Effects Of Home-based Exercise Research Articles

Effects of home-based exercise with telehealth guidance in lymphoma cancer survivors entering cardio-oncology rehabilitation: rationale and design of the tele@home study

BackgroundParticipation in cardio-oncological rehabilitation is low, and the effects incline to decrease after the initial rehabilitation term. Home-based exercise has the potential to enhance involvement in cardio-oncology rehabilitation and was demonstrated to be feasible, safe, and helpful in increasing short-term cardiorespiratory fitness. The lasting effects on cardiorespiratory fitness and physical activity are uncertain. Hence, a novel approach via telehealth management based on objectively measured exercise at home was proposed.ObjectivesTo improve self-monitoring, such as self-confidence, behavioral change, and goal setting for individual exercise, and afterward, increase long-term effects concerning cardiorespiratory fitness.DesignThis randomized controlled trial compares a 12-week guided home exercise telehealth intervention with a center-based exercise intervention of the same duration and intensity of exercise in lymphoma cancer survivors entering cardio-oncology rehabilitation after treatment. Participants will be instructed to exercise gradually at 60–85% of their maximum heart rate for 30–50 min 3 times a week. Participants will receive individual remote guidance (feedback about frequency, duration, and exercise intensity) by preferred contact (phone call, text message) once a week based on shared exercise data through the web platform. The primary outcome is a change in cardiorespiratory fitness expressed as maximal oxygen uptake assessed through cardiopulmonary exercise test at baseline, 12 weeks, and 1 year. Secondary objectives are quality of life, muscle strength, body composition, incidence of adverse events, and exercise adherence.SummaryThis study will determine whether a telehealth model is effective and safe compared to a center-based model in cancer survivors and whether exercise prescriptions are followed by participants. Additionally, an overview of the long-term effectiveness of telehealth cardio-oncology rehabilitation will be provided. This approach aligns with the trend of moving non-complex healthcare services into the patients’ home environment.Trial registrationClinicalTrials.Gov Identifier: NCT05779605

Abstract 15871: Clinical Characteristics Associated With Response to Exercise and Serious Adverse Events During Home-Based Walking Exercise in People With Lower Extremity Peripheral Artery Disease

Background: Home-based walking exercise improves walking performance in people with lower extremity peripheral artery disease (PAD). However, whether clinical and sociodemographic factors, such as age, sex, race, comorbidities, and income, are associated with response to exercise or rates of serious adverse events (SAEs) during a home-based walking exercise intervention for PAD is unclear. Methods: Data from participants randomized to two clinical trials of home-based walking exercise for PAD were pooled. Both clinical trials used behavioral methods to help participants adhere to walking exercise up to 5 days/week for up to 50 minutes/session for 6-months. Outcomes were change in six-minute walk (6MW) at 6-months and rates of SAEs at 12-months. SAEs were defined as death or hospitalization. Results: 325 unique participants [mean age 69.8 (9.1), 161 (49.5%) female, 182 (56.0%) Black] had available 6MW and SAE data. Home-based walking exercise improved 6MW distance, compared to control, at 6-month follow-up [mean: +46.4 meters (95% CI: +31.5 meters, 61.2 meters)]. The effect of home-based exercise on 6MW was similar across clinical and sociodemographic characteristics. 51 (27.3%) participants reported SAEs in the home-based exercise group and 32 (23.2%) reported SAEs in the control group (p=0.40). Among those randomized to home-based walking exercise, odds of SAE were significantly higher among Black compared to White participants, those with history of coronary artery disease (CAD) and heart failure (HF) compared to those without (Figure). Statistically significant interactions were identified between Black race (P<0.001), coronary artery disease (P=0.006) and lower income zipcodes (P=0.047) and the effect of exercise on rates of SAEs. Conclusion: In people with PAD randomized to home-based exercise, those who were Black, had a history of CAD or HF were significantly more likely to experience SAEs, compared to people without these characteristics.

Effectiveness of home-based exercise in breast cancer survivors: a randomized clinical trial

BackgroundBreast cancer patients are recommended to engage in regular exercise. In developing countries, where there is a lack of facilities to offer specialized, supervised exercise for this population, regularly exercising might be a challenge. We aimed to evaluate the effectiveness of a home-based intervention in this population.MethodsBreast cancer survivors were randomly assigned to either the home-based exercise program or the usual care group. Exercise intervention included walking, balance, and stretch exercises, along with weekly follow-up telephone calls. Quality of life (QOL) was evaluated using EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires and the predicted VO2 peak was measured using the Ebbeling submaximal treadmill test.ResultsEighty-nine patients were enrolled in the study. Reported minutes of exercise gradually increased from 40.7 min per week in week 1 to 116.9 min per week in week 12. This intervention improved global QOL (P = 0.001), social functioning (P = 0.04), and the predicted VO2 peak (P = 0.01).ConclusionThis home-based exercise regime effectively increased quality of life and physical activity levels.Trial registryIranian Registry of Clinical Trials identifier: IRCT20140810018746N1, prospectively registered 08/01/2018, https://en.irct.ir/trial/27959.

Effects Of Home-based Exercise On Non-specific Shoulder Pain: A Systematic Review And Meta-analysis

Non-specific should pain (NSSP) refers to shoulder pain experienced without clearly defined pathology or physical signs. Compared with other conservative treatments, home-based exercise could be more cost-effective and more flexible in time. Yet, the effect of home-based exercise on NSSP is unclear. PURPOSE: To evaluate the effect of home-based exercise on the management of NSSP. METHODS: EMBASE, MEDLINE, CENTRAL, CINAHL and PEDro were searched from inception to January 2021. Following PRISMA guidelines, two independent reviewers selected randomized clinical trials comparing home-based exercise alone with other conservative treatments (i.e., other types of active or passive physical therapy interventions, pharmacological interventions, or multimodal conservative interventions) in adults with NSSP. Outcome measures included pain intensity and functional disability. The meta-analysis was conducted using RevMan V.5.4 software to calculate standardized mean difference (SMD) and corresponding 95% confidence interval (CI). The risk of bias was assessed using the PEDro scale, and the overall quality of the evidence was assessed using the GRADE approach. RESULTS: Nine studies involving 748 participants were included. Overall, there is moderate-quality of evidence that home-based exercise and other conservative treatments have no significant differences in reducing pain (SMD = 0.14; 95% CI: -0.01 to 0.28; I2 = 29%; p = 0.06) and improving function (SMD = 0.06; 95% CI: -0.35 to 0.47; I2 = 65%; p = 0.78). CONCLUSIONS: Home-based exercise and other conservative treatments appear to be equally effective for the management of NSSP. Therefore, for individuals with NSSP, home-based exercise may be a suitable alternative therapeutic method to replace other conservative treatments.

The effects of the home-based exercise during COVID-19 school closure on the physical fitness of preschool children in China.

BackgroundSocial distancing and school closures during the COVID-19 pandemic reduced the physical activities of the preschool children living in China. However, the effects of home-based exercise on the physical fitness of Chinese preschool children during COVID-19 school closures are still unknown. This study aimed to investigate the effects of home-based exercise on the physical fitness of Chinese preschool children during COVID-19 school closure.MethodsIn this retrospective analysis, data from 1,608 Chinese preschool children (aged 3–5.5 years) in a second-tier city of Guangdong Province of China (Zhongshan city) were extracted from three successive National Physical Fitness Measurement (NPFM) from 2019 to 2021. NPFM consists of weight, height, and six subtests of physical fitness including 10-m shuttle run test (SRT), standing long jump (SLJ), balance beam walking (BBW), sit-and-reach (SR), tennis throwing (TT), and double-leg timed hop (DTH) tests. The change differences or change ratios of all the items in NPFM between any two successive years from 2019 to 2021 were compared. The exercise profiles about home-based and outdoor exercise before, during, and after COVID-19 school closure were obtained from 185 preschool children via retrospective telephone survey.ResultsBetween 2019 and 2021, 1,608 preschool children were included in this study. We observed larger changes in SLJ, SR, TT, and DTH tests during school closure than after school closure. But the children showed lower reduction rates in the completion time of SRT and BBW. During school closure, higher change ratios in SLJ and TT were observed in the children primarily participating in home-based exercise than those primarily participating in outdoor exercise. However, no statistical differences were observed in the changes in SRT and BBW between home-based and outdoor training groups.ConclusionThe home-based exercise program might be an alternative approach to improve the physical fitness of preschool children during COVID-19 school closure, but could not be beneficial to speed-agility and balance functions. A specific guideline geared toward a home-based exercise program during the COVID-19 outbreak is highly needed.

Effect of home-based exercise on falls in community-dwelling older adults: an umbrella review.

AimsThe aim of this review study was to examine the effectiveness of home-based and community-based exercise programmes in the rate of falls and improving physical functioning in community-dwelling older adults.MethodsAll types of home-based and community-based exercise interventions were searched. From 1186 studies identified, 14 studies were selected for the umbrella review. Most studies had high methodological quality. The types of interventions were multi-functional programmes (n = 11 studies) and Otago Exercise Programme (OEP) (n = 3 studies).ResultsThe results showed that home-based and community-based exercise interventions can reduce falls by 22–32%. Studies that included meta-analysis showed that the clinical significance of home-based interventions in fall prevention and improving physical function was moderate to high.ConclusionsIn conclusion, home-based and community-based exercise interventions are a safe, effective, and feasible method of fall prevention that could be implemented with minimum supervision by allied health professionals to maximise autonomy, self-efficacy, and adherence in community-dwelling older adults.

Home-based exercise programs in patients with chronic kidney disease: A systematic review and META-analysis.

Intradialysis exercise programs in renal patients result in improved functional capacity, muscle strength, symptoms of depression, and health-related quality of life. Home-based exercise programs are an alternative to overcome logistical and human resource problems. However, the implementation of these programs is not an easy task and there is a lack of knowledge regarding the benefits associated with home-based exercise programs. To determine whether home-based exercise programs improve functional capacity, health-related quality of life, muscle strength, and symptoms of depression among patients with stage III-V chronic kidney disease. A systematic review and meta-analyses following PRISMA guidelines were utilized. Relevant articles were collected and independently assessed for their inclusion eligibility. Effects of home-based exercise were summarized by the standardized mean differences and represented by forest plots (Review Manager 5.4). Eight studies were included, none of which reported any adverse effects. The intervention was usually aerobic, 76% of these programs lasted 3-6months, and exercise adherence was 60-87.5%. Four studies measured health-related quality of life and found significant improvements in several subscales. Regarding functional capacity, five studies used the six-minute walking test (44.9 meters; 95% CI [30.45, 59.30]; p ≤ .001), three studies used the sit-to-stand-to-sit test (-0.45 seconds; 95% CI [-0.46, -0.26]; p ≤ .001), and two studies used the timed up-and-go test (-0.76 seconds; 95% CI [-1.38, -0.15]; p ≤ .001) and the handgrip strength test (1.16 kg; 95% CI [-2.88, 5.20]; p ≤ .001). Home-based exercise programs are beneficial to renal patients. These interventions are safe and effective to improve health-related quality of life and functional capacity and reduce symptoms of depression among patients with chronic kidney disease.

Home-Based Exercise for People With Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

Exercise performed at home could be a useful therapy for people with chronic kidney disease. This systematic review and meta-analysis aimed at describing the characteristics, main findings, methodological quality, and adherence rate reported in the existent randomized controlled trials that have provided information regarding the impact of home-based exercise programs on people with chronic kidney disease. Electronic databases (MEDLINE/PubMed, SPORTDiscus, Scopus, and CENTRAL) were searched up to April 2021, using the keywords: "Exercise"; "Home"; "Kidney Disease." Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was adopted. Jadad scale and Cochrane's tool were used to assess the methodological quality and risk of bias. Out of the 14 studies finally selected, 11 were included in the meta-analysis and most presented high methodological quality. The meta-analysis showed significant effects of home-based exercise on fitness and quality of life, but a little impact on renal function. Although exercise performed at home was mostly feasible and safe, adherence was not high and a considerable number of dropouts were observed. Home-based exercise has positive effects on the fitness' level and on the quality of life on people with chronic kidney disease. Future studies are needed to identify whether exercise performed at home is a better physical therapy option than center-based exercise.

Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis.

Background: Exercise therapy is recommended to treat non-specific low back pain (LBP). Home-based exercises are promising way to mitigate the lack of availability of exercise centers. In this paper, we conducted a systemic review and meta-analysis on the effects of home-based exercise on pain and functional limitation in LBP. Method: PubMed, Cochrane, Embase and ScienceDirect were searched until April 20th, 2021. In order to be selected, studies needed to report the pain and functional limitation of patients before and after home-based exercise or after exercise both in a center and at-home. Random-effect meta-analyses and meta-regressions were conducted. Results: We included 33 studies and 9588 patients. We found that pain intensity decreased in the exclusive home exercise group (Effect size = −0.89. 95% CI −0.99 to −0.80) and in the group which conducted exercise both at-home and at another setting (−0.73. −0.86 to −0.59). Similarly, functional limitation also decreased in both groups (−0.75. −0.91 to −0.60, and −0.70, −0.92 to −0.48, respectively). Relaxation and postural exercise seemed to be ineffective in decreasing pain intensity, whereas trunk, pelvic or leg stretching decreased pain intensity. Yoga improved functional limitation. Supervised training was the most effective method to improve pain intensity. Insufficient data precluded robust conclusions around the duration and frequency of the sessions and program. Conclusion: Home-based exercise training improved pain intensity and functional limitation parameters in LBP.

Home-based exercise and bone mineral density in peritoneal dialysis patients: a randomized pilot study

BackgroundThe prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD.MethodsStable outpatients undergoing PD were randomly assigned to the intervention group (n = 26; male, 20; median age, 66 years) or usual-care group (n = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared.ResultsThere was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results.ConclusionsHome-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD.Trial registrationUMIN Clinical Trials Registry, UMIN000041678. Registered September 4, 2020; retrospectively registered.

The effect of home-based exercise in sleep quality and excessive daytime sleepiness in elderly people: A protocol of randomized controlled clinical trial

Background: Sleep-disordered breathing is associated with significant morbidity and mortality, presenting a high prevalence in the general population and being considered today as an important public health problem worldwide, affecting about 45% of the world population. It is estimated that about from 50 to 75% of the elderly complain of difficulties in initiating or maintaining sleep. The regular practice of physical exercise of mild to moderate intensity is associated with improved sleep quality in the elderly and has increased its recommendation as one of the main non-pharmacological resources of preventive and therapeutic action. Objectives: To verify the effect of a semi-supervised home-based physical exercise program on sleep quality in a sedentary elderly population, which influences the improvement of self-reported sleep quality and the reduction of excessive daytime sleepiness in a sedentary elderly population. Methods: This protocol study of randomized, controlled, blinded clinical trial was designed, is being conducted and will be reported according to the guidelines of the CONSORT (Consolidated Standards of Reporting Trials) Statement, and is being conducted from July 2016 to December 2017, involving elderly people of both sexes, over 60 years old, living in Senhor do Bonfim. The home physical exercise program is based on the recommendations of the American College of Sports Medicine for exercise and physical activity for the elderly. Results: The first expected outcome is the improvement of self-reported sleep quality verified through the PSQI. The secondary outcomes are reduction in excessive daytime sleepiness among the sedentary elderly subjects undergoing the semi-supervised home-based physical exercise program, verified by the ESS, and the adherence of the subjects to the program. Conclusions: We hope that through this study, we can show that the regular practice of semi-supervised home exercises is effective in improving sleep quality and reducing excessive daytime sleepiness in sedentary elderly people and can be considered as a therapeutic, safe, easy-to-implement, and low-cost non-pharmacological resource.

Risk factors of impairment of shoulder function after axillary dissection for breast cancer.

Postoperative shoulder joint dysfunction has been observed at a certain rate after breast cancer surgery with axillary lymph node dissection. The purposes of this study were to verify the feasibility and effects of home-based exercise using a DVD and clarify the target of intensive intervention with physiotherapy by identifying the factors that cause postoperative shoulder dysfunction. The study comprised 237 female patients who underwent breast cancer surgery with axillary lymph node dissection, whose data were acquired until 3months postoperatively. All patients were instructed to exercise at home using a DVD. Range of motion (ROM) of shoulder flexion and abduction and the disability of the arm, shoulder, and hand (DASH) score were measured before surgery, 1week and 1, 2, and 3months after surgery. As factors influencing the recovery of shoulder ROM at 3months after surgery, the presence or absence of radiation and factors up to 1month after surgery (age, body mass index, the relationship between operated side and dominant side of the hand, treatment modalities, and complications). Shoulder ROM and DASH scores had gradually recovered from 1week to 3months postoperatively. As the results of the multivariate analysis, the factors that were associated with the recovery of ROM of shoulder flexion at 3months were the side of surgery corresponding to the dominant hand (negative factor) and the presence of paresthesia at 1week postoperatively (positive factor) (p < 0.05). Radiation therapy and the side of surgery corresponding to the dominant hand were negative factors for the recovery of shoulder abduction (p < 0.01). Regarding the feasibility of the home exercise, 214/229 (93.4%), 172/210 (81.9%), and 139/206 (67.5%) of patients performed exercise at least once a day at 1, 2, and 3months after surgery, respectively. Our result indicated that the side of surgery corresponding to the dominant hand was the inhibiting factor for recovery for both shoulder flexion and abduction at 3months after surgery. Home-based exercise with DVD was considered feasible. For the verification of this effectiveness, a randomized control study should be planned in the future.

Effect of Home-Based Exercise and Weight Loss Programs on Breast Cancer–Related Lymphedema Outcomes Among Overweight Breast Cancer Survivors

To our knowledge, no randomized clinical trials have assessed the effects of the combination of weight loss and home-based exercise programs on lymphedema outcomes. To assess weight loss, home-based exercise, and the combination of weight loss and home-based exercise with clinical lymphedema outcomes among overweight breast cancer survivors. This randomized clinical trial (Women in Steady Exercise Research [WISER] Survivor clinical trial ) of 351 overweight breast cancer survivors with breast cancer-related lymphedema (BCRL) was conducted in conference rooms at academic and community hospitals and in the homes of participants from March 12, 2012, to May 28, 2016; follow-up was conducted for 1 year from the start of the intervention. Statistical analysis by intention to treat was performed from September 26, 2018, to October 28, 2018. A 52-week, home-based exercise program of strength/resistance training twice per week and 180 minutes of walking per week, a weight loss program of 20 weeks of meal replacements and 52 weeks of lifestyle modification counseling, and a combination of the home-based exercise and weight loss programs. The 12-month change in the percentage of interlimb volume difference. Of 351 participants, 90 were randomized to the control group (facility-based lymphedema care with no home-based exercise or weight loss intervention), 87 to the exercise intervention group, 87 to the weight loss intervention group, and 87 to the combined exercise and weight loss intervention group; 218 (62.1%) were white, 122 (34.8%) were black, and 11 (3.1%) were of other races or ethnicities. Median time since breast cancer diagnosis was 6 years (range, 1-29 years). Mean (SD) total upper extremity score changes from the objective clinical evaluation were -1.40 (11.10) in the control group, -2.54 (13.20) in the exercise group, -3.54 (12.88) in the weight loss group, and -3.84 (10.09) in the combined group. Mean (SD) overall upper extremity score changes from the self-report survey were -0.39 (2.33) in the control group, -0.12 (2.14) in the exercise group, -0.57 (2.47) in the weight loss group, and -0.62 (2.38) in the combined group. Weight loss from baseline was -0.55% (95% CI, -2.22% to 1.11%) in the control group, -8.06% (95% CI, -9.82% to 6.29%) in the combined group, -7.37% (95% CI, -8.90% to -5.84%) in the weight loss group, and -0.44% (95% CI, -1.81% to 0.93%) in the exercise group. Study results indicate that weight loss, home-based exercise, and combined interventions did not improve BCRL outcomes; a supervised facility-based program of exercise may be more beneficial than a home-based program for improving lymphedema outcomes. ClinicalTrials.gov identifier: NCT01515124.

Effects of home-based exercise for patients with early-stage amyotrophic lateral sclerosis

Effects of home-based exercise for patients with early-stage amyotrophic lateral sclerosis

人工膝関節置換術患者における大腿四頭筋の量的・質的解析と在宅理学療法による介入効果の検証(平成25年度研究助成報告書)

人工膝関節置換術患者における大腿四頭筋の量的・質的解析と在宅理学療法による介入効果の検証(平成25年度研究助成報告書)

Effect of home-based exercise on functional ability of hemodialysis patients: a systematic review and meta-analysis

Effect of home-based exercise on functional ability of hemodialysis patients: a systematic review and meta-analysis

Effects of home-based exercise with expiratory muscle training on the prevention of falls and aspiration pneumonia in community-dwelling older adults

accessed from anywhere with minimal disruptions to their daily routine. A telerehabilitation project was initiated at our university hospital since 2012 using iPads onVirtual Personal Networks (VPN), called the e-MADO system (electronic Multidirectional Access andDelightful Opportunity-offering System). At the moment, the take-up rate for this option for family/patient consultation regarding their follow-up rehabilitation and monitoring is low with only 4 participants. The reason for this is unclear. Purpose: The aim of this study was to conduct a patient satisfaction survey to obtain feedback on the e-MADO system from these participants in order to understand the shortcomings and problemswith the e-MADO system so that improvements may be proposed and undertaken. Methods:A telephone interview was conducted to obtain feedback from the 4 participants in 5 main areas:

Accelerometer-based gait analysis identifies frail older adults among the general Japanese population

and after intervention. On the other hand, there were no differencesC group in all measurements. Conclusion(s): This result showed that there were significant decrease of fall incidence and improvements of PCF by home-based exercisewith expiratorymuscle training. This study suggested that we should explore to prevent for fall and aspiration pneumonia in community-dwelling individuals. Implications: Effects of home-based exercise with expiratorymuscle trainingon the preventionof falls and aspiration pneumonia could broaden the vision of physical therapist’s potential in prevention of disease and health promotion.

Home-based exercise for middle-aged Chinese at diabetic risk: A randomized controlled trial

ObjectiveTo evaluate short- (3months) and long-term (9months) effects of home-based exercise on adiponectin, exercise behavior and metabolic risk factors in middle-aged adults at diabetic risk. MethodsOne hundred and thirty-five middle-aged adults (38 men, 97 women) with at least one diabetic risk factor were randomly assigned to either a home-based exercise group (Ex-group) or a usual care group (C-group). Outcome measures included plasma adiponectin, exercise self-efficacy, physical activity, and metabolic risk factors, as follows: insulin levels, insulin resistance by homeostasis model assessment (HOMA-IR), physical fitness, and components of metabolic syndrome. This study was conducted in metropolitan Taipei from 2004 to 2005. ResultsThe Ex-group had improvements in exercise self-efficacy (+2.5, p=0.01), body mass index (BMI) (−0.6kg/m2, p<0.001) and flexibility (+2.4cm, p<0.001) at 3-month follow-up and maintained BMI and flexibility at 9-month follow-up. The Ex-group exhibited significantly increased physical activity while the C-group exhibited decreased physical activity at 9-month follow-up (p<0.001). No intervention effect was found on adiponectin (p=0.64) or other outcome measures over time. ConclusionsHome-based exercise did not improve adiponectin levels, but significantly improved exercise behavior, and certain metabolic risk factors, with the effects maintained for 9-months in subjects with type 2 diabetic risk.