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Currently accepted at: JMIR Research Protocols

Date Submitted: Sep 4, 2026
Date Accepted: Oct 29, 2026

This paper has been accepted and is currently in production.

It will appear shortly on 10.2196/110430

The final accepted version (not copyedited yet) is in this tab.

Fitness and Wellness Inclusive Tele-Health User System (FitWithUs): Protocol for a SMART Trial Using Adaptive Telehealth to Increase Physical Activity in Adults with Mobility Impairments

  • Mohanraj Thirumalai; 
  • Christen John Mendonca; 
  • Ayse Zengul; 
  • Tapan Mehta; 
  • James Rimmer; 
  • Sangeetha Mohanraj

ABSTRACT

Background:

Despite significant evidence that regular physical activity improves health and quality of life among people with disabilities, almost half of the people with physical disabilities living in the United States are physically inactive. The use of recent technological innovations combined with advanced research methodologies may provide participants with more precision-based tailoring (flexibility/adaptability) of an intervention to increase their adherence to exercise

Objective:

The overall objective of this mixed-methods study is to develop an effective, resource-sensitive telehealth strategy to enhance physical activity levels among individuals with physical disabilities.

Methods:

The FitWithUs study is a sequential multiple assignment randomized trial (SMART) evaluating the delivery of a 32-week telehealth intervention comprising health coaching, live adaptive exercise training, educational content, and AI-driven monitoring in individuals with physical disabilities. As a significant innovation, the study uses a random forest classifier to identify participants at risk of non-adherence to the intervention and provides targeted health coaching support.

Results:

The FitWithUs study was approved by the university’s institutional review board, and recruitment and enrollment began in July 2025.

Conclusions:

The FitWithUs study will improve our understanding of the feasibility and efficacy of a telehealth exercise program for people with disabilities. Clinical Trial: ClinicalTrials.gov identifier: NCT06207084, 01-05-2024.


 Citation

Please cite as:

Thirumalai M, Mendonca CJ, Zengul A, Mehta T, Rimmer J, Mohanraj S

Fitness and Wellness Inclusive Tele-Health User System (FitWithUs): Protocol for a SMART Trial Using Adaptive Telehealth to Increase Physical Activity in Adults with Mobility Impairments

JMIR Research Protocols. 29/10/2026:110430 (forthcoming/in press)

DOI: 10.2196/110430

URL: https://preprints.jmir.org/preprint/110430

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