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Efficacy of Tele-exercise to Promote Empowered Movement with Spinal Cord Injury (TEEMS): An Online Group Exercise Program
Abstract   Peer reviewed

Efficacy of Tele-exercise to Promote Empowered Movement with Spinal Cord Injury (TEEMS): An Online Group Exercise Program

Laura Baehr, Martha Childress, June Maloney, Jim Morrison, Shivayogi Hiremath, Michael Bruneau and Margaret Finley
Archives of physical medicine and rehabilitation, v 107(5), e22
May 2026
DOI: https://doi.org/10.1016/j.apmr.2026.02.059
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Abstract

Physical activity Telehealth Spinal Cord Injury
To investigate the efficacy of Tele-Exercise to promote Empowered Movement for individuals with Spinal cord injury (TEEMS), an online group exercise program, on exercise self-efficacy, outcome expectations, physical activity behavior, and quality of life. Parallel mixed methods single group with baseline, post-intervention, and retention timepoints Community, online web-based platform Individuals with chronic (>12 months) spinal cord injury (SCI) ages 18-75, who used assistive devices for community mobility, demonstrated some shoulder movement, and not currently attending structured rehabilitation. TEEMS is an online group exercise program delivered by co-instructors including a rehabilitation clinician (physical therapist or occupational therapist) and a study team member with an SCI. TEEMS is an 8-week program that meets live 2x/week for 60-minute sessions, that include mindfulness, mobility, stability, strength, aerobic, and exercise education elements. Primary quantitative outcome measures included reliable and valid self-report instruments assessing constructs of exercise self-efficacy, exercise outcome expectations, physical activity behavior. Secondary quantitative outcome measures were quality of life indicators (social satisfaction, participation). Qualitative outcomes included themes from narrative data elaborating on numeric findings. Sixty-three individuals with SCI enrolled in the study, with 51 completers. No adverse events occurred. Significant improvements in exercise self-efficacy (p=0.004, d=0.88), exercise outcome expectations (p< 0.001, d= 2.06), and vigorous weekly physical activity minutes (p=0.02, d=0.69) were observed at post-program. Secondary outcomes also significantly improved, including subjective quality of life (p=0.03, d=0.90) and satisfaction with social roles (p=0.01, d=1.11), with moderate effects sizes for social participation (d=0.56) and self-esteem (0.53). At retention, all significant improvements were made. Prior to TEEMS, participants emphasized that their previous experiences and social access influenced exercise confidence. Following TEEMS, participants describe a sense of exercise autonomy and knowledge ownership, and that the social accountability and structure of TEEMS motivated their learning. Participants describe carrying elements of TEEMS into their daily lives outside of the structured class. They also touch on the complexity of the meaning of quality of life with SCI. TEEMS is an efficacious group exercise intervention that appears to enhance personal determinants of sustainable physical activity behavior and quality of life indicators. In the short-term, TEEMS also appears efficacious to increase vigorous weekly physical activity minutes. Findings are confirmed by integration of both statistical significance and participant experience. The next step in the evaluation of TEEMS is a randomized controlled trial to evaluate its effectiveness.

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