Effects Of Home Exercise Research Articles

Effects of Home Exercise and Manual Therapy or Supervised Exercise on Nonspecific Chronic Low Back Pain and Disability

In this study, we aimed to evaluate the effects of two therapeutic methods: home-based exercise and manual therapy (MT) or supervised exercise on pain and functional status in individuals with chronic nonspecific low back pain. In total, 60 individuals with LBP were included in this randomized study. All participants were treated for 6 weeks in one of two groups: the manual therapy group or the exercise therapy group. In addition, all participants were asked to perform an exercise program at home independently. Levels of pain, spinal mobility, disability, and abdominal and back muscle endurance were measured before and after 6 weeks of intervention. Results: After MT, disability was reduced by 70% (F = 42.2; p < 0.00; ηp2 = 0.99) and pain was reduced by 78% (F = 4.9; p < 0.00; ηp2 = 0.51). After exercise therapy, disability and pain were reduced by 78% (F = 11.5; p < 0.00; ηp2 = 0.78) and 68% (F = 9.4; p < 0.00; ηp2 = 0.41), respectively. Muscle endurance and lumbar spine mobility values were significantly higher in both groups after 6 weeks of intervention (p < 0.00). After 12 MT interventions, lumbar spine mobility increased by 40% (F = 1.9; p < 0.00; ηp2 = 0.24) and after exercise therapy by 38% (F = 28.4; p < 0.00; ηp2 = 0.82). Abdominal muscle endurance improved by 29% (F = 24.2; p < 0.00; ηp2 = 0.79) after MT and by 34% (F = 57.6; p < 0.00; ηp2 = 0.67) after exercise therapy; back muscle endurance improved by 18% (F = 48.6; p < 0.00; ηp2 = 0.78) after MT and by 20% (F = 14.2; p < 0.00; ηp2 = 0.76) after exercise therapy. After 6 weeks of intervention, there was no statistically significant difference between the pain, disability, and spinal mobility groups (p > 0.05). However, differences between groups in kinesiophobia (p = 0.02), back (p < 0.02) and abdominal (p < 0.03) muscle endurance values were statistically significant. Following the home exercise program and manual therapy, or the home exercise program and supervised exercise, LBP and disability had clinically significant reductions and functional status showed improvement.

Effects of Home Exercises on Shoulder Pain and Pathology in Chronic Spinal Cord Injury: A Randomized Controlled Trial.

The aims of this study were to replicate findings that a home exercise program intervention improved shoulder pain and function and to assess changes in supraspinatus tendon pathology associated with the home exercise program in persons with chronic spinal cord injury. The study is a single-blind randomized controlled trial. Individuals with spinal cord injury of at least 1 yr and chronic shoulder pain of moderate or greater average intensity were enrolled. Participants were randomized to a 12-wk home exercise program consisting of strengthening and stretching exercises or to an education-only control group, with immediate postintervention and 4-wk postintervention (16 wks) follow-ups. The main outcome measures were self-report measures of shoulder pain and impairment, the Physical Examination of the Shoulder Scale, quantitative ultrasound metrics of the supraspinatus tendon, and the Ultrasound Shoulder Pathology Rating Scale. Thirty-two participants were randomized to home exercise program or education-only control condition. The mean ± SD age was 44.8 ± 12.5; 81.3% were male; 65.6% had motor complete paraplegia. Using a per-protocol, within-group analysis method, significant differences were observed between baseline and postintervention for the home exercise program group for the least pain intensity (P = 0.02), number of days with shoulder pain (P = 0.042), Physical Examination of the Shoulder Scale scores (dominant side, P = 0.036; nondominant side, P = 0.008), the Disabilities of the Arm, Shoulder, and Hand (P = 0.028), and the Patient Global Impression of Change (P = 0.015). The education-only control condition group demonstrated significant changes in average unpleasantness of shoulder pain after the intervention period (P = 0.049). Comparisons in changes from baseline between groups showed that the home exercise program group had greater improvements in nondominant-side Physical Examination of the Shoulder Scale scores and global impression of change, whereas the education-only control condition group had greater improvements in depressive symptoms.For quantitative ultrasound measures, no significant changes were found with within-group analyses for the home exercise program group, although the education-only control condition group demonstrated a decrease in tendon width in the nondominant-side supraspinatus tendon (P = 0.036). Comparison of changes between groups suggests that the education-only control condition group had a greater increase in dominant shoulder supraspinatus tendon ultrasound contrast at the end of the study. Changes in several measures of shoulder pain and function occurred after the home exercise program intervention, although the magnitude of changes was only significantly greater than those of the education-only control condition group for two measures. Significant changes in supraspinatus pathology were not detected with quantitative ultrasound metrics.

Home exercises and supervised exercises are similarly effective for people with subacromial impingement: a randomised trial.

Are there different effects of home exercises and supervised exercises on pain and disability for people with subacromial impingement? Randomised trial with two treatment arms, concealed allocation, blinded assessment of some outcomes, and intention-to-treat analysis. Forty-six patients with subacromial impingement were recruited from an interdisciplinary outpatient clinic of physical medicine and rehabilitation at a university hospital in Norway. The home exercise group had one supervised exercise treatment followed by exercises at home for 6 weeks. The supervised exercise group had up to 10 supervised exercise treatments in addition to home exercises for 6 weeks. The primary outcome was the Shoulder Pain and Disability Index (SPADI). Secondary outcome variables were: average pain during the past week, the Fear Avoidance Beliefs Questionnaire, participant satisfaction with treatment, active range of motion, work status and clinical shoulder tests. Pain was assessed weekly and all outcomes were assessed at 6 weeks. Participants were free to seek ongoing treatment of their choice until 26 weeks, when the SPADI was assessed again. While both groups improved considerably, the groups did not differ significantly on the SPADI after the intervention at 6 weeks (0 points, 95% CI -14 to 14) or when followed up at 26 weeks (-2 points, 95% CI -21 to 17). There were no between-group differences for pain at any time. The remaining outcomes also did not differ significantly, except for the clinical tests of shoulder impingement. In the supervised exercise group, 11 out of 23 participants had two or more positive tests, compared to 18 out of 21 in the home exercise group. Supervision of more than the first session of a 6-week exercise regimen did not cause significant differences in pain and disability in people with subacromial impingement. NCT01257113.

Effectiveness of Home Exercise on Pain, Function, and Strength of Manual Wheelchair Users With Spinal Cord Injury: A High-Dose Shoulder Program With Telerehabilitation

ObjectiveTo test the effectiveness of a high-dose home exercise/telerehabilitation program for manual wheelchair users who have a spinal cord injury (SCI) by determining whether the intervention would reduce pain and increase function, as we hypothesized. DesignA pre-post trial with outcomes measured at 3 time points: baseline, postintervention (12wk), and follow-up (>24 wk). SettingSubjects performed an exercise program at their homes using telerehabilitation for therapist monitoring of technique and exercise advancement. Baseline and postintervention data were collected at a motion analysis laboratory in a tertiary medical center. ParticipantsA convenience sample of manual wheelchair users (N=16, 3 women; average age, 41y; average time in a wheelchair, 16y) with shoulder pain (average pain duration, 9y) and mechanical impingement signs on physical examination. InterventionsA 12-week home exercise program of rotator cuff and scapular stabilization exercises was given to each participant. The program included a high dose of 3 sets of 30 repetitions, 3 times weekly, and regular physical therapist supervision via videoconferencing. Main Outcome MeasuresPrimary outcomes of pain and function were measured with the Wheelchair User's Shoulder Pain Index (WUSPI), Disabilities of Arm, Shoulder, and Hand (DASH) Index, and Shoulder Rating Questionnaire (SRQ). Secondary outcomes of strength were measured with isometric strength tests of scapulothoracic and glenohumeral muscles, and a static fatigue test of the lower trapezius. ResultsPain was reduced and function improved after the intervention. There was a significant main effect for pain and function between the 3 time points based on the Friedman signed-ranked test, WUSPI (χ22=5.10, P=.014), DASH Index (χ22=5.41, P=.012), and SRQ (χ22=23.71, P≤.001). Wilcoxon signed-rank tests demonstrated that isometric strength measurements of the serratus anterior and scapular retractors increased after the exercise intervention ([t=2.42, P=.04] and [t=4.67, P=.003], respectively). Muscle impulse produced by the lower trapezius during a fatigue task also improved (t=2.2, P=.02). No differences were measured in isometric strength for the lower trapezius, glenohumeral rotators, and abductors between the baseline and 12-week time points. ConclusionsA high-dose scapular stabilizer and rotator cuff strengthening program using telerehabilitation for supervision holds promise for shoulder pain treatment in manual wheelchair users with SCI. Additional work is needed to determine the effectiveness compared with other interventions, as well as the potential for earlier intervention to prevent development of shoulder pain.

Effects of home exercise on physical function and activity in home care patients with Parkinson's disease.

[Purpose] The aim of this study was to clarify the effects of guidance in home exercise on physical function and the amount of activity in home care patients with Parkinson’s disease (PD). [Subjects and Methods] A 2-month home exercise intervention consisting of self-administered exercise by patients (self-exercise) and home visit exercise therapy guided by a physical therapist (home visit exercise) was conducted in 10 home care patients with PD to compare changes in physical function, activities of daily living, and postural status between before and after the intervention. [Results] A decreased number of chief complaints and alleviation of fear of falling were observed after the intervention. In terms of physical function, a significant increase in flexibility and muscle strength were observed, although no significant changes were found in activities of daily living, gait, and balance. Although there was no significant change in the total amount of daily physical activity, the analysis of daily posture changes revealed a significant reduction in the percentage of time spent lying down and a significant increase in the percentage of time spent sitting after the intervention. [Conclusion] Guidance in home exercise in home care patients with PD can be effective in making self-exercise a habit, improving range of motion and muscle strength, and reducing the time spent in a supine position.

Commentary on "feasibility and initial effectiveness of home exercise during maintenance therapy for childhood acute lymphoblastic leukemia".

Commentary on "feasibility and initial effectiveness of home exercise during maintenance therapy for childhood acute lymphoblastic leukemia".

The effects of home exercise on insulin resistant in chronic kidney disease patients

Insulin resistance appears at an earlier stage of chronic kidney disease (CKD) and closely correlates with atherosclerosis and cardiovascular mortality. Exercise training may improve hyperinsulinemia in patients with chronic disease, but it has proven difficult to motivate many such patients to undergo exercise training chronically. We aimed to demonstrate the effect of regular home rubber band exercise on insulin resistant in patients with CKD stage 3-5.The randomized controlled trial was conducted in CKD clinic at Phramongkutklao hospital, Bangkok, Thailand, during June to December 2010. The eligible CKD stage 3-5 participants were asked to randomly assigned to do only home gentle exercise (control) or plus home resistance exercise by using rubber band (treatment) for 12 weeks. The exercise training was supervised and strictly monitored by sport scientist every four weeks. Fasting plasma glucose and insulin concentrations was performed to calculate homeostasis model assessment (HOMA). There were 21 patients in the control group (mean age 66.05±13.72 years) and 24 patients in the treatment group (mean age 66.05±13.72 years) . At the end of study, the fasting plasma glucose (-0.76±1.84 mmol/L) and HOMA-IR (-1.09±2.43) decreased significantly in the treatment group, whereas the fasting plasma glucose (0.49±1.65 mmol/L) and HOMA-IR (0.38±2.12) slightly increase significantly in the control group. In addition, there were significant different of HOMA-IR between the control group and the treatment group (1.9±1.85 vs 3.72±3.26, P= 0.031, respectively). Moreover, all patients in the treatment group did not have serious side effect from resistance exercise, but only five patients had muscle cramp. In conclusion, regular home exercise ameliorate insulin resistance without any serious adverse effects in the CKD population.

P1.224 Effects of home exercises in patients with Parkinson's disease

P1.224 Effects of home exercises in patients with Parkinson's disease

P1.225 Effects of home exercise on the risk of falls and their influence on quality of life

P1.225 Effects of home exercise on the risk of falls and their influence on quality of life

A narrative review on home-based exercise training for patients with chronic heart failure

Objective: In view of the growing incidence of chronic heart failure (CHF) and its poor prognosis, there has been increasing interest in optimising management of people with this condition. Exercise has been widely accepted as part of the management plan for patients with CHF. Traditionally, exercise training for this group of patients has concentrated on supervised centre-based training. However, home-based training may offer an alternative to conventional training or a means of maintaining physical fitness after graduating from the centre-based training. This review was undertaken to examine the literature for home-based exercise training in patients with CHF.Methods: Literature searches were performed initially using electronic databases. The obtained papers were cross-referenced and appropriate articles were ordered through interlibrary loans.Results: A total of 21 relevant papers were identified for review. The majority of studies documented benefits with home-based training including increased exercise capacity, improved self-efficacy and increased muscle strength.Conclusions: Home-based exercise training has been shown to benefit people with CHF in the short term. Further research is required to investigate the long-term effects of home exercise and to determine the optimal strategies for improving exercise adherence in patients with CHF.

The Effects of Home Exercise on Muscle Strength, Physical Balance and Gait of Community-Dwelling Elderly Women.

The Effects of Home Exercise on Muscle Strength, Physical Balance and Gait of Community-Dwelling Elderly Women.