The Development of a Structured Exercise Program for Overweight and Obese Adolescents and Young Adults with Spina Bifida (SB) Using a Mobile Health App

Background: The prevalence of obesity in children and youth with Spina Bifiida (SB) is estimated between 28–50% in children and 34–64% in young adults1. The use of mobile and wireless technologies has increased as well as the use of coaching in obesity programs2. The primary aim of this pilot study is to evaluate the feasibility of using a mobile app in a novel 3-month weight management program for overweight and obese adolescents and young adults with SB. Methods: Participants between 11-21 years from the CHLA Spina Bifida Clinic identified as overweight and obese defined by a BMI >85th percentile were invited to participate. Participants had individualized exercise plans based on spina bifida functional level, paired with coaching from a dedicated athletic trainer for 3 months using PTPal™ Mobile Health App. Participants were prescribed 19 different exercises to perform a minimum of three times a week. Feasibility will be measured through use of the PTPal™ mobile app, prescribed exercise completion, and feedback on the exercise program on pain and difficulty. Results: There were a total of 10 participants. There were 494 attempted exercises. Eighty-four percent of attempted exercises were completed. Of the 77 exercises not completed, 89.6% did not provide a reason for incompletion. Six exercises were incomplete secondary to pain and 2 exercises were incomplete secondary to perceived difficulty. The seated crunch was most associated with pain in 3 responses and the seated scapular squeeze was most associated with being difficult in 3 responses. Conclusion: The novel use of a mobile app and tailored exercise program is feasible in overweight/obese adolescents and young adults with spina bifida. Overall few exercises are associated with reported pain or difficulty. There is an expected decay of use over time in this population. These findings are helpful in creating a structured weight management program with use of a mobile app in SB patients and other overweight and obese adolescents with disabilities.