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Detailed Description

Women with mobility impairments experience disproportionately high rates of obesity, cardiometabolic disease, chronic stress, sleep disturbances, depression, anxiety, and reduced quality of life compared with women without disabilities. Despite these health disparities, accessible physical activity and stress management interventions specifically designed for women with mobility impairments remain limited. Barriers such as transportation challenges, inaccessible facilities, pain, fatigue, environmental constraints, and lack of disability-adapted programming often prevent participation in traditional exercise interventions. Consequently, there is a critical need for accessible, scalable, home-based interventions that can improve both physical and psychological health outcomes in this underserved population. The purpose of the REVIVE study is to evaluate the effectiveness of a remotely delivered seated Tai Chi/Qigong (TCQ) intervention for improving cardiometabolic health and stress-related outcomes among women with mobility impairments. Tai Chi and Qigong are mind-body practices that combine gentle movements, controlled breathing, meditation, and focused attention. These practices have demonstrated beneficial effects on stress reduction, emotional regulation, sleep quality, cardiovascular function, and overall well-being in a variety of populations. However, few studies have examined their effectiveness among women with mobility impairments, particularly when delivered remotely and adapted for seated participation. This study is a two-arm randomized controlled trial conducted entirely remotely across the United States. Eligible participants are women aged 35-64 years with a long-term mobility impairment who regularly use a mobility aid and meet study eligibility criteria. Following screening and baseline assessments, participants will be randomly assigned to either a seated Tai Chi/Qigong intervention group or a health education video (HEV) control group. The study duration is approximately 30 weeks and consists of three assessment periods. Baseline assessments (T1) occur over approximately three weeks and include an initial run-in period followed by physiological and behavioral assessments. Participants then complete a 12-week intervention phase, followed by post-intervention assessments (T2). After T2, participants enter a 12-week maintenance phase during which they may continue engaging with intervention materials independently. Follow-up assessments (T3) are completed at the end of the maintenance period. Participants randomized to the Tai Chi/Qigong condition will receive daily access to seated Tai Chi/Qigong video sessions adapted for individuals with mobility limitations. Videos include both shorter and longer practice options to accommodate participant preferences and daily schedules. The intervention emphasizes gentle upper-body and seated movements, breathing exercises, mindfulness, relaxation, body awareness, and meditative movement practices. Participants are encouraged to engage in the assigned activities daily throughout the 12-week intervention period. Participants randomized to the health education video control condition will receive daily wellness education videos matched in frequency and delivery format. Topics may include healthy aging, stress awareness, chronic disease prevention, communication with healthcare providers, preventive care, safety, and other general wellness topics. Control content is designed to provide health information without including meditative movement, structured exercise instruction, or behavior change strategies related to physical activity. All intervention materials are delivered remotely through online video platforms, allowing participation from home without the need for travel. Participants also receive regular reminders and motivational messages designed to support engagement and adherence throughout the study. The primary objective of the study is to determine whether participation in the seated Tai Chi/Qigong intervention improves cardiometabolic health compared with the health education control condition. The primary outcome is waist circumference, a clinically important indicator of central adiposity and cardiometabolic risk. Additional primary outcomes include physiological indicators of stress regulation, including heart rate variability (HRV) and salivary cortisol. Heart rate variability is measured using wearable technology and serves as a noninvasive indicator of autonomic nervous system function and stress resilience. Salivary cortisol samples are collected remotely by participants. Together, these physiological measures provide objective indicators of stress regulation and potential mechanisms through which meditative movement may influence health outcomes. Secondary outcomes include perceived stress and emotion regulation, depressive symptoms and anxiety, emotional eating and sleep quality. Sleep outcomes are assessed through a combination of wearable device data, sleep diaries, and validated self-report questionnaires. Participants wear an Oura Ring during each assessment period to collect objective measures of sleep, physical activity, and heart rate variability. Additional data are collected through online surveys, remote waist circumference measurements, daily sleep diaries, and saliva collection procedures completed at home. Study staff provide training and support for all remote assessments. A secondary objective of the study is to examine potential mechanisms that explain intervention effects. The study evaluates whether improvemens in stress regulation, emotional functioning, sleep, and health behaviors mediate changes in cardiometabolic outcomes. By simultaneously examining biological, psychological, and behavioral pathways, the study seeks to better understand how meditative movement interventions influence health among women with mobility impairments. This research addresses a significant public health need by focusing on an underserved population that experiences substantial health disparities and limited access to evidence-based interventions. Results from the study may inform future clinical and community-based programs aimed at reducing cardiometabolic risk, improving stress regulation, enhancing sleep quality, and promoting overall health and well-being among women with mobility impairments. The long-term goal of this research is to develop scalable, accessible, and sustainable interventions that improve health outcomes and quality of life for individuals living with mobility impairments and other physical disabilities.