonstrated improved clinical interaction and confidence toward working with the participants. The participants had an average weight loss of 2.0 ± 2.9 kg, ranging from 0.0 to 9.0 kg. All participants had improved functionality and fitness and reported high satisfaction toward the program., Conclusions: This study demonstrated the impact of a unique program on the education of pre-healthcare professionals and the overall wellness of participants with disabilities. The program model has the potential to provide clinical health education among pre-healthcare professionals through interacting with individuals with disabilities., (Copyright © 2015 Elsevier Inc. All rights reserved.)