Home-based Exercise Training Program Research Articles

Home-based tele-exercise training and physical activity during the COVID-19 pandemic in chronic kidney disease patients.

The coronavirus disease 2019 (COVID-19) pandemic and lockdown reduced physical activity levels in hemodialysis (HD) patients and kidney transplant recipients (KTRs). This study aimed to describe physical activity levels during lockdown and assess the effects of an online home-based exercise training program on physical activity levels in HD patients and KTRs. Forty-five HD patients and thirty-five KTRs were divided into four groups: exercise groups 1 (ΕΧ-HD) and 2 (EX-KTR) followed a 4-month tele-exercise training program, while control groups received usual care. All participants at baseline and at the end of the study completed the International Physical Activity Questionnaire (IPAQ), while their daily physical activity levels were recorded via a step counting application. At the end of the study, the repeated measures analysis revealed a significant effect of time, group, and time-by-group interaction in the average steps per day, walking, and moderate activity for the exercise-HD group (p < 0.05). Similarly, the analysis revealed a notable effect of time, group, and time-by-group interaction in the exercise-KTR group in average daily steps, vigorous and walking activity (p < 0.05). Multiple regression analysis showed that the level of physical activity at the end of the study was related to the urban place of residence and theparticipation in the 4-month exercise program of both HD patients and KTRs. Participation in a tele-exercise training program led to favorable effects on physical activity levels both in HD patients and KTRsduring lockdown.

A Home-Based Exercise Program With Active Video Games for Balance, Motor Proficiency, Foot and Ankle Ability, and Intrinsic Motivation in Children With Chronic Ankle Instability: Feasibility Randomized Controlled Trial.

Children with chronic ankle instability (CAI) frequently experience ankle unsteadiness, causing trips, falls, and ankle sprain injuries resulting in poor quality of life. A specific exercise program focused on physical and psychological purposes in children with CAI is needed. The purpose of this study was to investigate the feasibility of a 4-week home-based exercise training program using active video games (AVGs) for balance, motor proficiency, foot and ankle ability, and intrinsic motivation in children with CAI. Sixty children with CAI (mean age 10, SD 2 years) were randomly assigned to an experimental group (AVG group; n=30) or a control group (CG; n=30). The AVG group played 2 selected video games, Catching Fish and Russian Block, while the CG received the traditional exercise program for CAI. Both programs were scheduled for 30 minutes per day, 3 times per week, for 4 weeks at home. The single-leg stance test was used to assess static balance. The walking forward on a line and standing long jump tests were used to assess motor proficiency. The Foot and Ankle Ability Measure (FAAM) and the Intrinsic Motivation Inventory questionnaire were used to assess foot and ankle ability and intrinsic motivation, respectively. Assessments were conducted at baseline and after 4 weeks. In the AVG group, the single-leg stand test (eyes open; on floor and on foam conditions), the FAAM (activities of daily living subscale), and intrinsic motivation (interest/enjoyment, pressure/tension, and value/usefulness dimensions) were improved compared with the CG (all P<.05). Motor proficiency did not differ between the 2 groups at the end of the 4-week program (P=.31 for the walking forward on a line, P=.34 for the standing long jump test). A 4-week home-based exercise training program using AVGs can be beneficial and may be an effective approach for improving balance, foot and ankle ability, and enhancing positive motivation by increasing the interest/enjoyment and value/usefulness dimensions and lowering the pressure/tension dimension in children with CAI that require long-term rehabilitation sessions.

The Effects of Pilates Exercise Training Combined with Walking on Cardiorespiratory Fitness, Functional Capacity, and Disease Activity in Patients with Non-Radiologically Confirmed Axial Spondylitis.

The objective of the study was to examine the effects of Pilates exercise training combined with walking on cardiorespiratory fitness, functional capacity, and disease activity in patients with non-radiologically confirmed axial spondylitis (nr-axSpA). Thirty patients with nr-axSpA (seven women (90%), with a mean age of 46.07 ± 10.48 years old and C-reactive protein (CRP) 2.26 ± 2.14 mg/L) were randomly divided into two groups: A (n1 = 15 patients) and B (n2 = 15 patients). Group A followed a 6-month home-based Pilates exercise training program, while Group B remained untrained until the end of the study. A cardiopulmonary exercise test (CPET), timed up and go test (TUG), five times sit-to-stand test (5×STS), sit-and-reach test (SR), back scratch test for the right (BSR) and the left arm (BSL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Ankylosing Spondylitis Disease Activity Score (ASDAS) were applied to all patients, both at the beginning and at the end of the study. After 6 months, Group A showed higher values in exercise time by 37.41% (p = 0.001), higher peak oxygen uptake (VO2peak) by 25.41% (p = 0.01), a higher ratio between oxygen uptake and maximum heart rate (VO2/HRmax) by 14.83% (p = 0.04), and higher SR by 18.70% (p = 0.007), while lower values were observed in TUG by 24.32% (p = 0.001), 5×STS by 12.13% (p = 0.001), BASDAI score by 20.00% (p = 0.04) and ASDAS score by 23.41% (p = 0.03), compared to Group B. Furthermore, linear regression analysis showed a positive correlation in Group A between BASDAI and 5×STS (r = 0.584, p = 0.02), BASDAI and TUG (r = 0.538, p = 0.03), and ASDAS and 5×STS (r = 0.538, p = 0.03), while a negative correlation was found between BASDAI and VO2peak (r = -0.782, p < 0.001), ASDAS and SR (r = -0.548, p = 0.03), and ASDAS and VO2peak (r = -0.659, p = 0.008). To sum up, cardiorespiratory fitness, functional capacity, and disease activity improved after a long-term Pilates exercise training program in patients with nr-axSpA.

Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus.

This randomized clinical trial aimed to examine the effects of a 6-month home-based, combined exercise training program on Cardiac Autonomic Neuropathy (CAN) in kidney transplant recipients (KTRs) with diabetes. Twenty-five KTRs (19 men (76.0%), with a mean age of 54.4 ± 11.3 years old, CAN and type II Diabetes Mellitus (DM-II)), were randomly assigned into two groups: A (n1 = 13 KTRs), who underwent a home-based exercise training program for 6 months, and B (n2 = 12 KTRs), who were assessed at the end of the study. A cardiopulmonary exercise testing (CPET), sit-to-stand test in 30 s (30-s STS), isokinetic muscle strength dynamometry, and 24-h electrocardiographic monitoring were applied to all participants, both at the baseline and at the end of the clinical trial. At first, there were no statistically significant differences between groups. After 6 months, group A showed higher values in exercise time by 8.7% (p = 0.02), VO2peak by 7.3% (p < 0.05), 30-s STS by 12.0% (p < 0.05), upper limb strength by 46.1% (p < 0.05), and lower limb strength by 24.6% (p = 0.02), respectively, compared to the B group. Furthermore, inter-group changes at the end of the 6-month study indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 30.3% (p = 0.01), root mean square of successive differences between normal heartbeats (rMSSD) by 32.0% (p = 0.03), number of pairs of successive NN (R-R) intervals that differ by more than 50 ms (pNN50) by 29.0% (p = 0.04), high frequency (HF (ms2)) by 21.6% (p < 0.05), HF (n.u.) by 48.5% (p = 0.01), and turbulence slope (TS) by 22.5% (p = 0.02), and decreased the low frequency (LF (ms2)) by 13.2% (p = 0.01), LF (n.u.) by 24.9% (p = 0.04), and LF/HF ratio by 24% (p = 0.01), compared to group B. Linear regression analysis after the 6-month study showed that there was a strong positive correlation between VO2peak and SDNN (r = 0.701, p < 0.05) in group A. Moreover, multiple regression analysis showed that KTRs' participation in the exercise program showed favorable modifications to sympathovagal balance and aerobic capacity, as measured with SDNN and VO2peak, respectively. To summarize, diabetic KTRs' cardiac autonomic function and functional capacity can be improved after a home-based long-term exercise training program.

The Edmonton frail scale is a tool to evaluate the effectiveness of cardiac rehabilitation in frail older patients after open cardiac surgery

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Together with the aging population, the part of older frail patients after cardiac surgery is increasing in cardiac rehabilitation (CR) settings. Frailty detection is crucial for choosing appropriate training programs, but according to the literature, there is not enough evidence on what tools should be used to detect frailty and evaluate its dynamics during CR. Purpose To evaluate the effectiveness of CR for older frail patients after open heart surgery using the Edmonton frail scale. Methods A prospective, randomized controlled clinical trial. Inclusion criteria: all patients were admitted to CR after open heart surgery, ≥ 65 years old, within 6-minute walking distance (6-MWD) ≥150 m, Edmonton frailt scale (EFS) score ≥ 4, patient’s agreement to participate in the study. Patients (N=100, 73,3±5,1 years, 17,1±7,4 days post-surgery, 62,0% male)) were randomly allocated for gender assigned (1:1 ration) to intervention or control groups (IG n=50, CG n=50). Both groups participated in exercise training during inpatient-CR. After completing the 20-day rehabilitation program, the intervention group (IG) participated in home-based exercise training that lasted 12 weeks. The home-based exercise training program included four different types of exercise: aerobic endurance training (5/week, 20–60 min) including walking, stair climbing, and cycling of moderate to high intensity; sensomotoric training (3/week, 15 min) including exercises on postural control, dynamic balance, and coordination of moderate to high intensity; resistance training (3/week, 20–25 min) including 4 – 8 exercises at moderate intensity, involving main muscle groups of the legs; flexibility training (3/week, 10–15 min) including isolated type flexibility exercises at low to moderate intensity. Participants of IG were monitored by phone calls every two weeks and the CG were assigned to usual care. Patients were assessed before (T1) and after 20-days inpatient CR (T2) and 12 weeks after completion of CR (T3). Patients' frailty was evaluated between groups and over time by the Edmonton frail scale (frail ≥ 6, prefrail 4-5, robust 0-3). SPSS 22 was used for statistical analysis. The Mann-Whitney U and chi-squared tests were applied to compute p-values for the differences between the groups and periods. Results There were no significant differences in patient characteristics between the groups except that in CG there were more women (p=0,013). As a result of inpatient-CR and home-based exercise training program prevalence of frailty decreased in both groups, but no statistical significance between the groups was observed. (Table 1). Conclusions EFS is a suitable tool to detect frailty and evaluate its dynamic during short-term CR (after 20 days) and medium-term (after 12 weeks) home-based CR programs. The results are encouraging, but probably because of the small sample size and short monitoring time, no significant differences were found between the groups.

Effects of Semisupervised Exercise Training on Health Outcomes in People With Lung or Head and Neck Cancer: Protocol for a Randomized Controlled Trial.

Lung or head and neck cancers are known for their high prevalence and mortality rates. Chemotherapy and radiotherapy are usually recommended as cancer treatment for these malignancies; however, they can negatively impact both the physical and mental status of patients. Hence, it is reasonable to consider resistance and aerobic exercise training to prevent these negative health outcomes. Further, several factors prevent patients from attending outpatient exercise training programs, and, therefore, a semisupervised home-based exercise training program may be seen as a well-accepted alternative. The aim of this study will be to investigate the effects of a semisupervised home-based exercise training program on physical performance, body composition, and self-reported outcomes; changes in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival in people with primary lung or head and neck cancer. Participants will be randomly allocated to the training group (TG) or control group (CG). The TG will undergo semisupervised home-based resistance and aerobic exercise training throughout their cancer treatment. The resistance training will be performed using elastic bands (TheraBand) twice a week. The aerobic training (ie, brisk walk) will be performed for at least 20 minutes per day outdoors. The equipment and tools used during the training sessions will be provided. This intervention will start the week before treatment commencement, will be performed throughout the duration of the treatment, and will continue for 2 weeks after treatment completion. The CG will undergo usual care (ie, cancer treatment with no formal exercise prescription). Assessments will take place 2 weeks before the beginning of the usual cancer treatment and 2 weeks after treatment completion. The measures of physical function (peripheral muscle strength, functional exercise capacity, and physical activity), body composition, and self-reported outcomes (symptoms of anxiety and depression, health-related quality of life, and symptoms related to the disease and treatment) will be collected. We will report on any change in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival. In February 2021, the clinical trial registration was approved. Recruitment and data collection for the trial are ongoing (as of April 2023, 20 participants had already been randomized), and findings of this study are likely to be published late in 2024. This exercise training as a complementary treatment for patients with cancer is likely to promote positive effects on the health outcomes assessed, over and above any change in the CG, and prevent the reduction of initial cancer treatment dose prescribed. If these positive effects are shown, they will likely impact long-term outcomes such as hospitalizations and 12-month survival. Brazilian Clinical Trials Registry (ReBEC) RBR-5cyvzh9; https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9. PRR1-10.2196/43547.

Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial

BackgroundLong-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a...

Effects of Home-Based Exercise Training on Cardiac Autonomic Neuropathy and Metabolic Profile in Diabetic Hemodialysis Patients.

This study aimed to investigate the effects of a home-based exercise training program on Cardiac Autonomic Neuropathy (CAN) and metabolic profile in Diabetic Kidney Disease (DKD) patients undergoing maintenance hemodialysis (HD). Twenty-eight DKD patients undergoing hemodialysis were randomly assigned into two groups. The exercise (EX) group followed a 6-month combined exercise training program at home, while the control (CO) group remained untrained. All participants at baseline and the end of the study underwent cardiopulmonary exercise testing (CPET), biochemical tests for glucose and lipid profile, and 24-h electrocardiographic monitoring for heart rate variability (HRV) analysis and heart rate turbulence (HRT). At the end of the study, compared to the CO, the EX group showed a significant increase in serum high-density lipoprotein (HDL) by 27.7% (p = 0.01), peak oxygen uptake (VO2peak) by 9.3% (p &lt; 0.05), the standard deviation of R-R intervals (SDNN) by 34.3% (p = 0.03), percentage of successive RR intervals higher than 50ms (pNN50) by 51.1% (p = 0.02), turbulence slope (TS) index by 18.4% (p = 0.01), and decrease in (glycated hemoglobin) HbA1c by 12.5% (p = 0.04) and low-frequency power LF (ms2) by 29.7% (p = 0.01). Linear regression analysis after training showed that VO2peak was correlated with SDNN (r = 0.55, p = 0.03) and HF (r = 0.72, p = 0.02). Multiple regression analysis indicated that the improvement of sympathovagal balance and aerobic capacity depended on patients' participation in exercise training. In conclusion, a 6-month home-based mixed-type exercise program can improve cardiac autonomic function and metabolic profile in DKD patients on HD.

Effect of a home-based exercise training program on anthropometric characteristics and exercise performance during Covid-19 quarantine in young high-level kayak athletes.

PurposeThe Covid-19 restriction exposed most athletes to insufficient training stimuli leading to detraining. This study investigated whether a home-based exercise training program could preserve body composition and exercise performance in young high-level kayak athletes during Covid-19 restriction.MethodsSeventeen healthy young high-level kayak athletes (10 males and 7 females), aged 14.7 ± 1 yrs, participated in this study. A 7-week home-based training program was followed during Covid-19 restriction. Baseline measurements were assessed 4 weeks before Covid-19 pandemic and ended on 4 May 2020. Body composition, flexibility, isometric muscle trunk strength (Biodex), anaerobic power (30-s all-out trial), and aerobic capacity (4-min maximal test) were evaluated. Personal daily loads and wellness details were collected with AthleteMonitoring.com software.ResultsHome-based exercise training program was effective to improve flexibility (9.20 ± 2.85%) and lean body mass (3.96 ± 0.89%), to maintain muscle strength, anaerobic power, body mass, and body fat percentage but insufficient to maintain aerobic capacity (− 8.96 ± 2.49%).ConclusionThe findings of the present study potentially highlight the importance of the implementation of such a program to minimize the detraining effect on young athletes during periods of movement restriction caused by pandemics.

Potential benefits of a virtual, home-based combined exercise and mindfulness training program for HSC transplant survivors: a single-arm pilot study

PurposeImpaired quality of life (QOL) including reduced physical fitness is a recognized late effect of hemopoietic cell transplantation (HCT). Guided exercise and mindfulness-based stress management (MBSM) programs have shown promise, mainly in the inpatient setting. We aimed to examine the feasibility of a virtual, home-based, combined exercise and MBSM program.MethodsPatients attending post-HCT clinic were invited to participate in this single-arm pre-post study. Eligibility criteria included age 18–75 years, > 6 months post allogeneic HCT. Consented participants attended an in-person session, followed by weekly exercise and MBSM training for 6 weeks via videoconferencing. Assessments were performed pre-training, and at 3-, 6- and 12-months and compared using a linear mixed effects model.Results21 of 24 patients consenting to the study completed the program (median age 56 years [IQR 46–62], median time post-HCT 37 months [IQR 26–46]). Six-minute walk test scores were significantly higher at 3 (mean difference 79.6, 95%CI 28–131, ES 0.55) and 12 months (mean difference 48.4, 95%CI 13–84, ES 0.33) compared to baseline. Sit-to-stand test was significantly higher at 3 (mean difference 4.4, 95%CI 1.4–7.4, ES 0.68) and 12 months (mean difference 3.9, 95%CI 0.24–7.6, ES 0.61). Dominant hand grip was significantly stronger at 3 (mean difference 0.16, 95%CI 0.04–0.28, ES 0.45), and 12 months (mean difference 0.21, 95%CI 0.08–0.24, ES 0.62). Significantly higher FACT-BMT total (mean difference 6.9, 95%CI 1.5–12.4, ES 0.49) and FACT-G scores (mean difference 5.2, 95%CI 1.4–9.1, ES 0.48) were found at 3 months. Over 80% of participants rated the virtual combined modal program highly and no adverse events were reported.ConclusionA 6-week virtual, home-based exercise and MBSM program was an acceptable, and potentially effective intervention for sustained improvement of some physical capacity and QOL outcomes in HCT survivors. Virtual-based healthcare service is highly relevant particularly during pandemics. To our knowledge, this study has the longest follow-up observation period for Internet based combined modality training program reported to date and warrants additional investigation.Trial Registration Research protocol approved by St Vincent’s Hospital Ethics Committee (HREC 12/SVH/175), approved 27/09/2012, trial commenced 24/05/13 and the first participant 07/06/13. Retrospectively registered with ANZCTR (ACTRN12613001054707) 23/09/2013.

P02-11 Effectiveness and implementation of a long-term home-based exercise training programme using minimal equipment in COPD patients: A multi-centre randomised controlled trial

BackgroundAlthough exercise training is an important component of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD), a majority of COPD patients fails to maintain training after PR. This study aimed to evaluate the effectiveness and implementation of a 12-months home-based, minimal equipment strength exercise programme.MethodsParallel arm, multicentre study across four Swiss PR clinics, random allocation of COPD patients (1:1 ratio) into intervention (IG) or control group (CG, usual care). Primary outcome was change in dyspnoea (Chronic Respiratory Questionnaire, CRQ) from baseline to 12-months, secondary outcomes change in exercise capacity (1-minute-sit-to-stand-test [1-min-STST], 6-minute-walk-test [6MWT]), health-related quality of life, exacerbations and symptoms. Main effectiveness analyses were based on the intention-to-treat approach and adjusted linear regression models were used. To assess the implementation outcomes dose, reach, fidelity, adherence, acceptability and appropriateness, we conducted interviews with patients, coaches and stakeholder and analysed reports, diaries and notes.Results123 patients (IG: 61, CG: 62) were randomised, 61 females, mean (SD) age 66.8 (8.1) years, and 104 participants completed 12-months follow-up (IG: 53, CG: 51). Of 53 IG participants, 37 (70%) conducted the training until study end. We found no difference in change of CRQ dyspnoea over 12 months (adjusted mean difference 0.28, 95% CI -0.23-0.80, p = 0.27). We found moderate evidence for a difference in 1-min-STST repetitions favouring the IG (adjusted mean difference 2.6 (95% CI 0.22-5.03, p = 0.033) but no evidence for an effect in other outcomes.All involved groups perceived the strength-training exercises as appropriate, efficient for COPD patients and relevant to maintain improvements after PR. The patients' most important facilitators for long-term motivation were self-perceived improvement in strength, supervision by a coach and integration of the training in daily routine. Based on these insights, we redesigned and reworded the training material and introduced three new exercises.ConclusionsThe exercise program had no effect on dyspnoea but improved 1-min-STST performance and patient-perceived fitness. The results from the insights of the involved persons enabled us to optimize the program for sustainable further use in clinical and other settings and inform the future design of patient-centred home-based exercise programs in COPD.

Effectiveness of a Long-term Home-Based Exercise Training Program in Patients With COPD After Pulmonary Rehabilitation: A Multicenter Randomized Controlled Trial

Most patients with COPD do not maintain exercise training after pulmonary rehabilitation (PR). Does a 12-month home-based, minimal-equipment strength training program after PR have an effect on dyspnea, exercise capacity, and patient-reported outcomes in patients with COPD? In a parallel-arm multicenter study across four Swiss PR clinics, patients with COPD were allocated randomly (1:1 ratio) into an intervention group (IG; home-based strength training program) or control group (CG; usual care). The primary outcome was change in Chronic Respiratory Questionnaire (CRQ) dyspnea scale score from baseline to 12months. Secondary outcomes were change in exercise capacity (1-min sit-to-stand-test [1MSTST], 6-min walk test [6MWT]), health-related quality of life, exacerbations, and symptoms. We assessed the IG's experience by interviews at study end. Main analyses were based on the intention-to-treat approach, and adjusted linear regression models were used. One hundred twenty-three patients with COPD (IG, n= 61; CG, n= 62) were randomized, 61 of whom were women and whose mean ± SD age was 66.8 ± 8.1 years and mean ± SD FEV1 was 39.3 ± 15.3%predicted. One hundred four participants completed 12months of follow-up (IG, n= 53; CG, n= 51). Of the 53 IG participants, 37 participants (70%) conducted the training until study end. We found no difference in change in CRQ dyspnea scale score over 12months (adjusted mean difference, 0.28; 95%CI, -0.23 to 0.80; P= .27). We found moderate evidence for a difference in 1MSTST repetitions favoring the IG (adjusted mean difference, 2.6; 95%CI, 0.22-5.03; P= .033), but no evidence for an effect in other outcomes. Seventy-nine percent of the IG reported positive effects that they attributed to the training. The home exercise program had no effect on dyspnea, but improved 1MSTST performance and patient-perceived fitness. The supported program was well accepted by patients with COPD and may facilitate continued exercise training at home. ClinicalTrials.gov; No.: NCT03461887; URL: www. gov.

Telehealth high-intensity interval exercise and cardiometabolic health in spinal cord injury

BackgroundThe number of exercise trials examining cardiometabolic outcomes in spinal cord injury (SCI) is low, and prescribed exercise is often inconvenient for individuals with SCI to perform within their community. Individuals with SCI experience a myriad of barriers to exercise participation, which can include a lack of time, accessible or usable equipment and facilities, and transportation. Thus, it is imperative to identify effective modes of exercise that provide the greatest overall health benefits but do not require a significant time commitment. Low-volume high intensity interval training (HIIT) has demonstrated the same improvements in cardiometabolic health as moderate intensity exercise training (MIT), despite only requiring 20% of the total time commitment in adults without disabilities and more recently in individuals with SCI.ObjectivesThe primary purpose of this study is to integrate a 16 week home-based telehealth HIIT arm crank exercise training program in individuals with SCI and assess changes in cardiometabolic health.MethodsMen and women between the ages of 19 and 60 with a confirmed diagnosis of SCI between C7 and T12 will be recruited for this study. Participants will be randomized to 16 weeks of telehealth HIIT exercise two days per week or a no-exercise control group. Aerobic capacity, muscular strength, blood lipids, glucose tolerance, resting energy expenditure, blood pressure, and body composition will be assessed at baseline and 16 weeks post-training.DiscussionInactivity associated with SCI leads to chronic cardiometabolic health conditions. The majority of exercise interventions to date show that exercise is capable of increasing physical function, aerobic capacity, and muscle mass, and strength. Additionally, we have recently shown the ability of HIIT to improve blood lipid and glucose concentrations. Advances in telehealth exercise approaches have improved the capability to prescribe home-based exercise programs. Therefore, we hypothesize that the utilization of a home-based telehealth HIIT program will improve cardiometabolic health markers, yield high adherence (> 75%), and will be more enjoyable in individuals with SCI.Trial registrationTelehealth High-Intensity Interval Exercise and Cardiometabolic Health in Spinal Cord Injury NCT04940598

Metabolic and functional effects of exercise training in diabetic kidney transplant recipients.

BACKGROUNDPhysical activity levels are significantly lower in kidney transplant (KT) recipients compared to the general population. The effects of exercise training in KT recipients with diabetes mellitus remain unclear, and so little is known about the role of increased exercise on cardiovascular risk and metabolic profile of KT patients.AIMTo investigate the effects of a 6-mo home-based exercise training program on functional capacity, glucose levels and lipid profile of diabetic KT patients.METHODSIn total, 21 type II diabetic KT recipients were randomly assigned into two groups: Exercise (n = 11, aged 52.9 ± 10.1 years) and control (n = 10, aged 53.01 ± 9.5 years). All participants at baseline and the end of the study underwent biochemical tests for fasting plasma glucose levels, glycated hemoglobin and lipid profile and cardiopulmonary exercise testing for maximum oxygen uptake [(VO2)peak] estimation. The exercise group followed a 6-mo supervised home-based aerobic and progressive resistance exercise program of moderate intensity 3 times per week, while the control group continued to receive usual care.RESULTSAt the end of the 6-mo study, the exercise group had significantly lower values in fasting plasma glucose by 13.4% (from 120.6 ± 28.9 mg/dL to 104.8 ± 21.9 mg/dL, P = 0.01), glycated hemoglobin by 1.5% (from 6.7% ± 0.4 to 6.6% ± 0.4, P = 0.01) and triglycerides by 8.5% (from 164.7 ± 14.8 mg/dL to 150.8 ± 11.6 mg/dL, P < 0.05) and higher values in high-density lipoprotein by 10.2% (from 51.4 ± 8.8 mg/dL to 57.2 ± 8.7 mg/dL, P < 0.05) and (VO2)peak by 4.7% (from 22.7 ± 3.3 to 23.8 ± 4.2, P = 0.02) than the control group. There were statistically significant differences between the two groups at the end of the study for fasting plasma glucose (decreased by 9.6%, P < 0.05), triglycerides (decreased by 4.5%, P = 0.04) and (VO2)peak (increased by 4.4%, P = 0.01). Finally, after training, there was a moderate, positive linear relationship between (VO2)peak and glycated hemoglobin in the exercise group (r = 0.408, P = 0.03).CONCLUSIONThe results demonstrated that a 6-mo home-based mixed type exercise training program can improve the functional capacity, levels of glucose and lipid profile of diabetic KT recipients.

Effect of a home-based pulmonary rehabilitation program on functional capacity and health-related quality of life in people with interstitial lung disease – A randomized controlled trial protocol

BackgroundCentre-based pulmonary rehabilitation is an effective, non-pharmacological intervention in improving outcomes for people with interstitial lung disease (ILD). Home-based pulmonary rehabilitation (PR) is a lower-cost rehabilitation alternative for people with chronic respiratory diseases. The aims of this study are to evaluate the efficacy of home-based PR on functional capacity and health-related quality of life in people with ILD, as well as to assess changes in dyspnea and fatigue, muscle strength, activities of daily living, depression, and anxiety after completing a home-based PR program. MethodsNinety-six individuals with ILD will be randomly assigned to either an intervention group (home-based PR exercise training program) or a control group (usual care). An assessor blind to group allocation will measure the 6-min walk distance, peripheral muscular strength, health-related quality of life, dyspnoea, anxiety and depression, fatigue, activities of daily living, upper limb and lower limb endurance at baseline, at program completion one month, and three months after the intervention. DiscussionIf home-based PR programs are proven to be beneficial over time, they will address a critical gap by giving a readily accessible and viable choice of rehabilitation to people with ILD, enabling more people to participate in an exercise program.

MO1014: The Effects of a 6-Month Exercise Training Programme on Glycemic Control, Lipid Profile and Functional Capacity of Diabetic Kidney Transplant Recipients

Abstract BACKGROUND AND AIMS The effects of exercise training in kidney transplant (KT) recipients with diabetes mellitus remain unclear [1]. This randomized controlled trial aimed to investigate the effects of a 6-month home-based exercise training programme on functional capacity, glucose levels and lipid profile of diabetic KT patients. METHOD A total of 21 type II diabetic KT recipients were randomly assigned into two groups: exercise (n = 11, aged 52.9 + 10.1 years) and control (n = 10, aged 53.01 + 9.5 years). All participants at baseline and at the end of the study underwent biochemical tests for fasting plasma glucose (FPG) levels, glycated haemoglobin (HbA1c) and lipid profile and cardiopulmonary exercise testing for maximum oxygen uptake (VO2peak) estimation. The exercise group followed a 6-month supervised home-based aerobic and progressive resistance exercise programme of moderate intensity, 3 times/week, while the control group continued to receive usual care. RESULTS At the end of the 6-month study, the exercise group had significantly lower values in FBG by 13.4% (P = .01), HbA1c by 1.5% (P = .01) and triglycerides by 8.5% (P &amp;lt; .05) and higher values in high-density lipoprotein by 10.2% (P &amp;lt; .05) and VO2peak by 4.7% (P = .02) than the control group. Moreover, there were statistically significant differences between the two groups at the end of the study for FBG, triglycerides and VO2peak. Finally, after training there was a moderate, positive linear relationship between VO2peak and HbA1c in the exercise group (r = 0.408, P = .03). CONCLUSION The results of this study demonstrated that a 6-month home-based mixed-type exercise training programme can improve the functional capacity, levels of glucose and lipid profile of diabetic KT recipients.

Feasibility and Efficacy of Telehealth-Based Resistance Exercise Training in Adolescents with Cystic Fibrosis and Glucose Intolerance.

The aims of this study were to (1) determine the feasibility of a home-based resistance exercise training (RET) program in patients with cystic fibrosis and impaired glucose tolerance using virtual personal training and (2) observe the effects completion of the RET program had on glucose metabolism, pulmonary function, body composition, and physical fitness. The feasibility of the program was defined as 80% compliance. Ten participants (15.80 ± 2.20 yr, 25.1 ± 7.4 kg/m2) began a home-based resistance training program consisting of 36 sessions supervised via online videoconferencing. Compliance scores of 78.9% (all participants) and 81.8% (without one outlier) were observed. A significant increase was observed in 2-h C-peptide levels (2.1 ng/mL; p = 0.04), with a moderate decrease in fasting glucose (−5.2 mg/dL; p = 0.11) and a moderate increase in 2-h insulin (35.0 U/mL; p = 0.10). A small decrease in the fat percentage (−1.3%; p = 0.03) was observed in addition to increases in fat-free mass (1.5 kg; p = 0.01) and the fat-free mass index (0.4; p = 0.01). Small, yet statistically significant increases were observed in V̇O2peak (0.1 L/min p = 0.01), V̇CO2peak (0.1 L/min; p = 0.01), and ventilation (5.3 L/min; p = 0.04). Telehealth-based RET is feasible in adolescents with CF and impaired glucose tolerance and elicits small yet favorable changes in insulin secretion, body composition, and exercise capacity.

A home-based exercise program during COVID-19 pandemic: Perceptions and acceptability of juvenile systemic lupus erythematosus and juvenile idiopathic arthritis adolescents.

ObjectivesTo investigate the perceptions and acceptability of a home-based exercise intervention in systemic lupus erythematosus (JSLE) and juvenile idiopathic arthritis (JIA) adolescent patients during the COVID-19 pandemic, and to explore the effects of the intervention on health-related quality of life (HRQoL), sleep quality, and mental health conditions parameters.MethodsThis was a randomized controlled trial of a 12-week, home-based exercise training program conducted between October and December 2020. During this period, social distancing measures were in place in Brazil to contain the spread of COVID-19. Adolescent patients diagnosed with JSLE and JIA participated in the study. Health-related qualitative and quantitative data were collected before and after the follow-up.Results21 JSLE patients and 30 JIA patients were analyzed. Six themes emerged from patients’ feedback: 1) Suitability of the home-based format; 2) Appropriate trainer supervision, 3) Motivators and facilitators for the program; 4) Barriers to the program; 5) Health benefits; 6) Patients’ suggestions to improve the program. Overall, data indicated that the intervention showed good acceptability and elicited improvements in the perceived HRQoL and fatigue in JIA and JSLE patients during the pandemic. However, further quantitative analyses with validated HRQoL, sleep quality, and mental health conditions instruments did not capture these benefits (p>0.05).ConclusionOur main findings based on in-depth qualitative assessments suggest that a home-based exercise training program was suitable and well-accepted by adolescents with JSLE and JIA during the COVID-19 pandemic. Nonetheless, adherence was not high, particularly among JIA patients, suggesting that facilitators and barriers identified in the current study should be explored to improve the quality of new home-based exercise programs implementation, particularly in a future emerging crisis.

Effect of a 12-week home-based exercise training program on aerobic capacity, muscle mass, liver and spleen stiffness, and quality of life in cirrhotic patients: a randomized controlled clinical trial

BackgroundPhysical inactivity and sarcopenia are two important predictors associated with increased morbidity and mortality in patients with cirrhosis. At present, the benefit of a home-based exercise training program is not well established in cirrhotic patients. The main objective of this study was to evaluate the effect of a 12-week home-based exercise training program on aerobic capacity in cirrhotic patients.MethodsThis is a randomized controlled study. Patients with compensated cirrhosis were randomized by a block of 4 with concealed allocation to the home-based exercise training (n = 20) or control (n = 20). Both groups received protein supplementation (9 g/day) for 12 weeks. The home-based exercise training program included several aerobic/isotonic moderate-intensity continuous training exercises for 40 min per session, at least four times a week, with a total duration of 12 weeks. The heart rate was continuously monitored using a Garmin® watch. In the control group, patients received exercise instruction without active encouragement and continuous monitoring. The primary outcome was a change in the 6-min walk test from baseline. Secondary outcomes were the difference in thigh muscle thickness, liver stiffness, spleen stiffness, and quality of life.ResultsA total of 40 patients were enrolled prospectively. The mean age was 56.3 ± 7.8 years, with a male predominance of 65%. The mean body mass index was 25.23 ± 3.0 kg/m2, and all were Child–Pugh A. Chronic hepatitis B or C was the primary cause of cirrhosis. The baseline values were a 6-min walk test of 475 ± 70 m, liver stiffness of 15.3 ± 9.3 kPa, spleen stiffness of 29.8 ± 21.7 kPa, and thigh muscle thickness (average compression index) of 0.64 ± 0.2 cm/m2. All baseline characteristics between the two groups were not different except the mean muscle mass which was significantly higher in the home-based exercise training group (p = 0.03, 95% CI 0.01 to 0.17). At the end of the study, no significant difference in the 6-min walk test was observed (p = 0.36, 95% CI −15.5 to 41.7). Liver stiffness measurement significantly improved in both groups, but no significant difference between groups was demonstrated (p = 0.77, 95% CI −1.3 to 1.8). Thigh muscle thickness was not different between groups. The fatigue domain of the quality of life index was significantly improved in the home-based exercise training group compared with the control group (p = 0.05, 95% CI 0.00 to 0.67). No adverse events occurred in a home-based exercise training program.ConclusionsA 12-week moderate-intensity home-based exercise training program in compensated cirrhotic patients significantly improved the fatigue domain of the quality of life index without an increase in adverse events. However, no benefit in terms of aerobic capacity, thigh muscle mass, liver stiffness, and spleen stiffness was demonstrated.Trial registration: Thai Clinical Trials Registry number TCTR20190926002, 26/09/2019 (Retrospectively registered).

Developing a community-engaged wheelchair exercise program for persons with MS: community advisory board formation and feedback

Purpose Exercise is a safe, evidence-based approach for improving symptoms such as mobility impairment, cognitive dysfunction, and fatigue; however, persons with multiple sclerosis (MS) who use wheelchairs for mobility have been excluded from most research. This paper describes our approach for recruiting ten community advisor board (CAB) members and partnering with them on developing a novel home-based exercise training program for wheelchair users with MS. Materials and Methods The exercise training program, which was developed based on initial qualitative research, includes a progressive exercise prescription, equipment, and one-on-one behavioural coaching based on Social Cognitive Theory. The CAB members convened in groups of five people for five meetings online, using virtual conference software. The CAB meetings each lasted approximately 1-hour and notes were transcribed into digital format for data analyses. Results Content analysis identified elements that aligned with meeting foci (i.e., prescription, equipment, coaching, and outcomes). Feedback was divided into categories to refine the program, specifically modifying, adding, or retaining content and/or activities. CAB member feedback was very positive and emphasised potential additions to the materials presented. The research team proposed implementing modifications based on the CAB member feedback such as adding wrist weights to the equipment options for completing resistance training exercises. Conclusions The overall CAB feedback was invaluable for assessing the appropriateness of the proposed exercise training program before initiating feasibility testing. This report provides a model and guidance for researchers who seek community-engaged research approaches in creating products and interventions. Implication for Rehabilitation Community advisory board participation was invaluable in creating and modifying a novel exercise training programmes for wheelchair users with multiple sclerosis (MS). The current study provides a framework for the creation of exercise interventions for subpopulations of persons with MS that may provide substantial rehabilitation benefits such as improved symptoms and quality of life. Health behaviour interventists targeting individuals with disabilities may consider the benefits of recruiting stakeholders from the community in creation of novel programmes.