Group Exercise Sessions Research Articles

Effects Of Jump Training On Postural Balance And Leg Muscle Function In Healthy Older Adults

Age-associated loss of skeletal muscle strength and postural balance are critical determinants of independent daily living activities in later life. PURPOSE: This study aimed to investigate the effects of different jumping exercise tempos on static balance and leg muscle function in healthy older adults. METHODS: Twenty-six community-living older adults were randomly assigned to a quick 108 per minute tempo (QJ; n = 14; 6 men) or slow 60 per minute tempo [AS1] (SJ; n = 12; 5 men) jumping exercise group. Both groups performed one set of jumps until they reached a level of exertion they perceived as difficult (Borg-RPE Scale of 15). Both groups trained three times a week for 12 weeks and participated in 60-min supervised group exercise sessions at a local health center. Outcome measures included center of foot pressure (CoP) sway parameters during quiet standing with eyes open (EO) and eyes closed (EC), four-square step (FSS), two-step stride length (TSL), and rate of force development (RFD) for vertical ground reaction force in sit-to-stand movement. RESULTS: Repeated-measures analysis of variance showed a significant main effect for FSS (P = 0.009) and TSL (P = 0.002). After the training period, QJ demonstrated a significantly decreased FSS time (5.17 ± 1.00 vs. 4.87 ± 1.00 s, P < 0.05) and SJ demonstrated a significantly increased TSL (210.8 ± 21.1 vs. 227.3 ± 27.2 cm, P < 0.05). Both groups showed no changes in CoP sway parameters with EO or EC in quiet standing. CONCLUSIONS: Jumps at a quick tempo improved dynamic standing balance evaluated by the FSS, while jumps at a slow tempo improved leg muscle strength. Thus, 12 weeks of jump training at different tempos appeared to have no effects on quiet standing balance, but different effects on dynamic standing balance and leg muscle strength in healthy older adults. [AS1]The phrase 'per minute' was included for one group only, but the meaning was not clear. Please check my suggested alterations.

Postmenopausal Women With Low Bone Mass Enjoy Bone-targeted, High-intensity Resistance Training: LIFTMOR Trial Observations

PURPOSE: The LIFTMOR trial improved bone and function with high-intensity progressive resistance and impact training (HiRIT) in postmenopausal women with low to very low bone mass. While efficacious in a research setting, a comprehensive evaluation of participant perception of HiRIT was required to inform implementation in the ‘real world’. Therefore, the aim of the current work was to examine physical activity enjoyment, quality of life (QOL), and participant perception of the HiRIT program undertaken in the LIFTMOR trial. METHODS: Postmenopausal women with low bone mass were randomized to either 8 months of 30-minute, twice-weekly supervised HiRIT (n=49) or unsupervised, low-intensity, home-based exercise (CON; n=52). At baseline and follow-up, all participants completed physical activity enjoyment (PACES-8) and QOL (WHOQOL-BREF) questionnaires (Kruskal-Wallis and Friedman’s test). At follow-up, 17 HiRIT and 15 CON participants completed an exit survey relating to their experiences, scored using a 5-point Likert scale. Of those, 14 participants from the HiRIT program underwent semi-structured interviews to facilitate qualitative analysis (Leximancer v4.50) of their experiences undertaking the HiRIT program. RESULTS: Participants who undertook the HiRIT program reported improvements in PACES-8 (3.3±1.0 vs -1.6±0.9, p<0.001), and on the exit survey, HiRIT were happier with their group allocation (4.8±0.6 vs 4.0±1.2, p=0.03), more enthusiastic about undertaking training sessions (4.4±0.5 vs 3.7±1.1, p=0.03) and more likely to participate in the LIFTMOR trial again given the chance (3.8±0.9 vs 2.9±1.3, p=0.028), than CON (p<0.05). Qualitative analysis revealed current bone health status as the most common motivator for enrolling in the LIFTMOR trial, time was an important barrier to previous physical activity participation and supervised group exercise sessions were perceived as positive. All HiRIT participants would recommend the program to a friend. No differences in QOL were observed (p>0.05). CONCLUSIONS: Supervised HiRIT was more enjoyable than a low-intensity home exercise program. The combination of high acceptability and the osteogenic nature of the LIFTMOR program suggests supervised HiRIT is an effective and appealing therapy for postmenopausal women at risk of fracture.

O4.1. AEROBIC EXERCISE DOSE DETERMINES THE COGNITIVE GAIN IN FIRST-EPISODE SCHIZOPHRENIA, SO HOW DO WE ENCOURAGE SUFFICIENT EXERCISE?

BackgroundIncreasing evidence supports the benefits of regular aerobic exercise for cognition and functioning in schizophrenia. The extent to which these gains are dependent on the amount of aerobic exercise completed remains unclear, although variability in adherence to intended exercise regiments is evident. Furthermore, strategies for encouraging regular exercise sessions in schizophrenia are only starting to be explored.MethodsIn a randomized controlled trial with 47 first-episode patients with schizophrenia, we contrasted six months of Cognitive Training & Exercise (CT&E) with Cognitive Training (CT) alone. The computerized cognitive training using PositScience BrainHQ and SocialVille programs was provided to all participants, four hours/week at the UCLA clinic for six months. The CT&E group also participated in total body circuit training exercises, with a goal of completing 150 minutes/week. Two of the aerobic exercise sessions were held at the clinic, while the other two were to be completed at home. Intensity of exercise was titrated individually with a heart rate monitor, targeting 60–80% of heart rate reserve. Several incentive strategies to encourage regular exercise were incorporated. Cognitive gain was measured by the MATRICS Consensus Cognitive Battery (MCCB), while the Global Assessment Scale: Role was used to index work/school functioning gain.ResultsBoth groups showed cognitive and work/school functioning gains, but the improvements were three times as large when aerobic exercise was added to cognitive training (for MCCB Overall Composite, Mixed Model F = 7.19, p<.02, effect size Cohen’s f = 0.43). The magnitude of cognitive improvement among the CT&E patients differed substantially, so predictors of the cognitive gain were sought. The CT&E patients completed a mean of 85% of their in-clinic aerobic exercise sessions, compared to an average of 39% of their home exercise sessions. Patients who completed a higher overall proportion of their exercise sessions showed the largest cognitive gains (r=0.51, p=.03). This relationship was particularly apparent for completion of home exercise sessions (r=0.54, p=.02). Thus, aerobic exercise showed a dose-response relationship to cognitive improvement. Paying $5 for each completed home exercise session was helpful, but variability in exercise adherence remained. Assigning points for completing the most exercise sessions in the desired heart rate zone and awarding a monthly winner also aided exercise adherence. Dividing patients into two groups that competed monthly for most exercise sessions in the heart rate zone was also motivating, but group competition had mixed results. Pilot work with smartphone reminder systems is underway.DiscussionThe addition of systematic aerobic exercise to cognitive training resulted in substantially more cognitive and functional gain than cognitive training alone. The magnitude of cognitive improvement was clearly related to the amount of regular exercise completed. Several strategies were employed to boost the frequency of exercise, particularly the number of exercise sessions completed outside of clinic group exercise sessions. Development of systematic incentive strategies to encourage regular aerobic exercise will be critical to successful dissemination of exercise programs as part of the treatment of schizophrenia.

Motivational climate of group exercise sessions in nursing homes

BackgroundMotivational climate in exercise group environments would have an impact on adherence, effort and enjoyment. We examined the motivational climate among nursing home residents who were involved in group exercise sessions.MethodsThis cross-sectional study was conducted in 10 nursing homes of Liège area that offer group exercise sessions. Sociodemographic data (age, sex, body mass index), cognitive status (by the Mini Mental State Examination) and independence in activities of daily living (by the Katz Scale) were retrieved in the medical records. The “Abbreviated-Perceived Motivational Climate in Exercise Questionnaire” was translated into French and then administered face to face with a clinical researcher. This is composed of 6 ego-involving climate items (corresponding to rivalry, comparison and favoritism) and 6 task-involving climate items (corresponding to valorization, individual efforts, self-improvement and cooperation). Each item is ranged on a 5-point Likert scale ranging from 1 (not at all focused on ego or task) to 5 (totally focused on ego or task). Each subscale has a total score expressed as an average.ResultsA total of 102 subjects of exercise group sessions were included (84.3 ± 7.7 years and 83 (81.4%) women). The mean score of task-involving and ego-evolving motivational climate was respectively 3.57 (SD = 0.67) and 1.52 (SD = 0.49), suggesting that the motivational climate was more focused on the task-involving climate than on ego-involving climate. Some items results were of particular interest: 55.9% of the respondents found that the instructor doesn’t remark/reward when they try hard, 63.7% said that the instructor doesn’t encourage mutual aid and 38.2% found that instructor doesn’t encourage to do new exercises.ConclusionsParticipants tended to perceive motivational climate as more task-involving than ego-involving. The absence of individual positive feedback, new exercises and mutual aid were also highlighted.

An Evaluation of Service Provision and Novel Strength Assessment on Patient Outcomes in a UK-Based Pulmonary Rehabilitation Setting

This study’s purpose was to (i) assess the impact of a 7-week pulmonary rehabilitation (PR) programme upon patient outcomes; incremental shuttle walk test (ISWT), COPD assessment tool (CAT), Clinical COPD Questionnaire (CCQ) and the Hospital Anxiety and Depression Scale (HADS); (ii) assess the impact of COPD severity on ISWT, psychological functioning and quality of life measures following PR; (iii) assess the feasibility of incorporating individually prescribed one repetition maximum (1RM) training loads into the existing strength training programme. Patients were people with COPD enrolled onto one of three versions (locations A, B and C) of a 7-week PR programme, which consisted of group exercise sessions and a social plus education element. Two locations incorporated individually prescribed training loads. Minimal clinically important changes (MCICs) are reported for the ISWT across all locations. Statistically significant changes in both CAT and the CCQ were found, with MCIC’s evident for CAT score overall and individually at location B. MCIC’s were not found for the CCQ. No statistically significant or MCICs were evident for the HADS. MCIC’s were present only in patients with mild to moderate severity for the ISWT. For the CAT, moderate, severe and very severe patients with COPD experienced MCIC’s. MCIC’s and statistically significant increases in 1RM strength were seen at both locations. These findings evidence an effective PR service. Basic strength exercise programming and assessment are feasible and should be implemented in PR services to maximise patient outcomes.

The perceived benefits of community-based group exercise sessions for survivors of stroke

Background/aims Post-stroke physical disability, cognitive impairment and emotional trauma can adversely affect the wellbeing of people who have survived stroke. Active participation in group exercise programmes has been advocated as an intervention to potentially enhance wellbeing. This study adopted a qualitative approach to explore the experiences of survivors of stroke who were participating in ongoing community-based group exercise sessions and their impact on subjective wellbeing. Methods Interviews were conducted with 12 participants from four community-based group exercise sessions. Of these, 6 were survivors of stroke (44–60 years) and the remaining 6 participants comprised caregivers, group coordinators and/or instructors, who were closely involved with sessions attended by the stroke survivors. Results Thematic analysis revealed that participation in community-based group exercise sessions offered survivors opportunities for building confidence; enhancing motivation; improving physical ability of affected limbs; enhancing interpersonal relationships; and providing support and knowledge. Participants all agreed that these physical and psychosocial benefits contributed to improved wellbeing and this supported previous research on the benefits of group work. Conclusions Participants explained how community-based group exercise sessions had facilitated their recovery journey and hence it is recommended that such programmes are made available, accessible and affordable to survivors of stroke.

Evaluating the effect of a smartphone app-based self-management program for people with COPD: A randomized controlled trial

AimTo examine the effect of a 6-month, smartphone app-based self-management program for people with chronic obstructive pulmonary disease (COPD). BackgroundTechnological interventions have been used for chronic disease management, but the effect of a self-management program using a smartphone app has not been evaluated in people with COPD. MethodsFor this randomized controlled trial, patients with COPD (N = 44) were recruited in pulmonary medicine outpatient clinics at two, metropolitan, tertiary care, academic hospitals. Eligible participants were randomized into two groups and received group education and exercise sessions in the first month of the 6-month intervention. Participants in the experimental group received a smartphone app-based self-management program, which included education, exercises, self-monitoring of symptoms and exercise, and social support. Participants in the control group received one call a month from the research staff. Self-care behavior was measured as a primary outcome. All measures were administered at baseline and at 6 months. ResultsAfter randomization, the experimental group numbered 22, the control group numbered 20, and 2 participants dropped out. Significant differences between groups were found in change score for self-care behavior, total activity count per wear time, and percent time spent in moderate-to-vigorous physical activity over 6 months. ConclusionA self-management program, using a smartphone app, can effect behavioral change in people with COPD. This program could be a boon to patients with COPD who have limited access to a health care provider, no opportunities for pulmonary rehabilitation, and frequent exacerbations.

Views and experiences of visually impaired older people and exercise instructors about the Falls Management Exercise programme: a qualitative study

Purpose To gain insight into visually impaired older people’s views regarding acceptability of an adapted Falls Management Exercise programme, and to explore Postural Stability Instructors’s perspectives on provision of the programme. Materials and methods Data from this qualitative study comprised interviews with nine visually impaired older people and two Postural Stability Instructors. Data were analysed using thematic analysis. Results Themes identified from interviews with the participants related to self-perception, exercise-related factors and facilitators to participation. Participants positioned themselves as not old or at risk of falls, felt exercises were not challenging enough and recommended that home exercise materials be offered in individually tailored formats. Themes identified from interviews with the instructors related to programme adaptations for visual impairments, exercises and facilitators to participation. Instructors recommended stratifying groups into levels of ability. Social time after the exercise sessions was deemed key in programme adherence by both participants and instructors. Conclusions Visually impaired older people have similar barriers and facilitators to group-based falls prevention sessions as older people without visual impairment, but seem to have more difficulties in motivation to exercise at home. Both participants and instructors felt the main facilitator to adherence to group exercise sessions was the social time. Implications for rehabilitation Visually impaired older people have similar barriers and facilitators to group-based falls prevention sessions as older people without visual impairment, but seem to have more difficulties in motivation to exercise at home. Key recommended adaptations for falls prevention interventions in visually impaired older people include offering individually-tailored home exercise materials, stratifying groups into level of ability and involving social time. The social time after the exercise sessions was key in programme adherence.

Facilitating Exercise Engagement among Community Dwelling Stroke Survivors: Is a once Per Week Group Session Sufficient?

Although exercise is proven as an effective strategy to combat post-stroke complications and the risk of stroke recurrence, many stroke survivors fail to engage in this activity following rehabilitation. In this study, we assessed the feasibility and usefulness of a low-frequency group exercise to determine its suitability as an approach to facilitate exercise engagement among stroke survivors. Forty-one stroke survivors, mean (SD) age 59.34 (10.02) years, mean time post-stroke 17.13 (17.58) months, completed a 90 minute, once per week, group exercise supervised by therapists for 12 weeks. The exercise outcomes were measured using standardized clinical tests. We observed improvement in the group’s physical performance; balance score by 3 units (Z = −3.88, p < 0.001), speed of repetitive sit to stand by 3.4 s (Z = −4.69, p < 0.001), and walking speed by 8.22 m/min (Z = −3.25, p < 0.001). Scores of seven out of 14 Berg’s balance scale items increased significantly, indicating better balance ability among the survivors. In conclusion, a 12-week, once per week group exercise session seems feasible and sufficient to improve the physical performance of community dwelling stroke survivors. This exercise arrangement may be offered to stroke survivors to facilitate exercise practice following rehabilitation.

The Feasibility of Remotely Delivered Exercise Session in Adults With Alzheimer's Disease and Their Caregivers.

Adults with Alzheimer's disease (AD) and their caregivers represent a segment of the population with low levels of moderate-intensity physical activity (MPA) and limited options for increasing MPA. The purpose of this study was to evaluate the feasibility of a group video conference approach for increasing MPA in adults with AD and their caregivers. Adults with AD and their caregivers attended 30-min group exercise sessions three times per week for 12 weeks. Exercise sessions and support sessions were delivered in their homes on a tablet computer over video conferencing software. Nine adults with AD/caregiver dyads enrolled, and seven completed the 12-week intervention. Adults with AD attended 77.3% of the group exercise sessions, and caregivers attended 79.2% of group exercise sessions. Weekly MPA increased in both adults with AD (49%) and caregivers (30%). Exercise delivered by group video conferencing is a feasible and potentially effective approach for increasing MPA in adults with AD and their caregivers.

Impacts of a multicomponent intervention programme on neuropsychiatric symptoms in people with dementia and psychological health of caregivers: A feasibility pilot study.

The objectives of this study are to explore the feasibility of a multicomponent intervention programme and to evaluate its impacts on behavioural and psychological symptoms of dementia (BPSD) and psychological health of caregivers. Fifty-six community-dwelling people with dementia (PWD) and knee osteoarthritis (OA) and their caregivers were recruited and randomized into the intervention group (IG) or comparison group (CG). Each participant in both groups received an individual physiotherapy session (personalized home exercises and care education) and underwent 8 weeks of a 1-hour-structured group exercise session weekly at a day care centre. They were instructed to follow the prescribed home exercise. The IG received a multicomponent programme, combining knee OA-specific therapeutic exercise with self-management support, while the CG attended the routine group exercise programme. The attendance rate and reasons for non-attendance were recorded for evaluating the feasibility. The Chinese versions of the Revised Scale for Caregiving Self-Efficacy (RSCSE) and the Neuropsychiatric Inventory Questionnaire (NPI-Q) were measured at the baseline and postintervention. Fifty-four dyads completed the programme with high attendance rate (94.4%). Compared with the CG, caregivers in the IG significantly improved in three domains of RSCSE scores (P ≤ .005) and caregivers' distress (P = .004) after the intervention. However, no effects were observed in terms of BPSD severity in PWD. No adverse events or falls were reported. This multicomponent programme is feasible and safe for dementia caregivers and older people with mild-to-moderate dementia and knee OA. The programme has beneficial effects on caregiving self-efficacy and distress of dementia caregivers.

The experience of motivation and adherence to group-based exercise of Norwegians aged 80 and more: a qualitative study

BackgroundPhysical activity is crucial for public health; worldwide, across all age groups, exercise has been recognised as a factor that leads to improved health. However, many people do not engage in regular physical activity and hence miss the opportunity to achieve these significant physical and mental health benefits. With the benefits of exercise in mind, the aim of the present study is to describe the experiences of older people’s motivation for participating in and adhering to a group-based exercise intervention in a local community setting.MethodsA qualitative design was used in which semistructured interviews of three men and four women of an advanced age (81–92) were conducted; the participants described their experiences with their participation in and adherence to a long-term group exercise intervention programme in a community setting. Data were analysed using systematic text condensation and discussed in light of the salutogenetic theory.ResultsFour main themes emerged from the data collection: (1) Experience of health challenges: A meaningful starting point; (2) Adherence motivated by increased life-manageability; (3) Comprehensibility through skilled instruction and (4) Social and professional support enhancing motivation. The participants; who had experienced negative changes to their health and function, as well as to their life situation, chose to sign up for the exercise groups and continued to participate throughout the entire intervention. Attending group exercise sessions meant positive changes to physical, mental and social functions enhancing the participants’ motivation to sustain their attendance and leading to positive behavioural changes that were important to their everyday lives.ConclusionEssential factors for these participants’ decision to sign up for the exercise groups were the following: having important life areas connected to physical activity in their history and having belief in exercise as an effective way to restore function and coping; as well as having current experience of health challenges. Adherence to the group exercise was associated with better coping and the ability to fulfil roles and keep up with important life areas. Support from family, friends and professionals also contributed, both to the process of signing up, and adhering to this long-term intervention. The professionals’ skills and the way the instructor tailored group instruction were emphasized as very important to the participants’ adherence. Understanding of motivational factors for participation in and adherence to, exercise programmes is of great importance to older people, health professionals and society.

Community-based self-management of chronic low back pain in a rural African primary care setting: a feasibility study.

A small pragmatic non-randomised controlled study investigated the feasibility and acceptability of a novel theory-informed community-based self-management programme targeting the biopsychosocial factors associated with chronic low back pain disability in a rural Nigerian primary care centre. Participants either received the programme, once weekly for 6 weeks, or usual care. The programme combined group exercise sessions with group/individual discussion sessions, informed by cognitive behavioural therapy and motivational interviewing. Recruitment rate, intervention delivery, proportion of planned treatment attended, retention/dropout rate, adherence to recommended self-management strategies and biopsychosocial outcomes were used to determine feasibility. Structured qualitative exit feedback interviews ascertained acceptability. Recruitment rate was 100%, treatment uptake was 83% and loss to follow-up was 8%. Greater benefits for the self-management group compared with control were observed for primary and secondary biopsychosocial outcomes. Although the programme appears promising, the exploratory design of this study warrants more rigorous intervention testing following suggested programme improvement.

Implementing physiotherapy services into fistula care at Panzi Hospital, Bukavu, DRC

Aims: To describe implementation of physiotherapy services in the context of fistula care and report early program observations.&#x0D; Methods: Process evaluation of treatment pathway/protocol implementation and presentation of provider observations of treatment results since January 2016.&#x0D; Results: Dedicated physician, nursing, social work and physiotherapy staff provide various aspects of rehabilitative care to women with fistula, pre- and post-operatively. Following variations in hospital census, 5-50 women participate in group exercise sessions 2-3x/week. Targeted individual physiotherapy is selectively provided to 1-15 women 1-5x/week. Staffing priorities reflect perceived importance and impact of physiotherapy services. Providers offer clinical observations of program successes, including improved post-surgical functional outcomes, and express interest in further training to cultivate advanced clinical skills.&#x0D; Conclusions: Early results indicate value of physiotherapy-informed care in a comprehensive approach to fistula care services. Improving and expanding upon these skills may prove equally useful in addressing the physical impairments associated with other reproductive morbidities, such as POP. In the future, systematic use of standardized tools, such as WHODAS 2.0 is recommended, both to quantify the burden of disability in this population, as well as to measure change with therapeutic interventions, including surgery and rehabilitation.

Feasibility and safety of a 6-month exercise program to increase bone and muscle strength in children with juvenile idiopathic arthritis

BackgroundArthritis in childhood can be associated with muscle weakness around affected joints, low bone mass and low bone strength. Exercise is recognized as an important part of management of children with juvenile idiopathic arthritis (JIA) but the exercise prescription to best promote bone and muscle health is unknown. We therefore aimed to: 1. assess feasibility and safety of a 6-month home- and group-based exercise program for children with JIA; 2. estimate the effect of program participation on bone mass and strength, muscle function and clinical outcomes and 3. determine if any positive changes in bone and muscle outcomes are maintained 6 months later.MethodsWe recruited 24 children with JIA who were part of the Linking Exercise, Physical Activity and Pathophysiology in Childhood Arthritis (LEAP) study to participate in a 6-month home-based exercise program involving jumping and handgrip exercises, resistance training and one group exercise session per month. We assessed lumbar spine bone mass (dual energy X-ray absorptiometry), distal tibia and radius bone microarchitecture and strength (high-resolution peripheral quantitative computed tomography), muscle function (jumping mechanography, dynamometry) and clinical outcomes (joint assessment, function, health-related quality of life) at baseline, 6- and 12-months. Adherence was assessed using weekly activity logs.ResultsThirteen children completed the 6-month intervention. Participants reported 9 adverse events and post-exercise pain was rare (0.4%). Fatigue improved, but there were no other sustained improvements in muscle, bone or clinical outcomes. Adherence to the exercise program was low (47%) and decreased over time.ConclusionChildren with JIA safely participated in a home-based exercise program designed to enhance muscle and bone strength. Fatigue improved, which may in turn facilitate physical activity participation. Prescribed exercise posed adherence challenges and efforts are needed to address facilitators and barriers to participation in and adherence to exercise programs among children with JIA.Trial registrationData of the children with JIA are from the LEAP study (Canadian Institutes of Health Research (CIHR; GRANT# 107535). http://www.leapjia.com/

Tele-Exercise as a Promising Tool to Promote Exercise in Children With Cystic Fibrosis.

Introduction: Cross-infection risk from contact exposure limits exercise opportunities in children with cystic fibrosis (CF). The purpose of this study is to evaluate the feasibility of a new live-streamed platform which delivered supervised and interactive group exercise sessions to CF children via digital devices while avoiding contact exposure.Methods: Ten CF children participated in a 6-week tele-exercise program. The program consisted of three 30-min sessions per week for a total of 18 sessions and included aerobic, resistance, and flexibility exercises. Sessions were streamed via a HIPAA compliant VSee telemedicine platform. Instructors and participants were able to interact in real-time online. Heart rate (HR) monitors were used to evaluate exercise intensity with a goal of moderate-vigorous physical activity ≥10 min, 70% of the sessions. System usability scale (SUS) and qualitative questionnaires were used to gauge participants' satisfaction and feedback.Results: On average participants attended 85% of the sessions. For the overall sessions participants exercise 21.1 ± 6.9 min at moderate-vigorous physical activity. Nine out of 10 participants used the exercise platform without parental guidance. Qualitative questionnaire and System Usability Scale (SUS) indicated that all participants enjoyed the tele-exercise program and highly rated the exercise platform 90.8 out of 100 (passing > 68).Conclusions: Tele-exercise platform is a promising new approach to promote exercise in children with CF. The online platform allows supervised virtual group exercise experience with optimal participation and no risk for cross-infection. This approach might prove to be useful in enhancing the use of exercise as therapy in children with CF.

Instructor-led versus Video-led Exercise: A Comparison of Intensity in Obese Youth

Background: Exercise is a key component in treating childhood obesity. Group exercise sessions with a trained instructor are ideal, but most treatment programs cannot offer these often enough to meet physical activity guidelines. At-home options that provide a similar-intensity workout are needed. Objective: To determine if exercise videos are a feasible at-home option for obese youth to meet recommended physical activity guidelines for moderate-to-vigorous exercise. Methods: Obese youth attended a summer camp focused on weight management. Subjects wore accelerometers to assess physical activity levels at camp. During camp, all subjects completed four exercise activities: three separate exercise sessions led by exercise physiologists (EP), as well as an exercise video (EV). Each exercise session utilized a different format: high intensity interval training (HIIT), group games (GG) and yoga. The EV, created by the same EP, included aerobic exercise and yoga. Data was analyzed to determine intensity associated with each exercise session. Results: Data was obtained from 16 (50%) accelerometers (9 girls, 7 boys). There was no difference in sedentary (SED) minutes per hour between activities. HIIT and GG had more moderate-vigorous physical activity (MVPA) than yoga (p&lt;0.0001 and p=0.01) and EV (p&lt;0.0001 and p=0.01). There was no difference in MVPA between HIIT and GG. Conclusions: Obese children exercised at higher intensities during instructor-led HIIT and GG exercise sessions than yoga or EV sessions.

A group-based, individualized physiotherapy intervention for people with multiple sclerosis-A qualitative study.

Group-based interventions for people with multiple sclerosis (MS) have gained increased attention in the field of physiotherapy research. However, no studies have investigated whether or how the prevailing principle of individualization is embedded in such interventions. The purpose of this study was to investigate how professional actions and interactions affect individualized exercise adaptations in a group intervention for people with MS. This study had a qualitative design and investigated and analysed the actions and interactions of six different physiotherapists (PTs) with expertise in neurology and 40 patients (27 female and 13 male, mean age 52.2years, mean Expanded Disability Status Scale 2.45) in a group-based exercise intervention (GroupCoreDIST) for people with MS. We performed nonparticipatory video observations of 13 group exercise sessions, each consisting of three patients, followed by 13 semistructured in-depth interviews with the PTs. Systematic text condensation analysis was conducted within an enactive theoretical framework. The results of our study indicated that the extent of embodied interaction and patient participation affect the possibilities and challenges regarding individualization within a group intervention. Handling, facilitation, emphasis on movement quality, and PTs who invited their patients to play an active role in the encounter enriched the reasoning and decision-making processes and yielded opportunities to adapt exercises to the specific patient's impairments. However, the combination of individuality and collectivity within a group context brings forth challenges in which the PTs are obligated to both preserve the benefits of being in a group and simultaneously attend to individual patients. Our study indicates that despite challenges, the PTs' integration of embodied interaction and mutual participation enables the patients to concurrently benefit from individualization and being in a group. These findings contribute to the question regarding the significance of individual adaptations in group interventions and point toward a need for future effect studies that compare standardized and individualized exercise protocols.

Development of a Community Wellness Program for Prostate Cancer Survivors

ABSTRACT Men living with prostate cancer benefit from multidisciplinary wellness programs that include physical activity, nutrition, and stress reduction. Such programs have been shown to decrease treatment-related side effects and reduce the risk of cancer recurrence and other comorbidities associated with prostate cancer, while also improving overall fitness, health, and quality of life. Despite these benefits, access to wellness programs and educational resources for men with prostate cancer are limited in Canada. This study aimed to describe the development of the TrueNTH Lifestyle Management program, an initiative aimed at establishing evidence-based wellness programs in the community to improve access to trained professionals and educational resources specific to the prostate cancer population. Protocol for an integrated, community-based 12-wk intervention of group exercise, yoga, and nutrition education sessions was developed based on evidence and insights from existing cancer-specific programs. Evidence-based tools, resources, and training were developed to support program facilitation and standardize intervention delivery. Pilot testing using the RE-AIM framework was conducted at three distinct community-based sites with demographics, physical fitness, and quality-of-life outcomes collected at baseline and 12 wk. Fifty-eight participants enrolled, with 32 completing quality-of-life measures and 39 completing fitness measures before and after the 12-wk intervention. Significant improvements were seen in the physical measures of body composition, flexibility, dynamic balance, muscular endurance, and functional aerobic endurance as well as weekly moderate and strenuous physical activity levels (all P’s &lt; 0.05). TrueNTH Lifestyle Management provides evidence-based professional training and survivorship resources necessary for the potential implementation of a safe, effective, and beneficial community wellness program for men living with prostate cancer.

A Weekly Structured Physical Activity Program Enhances Short-term Retention Of Middle-aged Adult Fitness Centre Users

Fitness centres can play a key role in addressing physical inactivity, yet several studies reveal low retention rate in fitness centres. Few centres, however, use a structured approach by providing a weekly physical activity (PA) program meeting ACSM guidelines. PURPOSE: To assess attendance and retention rates in inactive middle-aged adults of a fitness centre between a traditional PA plan and a structured PA program meeting ACSM guidelines. METHODOLOGY: Eighty inactive middle-aged adults (44.32 ± 6.99 years; 77.89 ± 19.22 kg; 158.75 ± 36.08 cm) from a Spanish fitness centre voluntarily enrolled in this study. Participants were randomly assigned to two groups (Free Exercise [FE = 40]; Structured Program [SP = 40]) and proved to be inactive through IPAQ short version. Participants completed baseline measures including body composition, VO2 max, cholesterol, triglycerides, blood glucose, flexibility, and muscular strength. During the ensuing 12 weeks, weekly attendance of both the FE and SP groups were tracked, with both groups initially agreeing to exercise 2-3 days per week for at least 20 sessions. FE group was introduced to trainers of the fitness centre and informed of group exercise sessions available. SP group received a structured program based on ACSM guidelines for PA. RESULTS: No baseline differences (p>0.05) existed between groups for age, body composition, VO2 max, haematocrit, flexibility, and muscular strength. A total of 13 participants (16%) never attend the initial assessment, and only 20 members (25%) attended 20 days or more (FE=5 [12.5%]; SP=15 [37.5%]). Members of SP group attended more total days (15.73 ± 8.19) than FE group (7.79 ± 8.62) during the 12 weeks (+7.93 days; p<0.001; ES = 0.945; IC: 3.83 – 12.04). CONCLUSION: Inactive adults receiving a structured PA program attended more days compared to those enjoying ‘free’ exercise, however, overall retention rate was still low for all participants. This pilot data shows the potential benefit of fitness centres providing structured daily programs to enhance retention.