Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial

Introduction While group, task-oriented, community-based exercise programs (CBEPs) delivered in-person can increase exercise and social participation in people with mobility limitations, challenges with transportation, cost and human resources, threaten sustainability. A virtual delivery model may h...

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Main Authors: Susan B Jaglal, Rahim Moineddin, Mark T Bayley, Sarah Munce, Jill I Cameron, Ruth Barclay, Heidi Sveistrup, Nancy Margaret Salbach, Elizabeth L Inness, Jennifer O’Neil, Heather M Hanson, C Allyson Jones, Lisa Sheehy, Jean Michelle Legasto-Mulvale, Renato Barbosa dos Santos, Joyce Fung, Robert W Teasell, Margot Catizzone, Nina Hovanec, Gayatri Aravind, Tai-Te Su
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e102694.full
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author Susan B Jaglal
Rahim Moineddin
Mark T Bayley
Sarah Munce
Jill I Cameron
Ruth Barclay
Heidi Sveistrup
Nancy Margaret Salbach
Elizabeth L Inness
Jennifer O’Neil
Heather M Hanson
C Allyson Jones
Lisa Sheehy
Jean Michelle Legasto-Mulvale
Renato Barbosa dos Santos
Joyce Fung
Robert W Teasell
Margot Catizzone
Nina Hovanec
Gayatri Aravind
Tai-Te Su
author_facet Susan B Jaglal
Rahim Moineddin
Mark T Bayley
Sarah Munce
Jill I Cameron
Ruth Barclay
Heidi Sveistrup
Nancy Margaret Salbach
Elizabeth L Inness
Jennifer O’Neil
Heather M Hanson
C Allyson Jones
Lisa Sheehy
Jean Michelle Legasto-Mulvale
Renato Barbosa dos Santos
Joyce Fung
Robert W Teasell
Margot Catizzone
Nina Hovanec
Gayatri Aravind
Tai-Te Su
author_sort Susan B Jaglal
collection DOAJ
description Introduction While group, task-oriented, community-based exercise programs (CBEPs) delivered in-person can increase exercise and social participation in people with mobility limitations, challenges with transportation, cost and human resources, threaten sustainability. A virtual delivery model may help overcome challenges with accessing and delivering in-person CBEPs. The study objective is to estimate the short-term effect of an 8-week, virtual, group, task-oriented CBEP called TIME™ (Together in Movement and Exercise) at Home compared with a waitlist control on improving everyday function in community-dwelling adults with mobility limitations.Methods and analysis A randomised controlled trial incorporating a type 1 effectiveness-implementation hybrid design is being conducted in four Canadian metropolitan centres. We aim to stratify 200 adults with self-reported mobility limitations by site, participation alone or with a partner, and functional mobility level, and randomise them using REDCap software to either TIME™ at Home or a waitlist control group. During TIME™ at Home classes (2 classes/week, 1.5 hours/class), two trained facilitators stream a 1-hour exercise video and facilitate social interaction prevideo and postvideo using Zoom. A registered healthcare professional at each site completes three e-visits to monitor and support implementation. Masked evaluators with physical therapy training evaluate participants and their caregivers at 0, 2 and 5 months using Zoom. The primary outcome is the change in everyday function from 0 to 2 months, measured using the physical scale of the Subjective Index of Physical and Social Outcome. The study is powered to detect an effect size of 0.4, given α=0.05, power=80% and a 15% attrition rate. Secondary outcomes are mobility, well-being, reliance on walking aids, caregiver assistance, caregiver mood, caregiver confidence in care-recipient balance and cost-effectiveness. A multimethod process evaluation is proposed to increase understanding of implementation fidelity, mechanisms of effect and contextual factors influencing the complex intervention. Qualitative data collection immediately postintervention involves interviewing approximately 16 participants and 4 caregivers from the experimental group, and 8 participants and 4 caregivers from the waitlist control group, and all healthcare professionals, and conducting focus groups with all facilitators to explore experiences during the intervention period. A directed content analysis will be undertaken to help explain the quantitative results.Ethics and dissemination TIME™ at Home has received ethics approval at all sites. Participants provide verbal informed consent. A data safety monitoring board is monitoring adverse events. We will disseminate findings through lay summaries, conference presentations, reports and journal articles.Trial registration number NCT06245135.
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spelling doaj-art-094db0d53bd8401ea0fb6ef465f55ad72025-08-20T03:35:22ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2025-102694Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trialSusan B Jaglal0Rahim Moineddin1Mark T Bayley2Sarah Munce3Jill I Cameron4Ruth Barclay5Heidi Sveistrup6Nancy Margaret Salbach7Elizabeth L Inness8Jennifer O’Neil9Heather M Hanson10C Allyson Jones11Lisa Sheehy12Jean Michelle Legasto-Mulvale13Renato Barbosa dos Santos14Joyce Fung15Robert W Teasell16Margot Catizzone17Nina Hovanec18Gayatri Aravind19Tai-Te Su20Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, CanadaRehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, CanadaRehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, CanadaDepartment of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, CanadaDepartment of Physical Therapy, University of Manitoba, Winnipeg, Manitoba, CanadaBruyère Health Research Institute, Ottawa, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaBruyère Health Research Institute, Ottawa, Ontario, CanadaProvincial Seniors Health and Continuing Care, Alberta Health Services, Edmonton, Alberta, CanadaDepartment of Physical Therapy, University of Alberta, Edmonton, Alberta, CanadaBruyère Health Research Institute, Ottawa, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaRehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, CanadaSchool of Physical and Occupational Therapy, McGill University, Montreal, Quebec, CanadaStroke Rehabilitation Program, Parkwood Hospital, London, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, CanadaIntroduction While group, task-oriented, community-based exercise programs (CBEPs) delivered in-person can increase exercise and social participation in people with mobility limitations, challenges with transportation, cost and human resources, threaten sustainability. A virtual delivery model may help overcome challenges with accessing and delivering in-person CBEPs. The study objective is to estimate the short-term effect of an 8-week, virtual, group, task-oriented CBEP called TIME™ (Together in Movement and Exercise) at Home compared with a waitlist control on improving everyday function in community-dwelling adults with mobility limitations.Methods and analysis A randomised controlled trial incorporating a type 1 effectiveness-implementation hybrid design is being conducted in four Canadian metropolitan centres. We aim to stratify 200 adults with self-reported mobility limitations by site, participation alone or with a partner, and functional mobility level, and randomise them using REDCap software to either TIME™ at Home or a waitlist control group. During TIME™ at Home classes (2 classes/week, 1.5 hours/class), two trained facilitators stream a 1-hour exercise video and facilitate social interaction prevideo and postvideo using Zoom. A registered healthcare professional at each site completes three e-visits to monitor and support implementation. Masked evaluators with physical therapy training evaluate participants and their caregivers at 0, 2 and 5 months using Zoom. The primary outcome is the change in everyday function from 0 to 2 months, measured using the physical scale of the Subjective Index of Physical and Social Outcome. The study is powered to detect an effect size of 0.4, given α=0.05, power=80% and a 15% attrition rate. Secondary outcomes are mobility, well-being, reliance on walking aids, caregiver assistance, caregiver mood, caregiver confidence in care-recipient balance and cost-effectiveness. A multimethod process evaluation is proposed to increase understanding of implementation fidelity, mechanisms of effect and contextual factors influencing the complex intervention. Qualitative data collection immediately postintervention involves interviewing approximately 16 participants and 4 caregivers from the experimental group, and 8 participants and 4 caregivers from the waitlist control group, and all healthcare professionals, and conducting focus groups with all facilitators to explore experiences during the intervention period. A directed content analysis will be undertaken to help explain the quantitative results.Ethics and dissemination TIME™ at Home has received ethics approval at all sites. Participants provide verbal informed consent. A data safety monitoring board is monitoring adverse events. We will disseminate findings through lay summaries, conference presentations, reports and journal articles.Trial registration number NCT06245135.https://bmjopen.bmj.com/content/15/7/e102694.full
spellingShingle Susan B Jaglal
Rahim Moineddin
Mark T Bayley
Sarah Munce
Jill I Cameron
Ruth Barclay
Heidi Sveistrup
Nancy Margaret Salbach
Elizabeth L Inness
Jennifer O’Neil
Heather M Hanson
C Allyson Jones
Lisa Sheehy
Jean Michelle Legasto-Mulvale
Renato Barbosa dos Santos
Joyce Fung
Robert W Teasell
Margot Catizzone
Nina Hovanec
Gayatri Aravind
Tai-Te Su
Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial
BMJ Open
title Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial
title_full Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial
title_fullStr Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial
title_full_unstemmed Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial
title_short Short-term effects of a virtual, community-based, task-oriented group exercise programme incorporating a healthcare–community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations: protocol for the TIME™ at Home randomised controlled trial
title_sort short term effects of a virtual community based task oriented group exercise programme incorporating a healthcare community partnership compared to a waitlist control on increasing everyday function among adults with mobility limitations protocol for the time™ at home randomised controlled trial
url https://bmjopen.bmj.com/content/15/7/e102694.full
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