Projects & Publications

Learn more about ongoing projects and past research by reviewing project summaries and publication list below.

Explore Our Completed and Ongoing Programs

Below, you’ll find detailed information on our past and current research projects. Understanding these projects will offer a greater understanding of CONTINUUM Lab’s purpose and give you insight into our future goals. We believe in the benefits and importance of sharing our findings for personal and professional use.

Interested in helping us? You can get involved as a support volunteer or a study participant.

Learn About Our Projects

Chime Time

CHIME Time is an ongoing project studying the effects of adaptable exercise training on the cardiometabolic health of wheelchair users (WCU). Using music and dance, we hope to test and observe the efficacy of adaptive exercise routines that offer participants a structured personal path for achieving their long-term health goals.

There are limited exercise options available for wheelchair users to improve their health. The major goal of this study is to test the efficacy of a live, synchronous exercise program with real-time monitoring of vital sign data to improve cardiometabolic health outcomes in WCU. The movement-to-music-cardio (M2M-C) intervention has the potential to improve the way exercise interventions are delivered to WCU, subsequently leading to an increase in sustainable and scalable solutions to improving health outcomes in this population.

Chime Time

This project developed a free, online, home-based exercise training program for people with spinal cord injuries. It offered access to an adapted exercise program, online training support, a health coach, and the ability to connect with others.

This project used a study design to create an adaptive intervention tailored to the individuals’ level of adherence. It was the first known study to utilize this type of design to develop an adaptive exercise intervention for people with SCI. Lastly, mobile health technology has been used in exercise intervention settings because of its ability to provide just-in-time, interactive interventions. Pilot data from this study will be used in a future R01 application to assess the implementation and efficacy of a full-scale SMART exercise intervention among people with SCI, assessing its ability to increase physical activity, improve quality of life, and reduce secondary health conditions among people with SCI.

Chime Time

The goal of this investigation was to increase understanding of psychological, social, and environmental determinants of activity participation among people with SCI by creating a computer-based program grounded in the Social Cognitive Theory.

This program was designed as a health promotion strategy that will enhance current, ready-to-use exercise programs for people with SCI. The primary mentor of this fellowship application (Dr. Rimmer) established the National Center on Health, Physical Activity, and Disability (NCHPAD) in 1999. Having the Center now located at Lakeshore Foundation provided a unique opportunity to quickly integrate this computer-based SCT strategy into an existing exercise program on NCHPAD’s website, allowing for quickly scaling this project to a national level. NCHPAD also offered the opportunity to disseminate the program to other public health and fitness professionals to use as an adjunct to their current exercise programs.

Chime Time

The SUPER-HEALTH study was an opportunity to provide regular exercise in the convenience of the person’s home in order to engage people with physical disabilities (PWD) who otherwise do not have access to regular physical activity (PA). Although this removes several major barriers to PA for PWD, such as transportation and accessible equipment, there are a significant number of PWD who complete screening and are eligible for the study; however, only half of those individuals complete testing and group allocation and a portion of those individuals either drop out or stop participating.

The first specific aim (SA1) was to identify the groups of responders and non-responders enrolled in an ongoing telehealth exercise trial from which individuals will be selected for interviews in aim 2. The second specific aim (SA2) was to explore modifiable factors that influenced their participation/non-participation. The third specific aim (SA3) was to develop a preliminary model through a grounded theory approach for explaining response/non-response of people with a physical disability to inform a future exercise trial. Study findings will be used in an R21 exploratory application to pilot a SMART telehealth exercise trial for PWD with the primary aim to increase adherence to the intervention protocol.


  1. Lai B, Wadsworth D, Spring K, Jones C, Mintz M, Malone L, Kim Y, Wilroy J, LeeH. Validity and Reliability of a Telehealth Physical Fitness and Functional Assessment Battery for Ambulatory Youth with and Without Mobility Disabilities: Observational Measurement Study. (2023). JMIR Rehabilitation and Assistive Technologies DOI: 10.2196/50582
  2. Wilroy JD*, Kim Y, Lai B, Young HJ, Giannone J, Powell D, Thirumalai M, Mehta T, Rimmer J. eHealth-Based Adaptive Exercise Intervention for Increasing Physical Activity in Persons with Spinal Cord Injury: Study Protocol for a Sequential Multiple Assignment Randomized Trial (SMART). (2023). JMIR Research Protocols. doi: 10.2196/47665
  3. Han A, Wilroy JD, Yuen HK. Effects of acceptance and commitment therapy on depressive symptoms, anxiety, pain intensity, quality of life, acceptance, and functional impairment in individuals with neurological disorders: A systematic review and meta-analysis. (2023). Clinical Psychologist. Advance online publication.
  4. Wilroy JD*, Kim Y, Lai, B, Ivankova N, Ivanovich H, Sinha T, Rimmer J. How Do People with Physical/Mobility Disabilities Benefit from a Telehealth Exercise Program? A Qualitative Analysis. (2022). Frontiers in Rehabilitation Science. 3:917898.
  5. Rimmer JH, Wilroy JD, Young HJ, Young R, Sinha T, Currie M, Lima CR, Lai B. Qualitative evaluation of a comprehensive online wellness program (MENTOR) among people with spinal cord injury. (2022). Frontiers in Rehabilitation Science. 3:932470
  6. Han A, Wilroy JD, Yuen H. Effects of a coach-guided videoconferencing acceptance and commitment therapy intervention combined with psychoeducation on distressed individuals living with spinal cord injury: A preliminary mixed-methods study. (2022). Disability and Rehabilitation. Advance online publication.
  7. Han A, Yuen HK, & Wilroy JD. Exploring associations of psychological inflexibility with depressive symptoms, anxiety, and stress in individuals living with a spinal cord injury: A cross-sectional study. Rehabilitation Psychology.(2022). DOI: 10.1037/rep0000444
  8. Rimmer J, Wilroy JD, Jeter A, Galea P, Lai B. Retrospective Evaluation of a Pilot eHealth/mHealth Telewellness Program for People with Disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR). (2022). mHealth. DOI: 10.21037/mhealth-21-34
  9. Hoekstra F, Gainforth HL, Broeksteeg,… Wilroy JD, Ginis, K. M. Theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury. (2022). Journal of Spinal Cord Medicine
  10. Young HJ, Lai B, Mehta T, Thirumalai M, Wilroy JD, Yates A, Kane B, Rimmer JH. The Movement-to-Music (M2M) Study: Study Protocol for a Randomized Controlled Efficacy Trial Examining a Rhythmic Teleexercise Intervention for People with Physical Disabilities. (2022) Nature: Trials. 7;22(1):779. doi: 10.1186/s13063-021-05751-2
  11. Lai B, Davis D, Samuel R, Swanson EM, Wozow CL, Wen H, Kim Y, Wilroy JD, Rimmer J. The effects of virtual reality tele-exergaming on cardiometabolic indicators of health among youth with cerebral palsy: a pilot randomized controlled trial. (2022). JMIR Protocol. 11(8):e40708. doi: 10.2196/40708.
  12. Wilroy JD*, Lai B, Currie M, Young HJ, Giannone J, Thirumalia M, Mehta T, Rimmer J. Feasibility of Teleassessments for Enrollment of Adults with Physical/Mobility Disability in a Home-based Exercise Trial in Response to COVID-19. Journal of Medical Internet Research: Formative Research. 2021;18;5(11).
  13. Wilroy, JD*, Lai, B, Davlyatov, G. et al. Correlates of adherence in a home-based, self-managed exercise program tailored to wheelchair users with spinal cord injury. Nature: Spinal Cord (2020).
  14. Lai BW, Rimmer JH, Yates A, Jeter A, Hui-Ju Young, Thirumalai M, Mehta T, Wilroy JD. Critical factors influencing the decision to enroll in a physical activity intervention among a predominant group of adults with spinal cord injury: a grounded theory study. Nature: Spinal Cord. (2020).
  15. Wilroy JD*, Martin Ginis KA, Rimmer JH, Wen H, Howell J, Lai B. An E-Learning Program for Increasing Physical Activity Associated Behaviors Among People with Spinal Cord Injury: Usability Study. JMIR Form Res. 2019;3(3):e14788. doi:10.2196/14788
  16. Lai B, Kim Y, Wilroy JD, Bickel CS, Rimmer JH, Motl RW. Sustainability of exercise intervention outcomes among people with disabilities: a secondary review. Disability and Rehabilitation. 2019:41(13):1584-1595 doi: 10.1080/09638288.2018.1432704
  17. Lai B, Wilroy JD, Young H, Howell J, Rimmer J, Mehta T, Thirumalai M. Usability of a Mobile App to Promote Adapted Exercise and Social Networking for People with Physical Disabilities. Journal of Medical Internet Research Formative Research. 2019;3(1):e11689. doi: 10.2196/11689
  18. Rimmer JH, Mehta T, Wilroy J*, et al. Rationale and design of a Scale-Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH) in people with physical/mobility disabilities: a type 1 hybrid design effectiveness trial. BMJ Open.2019;9(3):e023538. doi: 10.1136/bmjopen-2018-023538

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