Group Exercise Program Research Articles

Feasibility of a Supervised Virtual Exercise Program for Women on Hormone Therapy for Breast Cancer

ABSTRACT Introduction/Purpose Adjuvant endocrine therapy significantly improves survival in women with hormone receptor–positive breast cancer and is typically administered for 5 yr or longer. Adverse treatment side effects, including arthralgias, reduce treatment adherence and physical activity levels. Aerobic and resistance exercise is one strategy to decrease treatment side effects and improve treatment adherence. This study aimed to explore the feasibility of a virtually delivered exercise program for women receiving adjuvant endocrine therapy as part of breast cancer treatment. Methods This is a single-arm pilot study with recruitment by self-referral or oncologist referral of female breast cancer survivors. To adapt to coronavirus disease 2019 (COVID-19) restrictions, a supervised strength and aerobic group exercise program was delivered virtually twice weekly via Zoom over 6 wk. Feasibility was evaluated based on a priori targets specific to program recruitment (>30% recruitment ratio), transition to virtual delivery (>75%), attendance (>70% virtual session attendance), attrition (<30% dropout), and fidelity of group belongingness (average score ≥15 on belongingness questionnaire) at the end of the program. Physical function (30-s chair stand test), quality of life RAND Short-Form 36-item test, and medication adherence (Voils Domains of Subjective Extent of Nonadherence) were assessed at baseline and 6 wk. Results A total of 24 participants completed the program. All feasibility measures were met. Statistically significant changes were found in physical function (P < 0.001), self-reported energy/fatigue (P < 0.001), emotional well-being (P < 0.001), and pain (P = 0.01). There was also a positive trend toward improvement in patient-reported medication adherence (17%). Conclusion A 6-wk supervised strength and aerobic group exercise intervention delivered virtually was feasible and improved physical function, energy/fatigue, emotional well-being, and pain. The trend toward improvement in adherence to adjuvant endocrine therapy should be explored further. These findings provide preliminary data to inform a future appropriately powered trial on exercise and physical function using a virtual platform that has the potential for greater reach.

DSFit: a feasibility pilot study of a group exercise programme for adolescents with Down syndrome.

While past research has underscored the benefits of physical activity for people with Down syndrome (DS), exercise programming that is customised to and/or accessible for children and adolescents with DS is limited. The objectives of this pilot were to (1) develop and refine an engaging exercise programme for adolescents with DS, called DSFit; (2) assess feasibility over the course of two pilot iterations; and (3) examine participant and parent feedback regarding exercise priorities and the DSFit exercise programme. Participants were 12 unique adolescents (ages 11-17years) with DS. Both pilot iterations of the programme consisted of weekly group exercise sessions and home exercises to complete between sessions. Physical fitness and mood/behaviour were assessed at baseline and at the end of the intervention. Parent and child goal-setting and feedback surveys were collected before and immediately after the intervention, and a 2-month follow-up assessed physical activity and exercise attitudes. Quality improvement methodology and participant/parent feedback were used to modify the second iteration to better meet the needs of our study population. Changes included an expanded age range, modified physical assessments, decreased burden of questionnaires, and video-recorded group sessions for at-home practice. Physical fitness evaluation of core/trunk strength and stability, lower- and upper-body strength, balance, flexibility, and walking was feasible, and the majority of participants in both pilot iterations improved in at least one category of physical assessment between baseline and end of intervention. Assessment of symptoms of anxiety, depression and behavioural concerns was also feasible and results showed slight improvements in some participants. Both parent and participant feedback indicated that participants enjoyed the programme and appreciated the opportunity to start developing sustainable exercise habits. A group exercise programme with supported at-home components is feasible for adolescents with DS. Future iterations will continue to examine programme efficacy with improved fitness testing and larger sample sizes. Strategies to increase at-home compliance, such as virtual sessions and parent/guardian-guided physical fitness assessments, will also be incorporated.

A Web-Delivered, Clinician-Led Group Exercise Intervention for Older Adults With Type 2 Diabetes: Single-Arm Pre-Post Intervention.

BackgroundThe COVID-19 pandemic created unprecedented shifts in the way health programs and services are delivered. A national lockdown to prevent the spread of COVID-19 in Australia was introduced in March 2020. This lockdown included the closure of exercise clinics, fitness centers, and other community spaces, which, before the pandemic, were used to deliver Beat It. Beat It is an 8-week in-person, community-based, and clinician-led group exercise and education program for adults self-managing diabetes. To continue offering Beat It, it was adapted from an in-person program to a fully web-based supervised group exercise program for adults with type 2 diabetes (T2DM).ObjectiveThis study aims to assess whether the Beat It Online program produced comparable health outcomes to the Beat It in-person program in terms of improving physical fitness (muscular strength and power, aerobic endurance, balance, and flexibility) and waist circumference in older adults with T2DM.MethodsAustralians with T2DM who were aged ≥60 years were included. They were enrolled in Beat It Online, a twice-weekly supervised group exercise and education program conducted via videoconference over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. The adaptations to Beat It are reported using the Model for Adaptation, Design, and Impact, including the type of changes (what, where, when, and for whom), the criteria for making those changes (why and how), and the intended and unintended outcomes. The intended outcomes were comparable functional fitness as well as physical and mental health improvements across demographics and socioeconomic status.ResultsA total of 171 adults (mean 71, SD 5.6 years; n=54, 31.6% male) with T2DM were included in the study, with 40.4% (n=69) residing in lower socioeconomic areas. On the completion of the 8-week program, significant improvements in waist circumference, aerobic capacity, muscular strength, flexibility, and balance were observed in both male and female participants (all P<.001). The Model for Adaptation, Design, and Impact reports on 9 clinical, practical, and technical aspects of Beat It that were adapted for web-based delivery.ConclusionsThis study found that Beat It Online was just as effective as the in-person program. This adapted program produced comparable health benefits across demographics and socioeconomic status. This study offers important findings for practitioners and policy makers seeking to maintain independence of older people with T2DM, reversing frailty and maximizing functional and physical fitness, while improving overall quality of life. Beat It Online offers a flexible and inclusive solution with significant physical and mental health benefits to individuals. Further evaluation of Beat It (both in-person and Online) adapted for culturally and linguistically diverse communities will provide greater insights into the efficacy of this promising program.

Six Months Of Objectively Measured Group Exercise Supports Adults Meeting Physical Activity Guidelines

PURPOSE: Physical inactivity is associated with a myriad of negative health outcomes and thus continues to be a public health concern. The COVID-19 pandemic highlights a need for novel health intervention strategies that improve moderate to vigorous aerobic physical activity and resistance training levels. Group exercise is one built environment strategy that should be better leveraged to improve physical activity levels. METHODS: Study participants self-selected to engage in a commercially-available group exercise program. Workouts ranged from 45-90 minutes and included interval training on treadmills, rowers, and total body resistance training. All participants attended at least two classes weekly for 28 consecutive weeks, while wearing heart rate monitors (HRMs) to objectively assess intensity. RESULTS: Participants (n = 295; mean age: 39 ± 11 years; 72% female) attended an average of 4.5 ± 0.9 group exercise sessions per week for 28 weeks. Data from HRMs indicate that participants spent an average of 50 ± 5 minutes in vigorous intensity activity (defined as heart rate > 60% max; VPA) across all classes, with an average working HR of 139 + 10 beats per minute, equating to an average weekly VPA dose of 221 + 46 minutes (range: 134-398 minutes). Age was associated with VPA (r = 0.166, p = 0.04). No significant differences in workout attendance or time spent in VPA were observed between sexes (p = 0.29, p = 0.07, respectively). CONCLUSIONS: This group exercise program provided a sustainable solution for adults to exceed VPA guidelines over a 6-month period. The availability of group exercise facilities in many communities facilitates access to long-term coaching, accountability, equipment, and a safe environment that should be used to improve public health. Future studies that include a control group, as well as pre-and post- data comparisons on key health and performance outcomes of interest, are warranted.

Impact Of 8-week Combined Group Exercise Program On Individuals With Down Syndrome

Impact Of 8-week Combined Group Exercise Program On Individuals With Down Syndrome

Multi Interventional Strategies on physiological and biochemical parameters on Polycystic Ovarian Syndrome – A Pilot Report

Background: Polycystic ovarian syndrome (PCOS) is a heterogeneous, chronic endocrine disorder commonly diagnosed in women of reproductive age. It often manifests with some or all of the following symptoms: menstrual dysfunction, infertility, hirsutism, acne, and obesity. Polycystic ovarian syndrome has now become one of the major health problem among adolescent and adult women. Lifestyle modifications, including diet modifications, exercise, and behavioral modification, appear to alleviate the metabolic dysfunction and improve the reproductive disorders of girls with PCOS. Therefore, lifestyle modifications have been gradually acknowledged as the first-line management for PCOS. Methods: Quantitative experimental and control group pre and post test design was used in this study.A total of 152 young girls from different colleges in Chennai were screened based on Rotterdam criteria and among that 30 study participants were selected who met the inclusion criteria. Structured self-administered questionnaire was used to elicit the baseline data. Participants were divided into three groups, 10 in each group – control group (only education regarding PCOS), experimental group I with all three interventions (cinnamon tea, exercise program and anxiety reduction counselling) given for 3 months, experimental group 2 with exercise program and anxiety reduction counselling given for 3 months. Post test I is conducted after 45 days and post test II is conducted after 3 months. Non probability Purposive sampling technique was used. Prior permissions were obtained from all the college principals and dean. Informed consent was obtained from all the participants. Results: This study shows that there was significant decrease (P&lt;0.001) in the Physiological parameters (BMI, Waist circumference) and biochemical parameters (Total testosterone level) of experimental 1 group with multi interventional strategies (cinnamon tea, exercise program and anxiety reduction counselling) when compared to experimental 2 group and control group. There was better reduction in the experimental 2 group (exercise program and anxiety reduction counselling) when compared to the control group. There is increase in BMI, Waist circumference and total testosterone level in the control group when compared to experimental 1 and 2 groups. Conclusion: The present study highlighted the beneficial role of multi interventional strategies (cinnamon tea, exercise program and anxiety reduction counselling) in reducing the BMI, waist circumference and total testosterone level of young girls with Polycystic ovarian syndrome. Hence, the study recommends multi interventional strategies for young girls with Polycystic ovarian syndrome.

Clinical efficacy of a personalized exercise program in the rehabilitation of patients with atrial fibrillation after radiofrequency ablation

Aim. To study the clinical efficacy and safety of a personalized exercise program in the rehabilitation of patients with paroxysmal atrial fibrillation (AF) after primary pulmonary vein radiofrequency ablation (RFA).Material and methods. Patients (n=48) with paroxysmal AF who underwent RFA were randomized into two groups: main (n=24) — patients involved in the exercise program and received standard therapy; control (n=24) — patients received standard therapy. The program included exercise complexes with the calculation of energy consumption, step training and walking. The program lasted 6 months, while the follow-up period — 12 months. All patients in the study underwent a faceto-face learning interview.Results. After 6-month exercise program, bicycle ergometer test revealed an increase in duration (by 18,6%, p&lt;0,001) and power (by 24,8%, p&lt;0,01) of the load, while these changes were not revealed in the control group. The positive aftereffect of training on these parameters persisted even after the completion of program. Left atrial and left ventricular end-diastolic dimension remained stable in exercise program group and significantly increased in the control group. In contrast to the control group, the following parameters significantly decreased in trained patients after 6 months: body mass index by 2,8% (p&lt;0,05), systolic blood pressure by 2,1% (p&lt;0,05), heart rate by 12,1% (p&lt;0,05), low-density lipoprotein cholesterol concentration by 18,8% (p&lt;0,001), high-sensitivity C-reactive protein by 22,9% (p&lt;0,05), N-terminal pro-brain natriuretic peptide by 28,2% ( p&lt;0,05), aldosterone by 41,5% (p&lt;0,001) and angiotensin II by 41,3%, p&lt;0,05). In addition, in the exercise program group an increase in high-density lipoprotein cholesterol by 20,6% (p&lt;0,05) and physical activity level by 23,8% (p=0,001) was revealed. At the same time, both groups showed a significant decrease in the concentration of fibrinogen and transforming growth factor-β1. After 6 months, in the exercise program group versus the control group, there was a decrease in the number of registered supraventricular premature beats (p&lt;0,01), episodes of supraventricular tachyarrhythmia (p&lt;0,05), including AF (p&lt;0,05).Conclusion. Involvement of patients with AF after catheter RFA in a cardiac rehabilitation program based on moderate-intensity aerobic training improves exercise tolerance, cardiac function, corrects thrombogenic factors, and reduces the likelihood of arrhythmia recurrence, including AF.

Effect of an exercise intervention on global cognition after transient ischemic attack or minor stroke: the MoveIT randomized controlled trial

BackgroundPatients with a transient ischemic attack (TIA) or ischemic stroke are at increased risk of developing cognitive impairment in the subacute phase. At present, the effects of exercise on cognitive functioning following a TIA or stroke are not fully known. The purpose of this trial was to investigate the effect of exercise on global cognition.MethodsThe MoveIT trial is a single-centre, observer-blinded, randomized controlled trial involving a 1-year exercise intervention consisting of a 12-week group exercise program, combined with three counselling visits to the physiotherapists over a 9-month period. The control group received standard care. The primary outcome was global cognitive functioning, assessed at one year, using the Montreal Cognitive Assessment (MoCA). Secondary outcomes included cardiorespiratory fitness, the cardiovascular profile, and attainment of secondary prevention targets, anxiety, depression and fatigue at one and two years.ResultsThe experimental group consisted of 60 patients, while the control group consisted of 59 patients. The mean age was 64.3 years and 41% were female. No between-group differences were found on global cognitive functioning (MD, 0.7 out of 30, 95% CI, − 0.2 to 1.6) or on secondary outcome measures at 12 months. The only significant between-group difference was found for fatigue, in favour of the experimental group at 12 months (MD, 0.6 out of 63, 95% CI, 0.1 to 1.1).ConclusionsNo benefit of this exercise intervention was found regarding global cognition. Future studies need to focus on optimizing rehabilitation strategies for this vulnerable group of patients.Trial registrationhttp://www.trialregister.nl. Unique identifier: NL3721.Date first registration: 06-03-2013.

Incorporating a Sense of Community in a Group Exercise Intervention Facilitates Adherence

Participant attrition is detrimental for exercise intervention studies, particularly if dropout is not random. Community engagement has helped facilitate participant adherence, which is particularly applicable for group exercise programs. Developing a sense of community (SOC) helps participants feel that they belong and provides ongoing social support. This paper reports on strategies used during an 11-week high intensity functional training (HIFT) intervention with exceptionally high adherence (96.7%) that involved 30 participants (57% women, age 36.7 ± 4.5 years). Participants recorded their heart rate variability using a smartphone app daily throughout the study, completed three different weeks of fitness assessments, and attended six weeks of five days/week HIFT group exercise sessions led by a certified coach. Coaches used strategies to facilitate group interactions and individual feedback and engagement. Participants completed a follow-up survey that included 14 items from the SOC in sport scale (SCS), eight questions about group dynamics, and three open-ended study feedback questions that were coded using the SOC categories. All SCS items were highly rated (mean range = 4.51-4.93/5) as were the group dynamics items (mean range = 4.30-4.85/5). Common interests were the most mentioned SOC category in open-ended responses, and while the participants reported really enjoying the study, they provided constructive feedback for improving future studies. Using specific strategies to facilitate a SOC in exercise intervention research (e.g., group exercise, social media connections, and facilitating participant interactions) are recommended for both researchers and practitioners to avoid attrition and encourage adherence, particularly for programs with high daily participant burden.

The importance of social connections in combating compulsive exercise among group-exercise participants: a network analysis

PurposeThis paper aims to use social network analysis (SNA) to determine whether compulsive exercise (CE) was related to social connections and network position among participants of group-exercise programs.Design/methodology/approachMembers from two group-exercise programs (Gym 1: n = 103; Gym 2: n = 56) completed an online survey measuring their social connections within the program, CE, depressive symptoms and sense of belonging. Network position was calculated for each person based on network centrality scores (i.e. closeness, eigenvector centrality). Linear network autocorrelation models determined whether respondents reported similar CE as their network ties (i.e., network effects) and whether network position was related to CE in these networks.FindingsEigenvector centrality (i.e., being connected to popular/important people within the network; Gym 1: parameter estimate [PE] = 0.51, p < 0.01, Gym 2: PE = 0.39, p = 0.02) and network effects (i.e. having similar CE scores as direct network ties; Gym 1: PE = 0.07, p < 0.01, Gym 2: PE = 0.19, p < 0.01) were related to CE among participants in these programs.Originality/valueThis study builds on existing SNA research suggesting the importance of social connections and network position on CE, and, to the best of the authors’ knowledge, is the first to explore these effects among group-exercise participants. This study describes how the social environment can impact, both positively and negatively, someone’s susceptibility for CE and supports fostering social connections within group-exercise programs as a way to potentially combat harmful CE among its participants.

A Sense of Connection: Examining Social Identity and Adherence to a School-Based Exercise Club

Purpose: This study aimed to investigate the relationship between social identity and adherence in the context of a school-based, 8-week structured group exercise program. Methods: Secondary students (N = 116; Mage = 15.52 years) from 10 newly formed school-based exercise clubs reported social identity perceptions specific to their exercise group, which were used to predict attendance and intentions to return to the club in the future. Results: Controlling for sex and grade level, the results of hierarchical regression analysis revealed that exercise group social identity was significantly positively related to program attendance (ΔR2 = .09, p &lt; .01). A positive relationship was also found between exercise group social identity and intentions to return to the exercise club in the future, while also controlling for sex, grade level, and program attendance (ΔR2 = .05, p &lt; .05). Discussion/Conclusion: The findings suggest that stronger exercise group social identity in the form of ingroup ties is associated with greater attendance and intention to return to the school-based exercise club among secondary school students.

CHANGES OF PLANTAR ARCH AFTER GLOBAL PHYSICAL EXERCISES IN HIGH SCHOOL STUDENTS

The bipedal position acquired by mankind through evolution comes with a heavy price, such as overburdening of the spinal column and lower limbs, comparable difficulties in both breathing and blood transport to the brain. The loads imposed on musculoskeletal tissues during daily activities are modified by variations in joint mechanics, which increases the risk of orthopaedic dysfunctions. The purpose of this study is to investigate the effects of a 3-month global physical exercise programme using the Pilates method on the plantar arch. The participants were 18 high school students (11 female and 7 male) aged between 14 and 16 years. Methodology: To evaluate the plantar arch under static and dynamic conditions, the barosensitive BTS P-Walk platform (BTS, Italy) was used. The participants performed a group exercise programme over three months under the close supervision of the therapist; it consisted of 20 sessions carried out twice a week on average, with each session lasting 50 minutes. Initial and final results were compared and statistically interpreted (using the Paired Samples t Test and multiple statistical indicators). Conclusion: The study found numerical improvements in all four parameters, and for three of them, the change was statistically significant (P &lt; 0.05 in the Paired Samples t Test). Statistically significant improvements were recorded for the left foot arch when evaluated in the standing position and for both feet during walking.

Research-Driven Guidelines for Delivering Group Exercise Programs via Videoconferencing to Older Adults

Telehealth holds much potential for supporting older adults’ physical and social health. In particular, telewellness interventions to support the physical and social wellness of older adults are needed to overcome participation barriers with in-person programs. This paper presents guidelines for delivering telewellness interventions to older adults, which were informed by a human factors approach to developing a Tele Tai Chi intervention for older adults with mobility disabilities, including reviewing user needs literature and conducting user-centered needs assessment research. From these findings, we developed a protocol and support materials for delivering a telewellness intervention and conducted a feasibility study. We also established an adaptation committee to provide recommendations on the intervention. The outcome of our human factors approach was the establishment of research-driven design guidelines for delivering group exercise programs to older adults using videoconferencing. The guidelines provide direction for designing a telewellness protocol, supporting remote participation, and promoting socialization and engagement. These guidelines can be used to deliver interventions that increase access to socially-engaging, physical activity programs for older adults, which can ultimately help support their physical health, mental health, and quality of life.

The Effects of an Online-Offline Hybrid Exercise Program on the Lives of Children with Cerebral Palsy Using Wheelchairs during the COVID-19 Pandemic in Korea.

Due to the ongoing COVID-19 pandemic, many online programs for social meetings, education, leisure, and physical activities have been developed and provided; however, children with cerebral palsy (CP) cannot enjoy online programs in the same way that those without disabilities can. The aim of this study was to investigate the differences in reintegration to normal living (RNL), social interaction, and quality of life among school-age children with CP after participation in a game-based online–offline hybrid group exercise program. The current study was conducted on 26 children with CP who participated in a hybrid exercise program. The RNL, social interaction, and quality of life were measured before and after the six-week program. The scores of RNL and quality of life were improved (p < 0.05) after program participation. Online or hybrid exercise programs incorporating interactive methods (i.e., competition and cooperating) could enhance RNL and quality of life of children with CP. Thus, well-designed online or hybrid exercise programs should be developed and provided for children with CP to enhance overall quality of life during the pandemic.

Efficacy of high-power laser therapy combined with exercise on wrist pain, function and joint position sense in female gymnasts with non-specific chronic wrist pain

Background: Wrist pain is common and debilitating among gymnasts, presenting a tricky diagnostic and therapeutic challenge resulting in falling down in training sessions and during performance. Objective: To find out the effect of high-power laser treatment, either alone or in combination with exercise, on wrist pain, function and joint position sense in female gymnasts with non-specific chronic wrist pain. Methods: Thirty-six female gymnasts (aged 10 to 16 years) who were diagnosed with non-specific wrist pain were recruited as the participants for the study, and were randomly allocated into three groups. The participants of the laser therapy group received only high power laser therapy, the exercise program group participants received exercises only, and the participants of the combined therapy group received both laser and exercises. Pain, function, and joint position sense were the outcomes measures in the study. Results: In all treatment groups, all measured results improved after therapy. The laser therapy group had the least significant impact, whereas the combined therapy group had the most significant impact. Conclusion: It might be early to say whether solely high-power laser therapy is an effective non-invasive modality for treating female gymnasts with non-specific chronic wrist pain. The addition of associated co-interventions to high power laser treatment can improve the beneficial effects of laser therapy.

“If somebody had told me I’d feel like I do now, I wouldn’t have believed them…” older adults’ experiences of the BELL trial: a qualitative study

ObjectivesThis study examined older adults’ experiences of participating in the Ballistic Exercise of the Lower Limb (BELL) trial, involving 12-weeks of group-based hardstyle kettlebell training.MethodsIn the BELL trial, 28 insufficiently active older adults (15 women, 13 men, 59–79 years) completed six weeks of face-to-face group training, and six weeks of home-based training. In-depth semi-structured interviews were audio recorded, transcribed, and inductively coded, with themes constructed from patterns of shared meaning.ResultsFour higher-order themes were developed that reflect older adults’ experiences participating in a group-exercise program of hardstyle kettlebell training. These included: (1) “It’s one of the best things we’ve done”—enjoying the physical and psychosocial benefits, (2) “It’s improved it tremendously!”—change in a long-term health condition, (3) “It put me on a better course”—overcoming challenges, and (4) “I wasn’t just a number”—feeling part of a group/community.DiscussionFindings highlight the perceived physical and psychological benefits of older adults participating in hardstyle group kettlebell training, and the value attributed to being part of an age-matched community of like-minded people engaged in group exercise. Implications for program design and delivery, and future research, are discussed.

The effects of exercises with aPilates ball on balance, reaction time and dual-task performance of kindergarten children.

Aim: This study investigated the effects of exercises conducted with a Pilates ball on the motor skills of preschool children. Methods: 62preschool children were randomly divided into two groups: an intervention group (IG) (n=30) and a control group (CG) (n=32). Exercises with a Pilates ball were practiced in IG. The One Leg Standing test, Functional Reach test, Ruler Drop test and Timed-Up and Go test were the outcome measures. Results: Static balance performance and dual-task performance were found to be significantly improved in the intragroup and intergroup comparisons, favoring the IG (p<0.05). Conclusion: The exercises carried out in this study were found to be effective on static balance and dual-task performance. The study can guide an exercise program for the preschool age group. Clinical Trial Registration: NCT04575441(ClinicalTrials.gov).

Adding Physical Activity Coaching and an Activity Monitor Was No More Effective Than Adding an Attention Control Intervention to Group Exercise for Patients With Chronic Nonspecific Low Back Pain (PAyBACK Trial): A Randomized Trial.

To investigate whether adding physical activity coaching and an activity monitor enhanced the effects of a group exercise program on pain intensity and disability for people with chronic nonspecific low back pain. Randomized controlled trial with concealed allocation, intention-to-treat analysis, and blinding of participants and assessors. One hundred sixty participants with chronic nonspecific low back pain who were aged between 18 and 60 years and seeking care at an outpatient physiotherapy clinic participated. Both groups received supervised group exercise therapy. The intervention group also received physical activity coaching sessions aimed at improving physical activity, and physical activity electronic feedback delivered by an activity monitor. The attention control group received modified approaches of coaching sessions and an activity monitor. Disability was measured using the Roland Morris Disability Questionnaire (0-24), and pain intensity was measured using the 11-point Numerical Rating Scale (0-10). Linear mixed models were performed to test for differences between groups. There were no differences between groups for reductions in disability (mean difference [MD] = -0.5 out of 24 points; 95% confidence interval [CI]: -2.2, 1.1) and pain intensity (MD = -0.4 out of 10 points; 95% CI: -1.3, 0.5) at 3-month follow-up. There were no between-groups differences at 6- and 12-month follow-up assessments. Adding targeted physical activity coaching and an activity monitor did not reduce pain intensity or disability more than an attention control approach in participants with chronic low back pain who were undertaking a group exercise program. J Orthop Sports Phys Ther 2022;52(5):287-299. doi:10.2519/jospt.2022.10874.

Can Group Exercise Programs Improve Health Outcomes in Pregnant Women? An Updated Systematic Review.

Current scientific evidence supports the recommendation to initiate or continue physical exercise in healthy pregnant women. Group exercise programs have positive effects on improving health, well-being, and social support. In 2015, a systematic review was provided to evaluate the evidence on the effectiveness of group exercise programs in improving pregnant women’s and newborns’ health outcomes and to assess the content of the programs. This review aims to update this knowledge between 2015 and 2020. The exercise program designs were analyzed with the Consensus of Exercise Reporting Template (CERT) model, the compliance with the current guidelines, and effectiveness in the maternal health and fitness parameters. Three databases were used to conduct literature searches. Thirty-one randomized control trials were selected for analysis. All studies followed a supervised group exercise program including aerobic, resistance, pelvic floor training, stretching, and relaxation sections. Group interventions during pregnancy improved health and fitness outcomes for the women and newborns, although some gaps were identified in the interventions. Multidisciplinary teams of exercise and health professionals should advise pregnant women that group exercise improves a wide range of health outcomes for them and their newborns.

Physiotherapist and participant perspectives from a randomized-controlled trial of physiotherapist-supported online vs. paper-based exercise programs for people with moderate to severe multiple sclerosis

Purpose There is a gap in research on how best to support exercise in moderate to severe MS. The objective of this study is to share perspectives of people living with MS and physiotherapists on their experiences in a randomized clinical trial of online physiotherapy vs. an active comparator. Methods Semi-structured exit interviews were conducted with volunteer participants from the online and comparator arms of the trial, and focus groups were held with study physiotherapists. Transcripts were analyzed using reflexive thematic analysis. Results Perspectives from participants with MS yielded three themes: usability of their program, utility of their program, and motivation to participate. Visual and dexterity impairments limited the usability of the online program. Having an opportunity “to be pushed” was valued by participants in both trial arms. Motivation to exercise was variable, and participants desired periodic face-to-face contact with their physiotherapists. Perspectives from trial physiotherapists yielded similar and complementary findings concerning usability and utility. Conclusions Participants with MS and physiotherapists found the online physiotherapy platform useful for supporting exercise, yet they identified some limitations. As the appeal of online platforms has increased since the pandemic, it will be important to consider the needs of people with moderate to severe MS. Trial registration number NCT03039400. IMPLICATIONS FOR REHABILITATION People with moderate-to-severe MS and physiotherapists involved in a clinical trial found online physiotherapy useful for supporting exercise. Physiotherapists and participants using the online program desired improved platform accommodations for people living with MS with visual and dexterity impairments. Physiotherapists and people living with MS from both the online exercise program and comparator groups perceived a need for more face-to-face contact and opportunities to build therapeutic alliance. Perspectives from prescribing physiotherapists and people living with MS about supporting exercise online may have practice implications during and post-pandemic.