Home Exercise Program In Patients Research Articles

Effectiveness of supervised physiotherapy versus a home exercise program in patients with distal radius fracture: a randomized controlled trial with a 2-year follow-up

ObjectiveTo determine in the long term whether supervised physiotherapy is more effective than a home exercise program for functional improvement and pain relief in patients with distal radius fracture (DRF). DesignRandomized controlled trial. SettingRehabilitation hospital. ParticipantsA total of 74 patients older than 60 years with extra-articular DRF were randomly allocated into two groups. InterventionsThe experimental group received 6 weeks of supervised physiotherapy (n = 37) and the control group received 6 weeks of home exercise program (n = 37). Main outcome measuresThe primary outcome was wrist/hand function assessed using the Patient-Rated Wrist Evaluation (PRWE) questionnaire; secondary outcomes were the pain visual analogue scale (VAS), grip strength and wrist flexion–extension active range of motion. ResultsAll patients completed the trial. For the primary outcome, at 6-weeks and 1-year follow-up, the PRWE questionnaire showed a mean difference between groups of 18.6 (CI 95% 12.8 to 24.3) and 18.5 points (CI 95% 12.7 to 24.2) respectively, these differences are clinically important. Conversely, at 2-year follow-up this effect decreases to 3.3 points (CI 95% −2.4 to 9.0). For secondary outcomes, at 6-weeks and 1-year follow-up, in all measurements the effect size range from medium to large. Conversely, at 2-year follow-up only grip strength showed large effect size in favor of supervised physiotherapy, the rest of outcomes did not show difference between groups. ConclusionAt the 6-week and 1-year follow-up, supervised physiotherapy is more effective for functional improvement and pain relief compared with a home exercise program in patients older than 60 years with extra-articular DRF. However, this effect decreases over time, at the 2-year follow-up, only grip strength showed a difference in favor of supervised physiotherapy. Contribution of the Paper•Current evidence has shown controversial results regarding the effectiveness of supervised physiotherapy versus a home exercise program in elderly patients with DRFs.•At the 6-week and 1-year follow-up, supervised physiotherapy is more effective for functional improvement and pain relief.•However, at the 2-year follow-up, only grip strength showed a difference in favor of supervised physiotherapy in these patients.

Uitbouw van vestibulaire revalidatie in een centrum voor ambulante revalidatie: behandelmethoden en resultaten bij patiënten met een unilaterale vestibulaire hypofunctie

Development of vestibular rehabilitation in an ambulatory care centre: treatment protocol and results in a group of 12 patients with a unilateral vestibular hypofunction Vestibular rehabilitation (VR) is recommended in patients with a unilateral vestibular hypofunction (UVH) or areflexia resulting from inflammatory, traumatic or other aetiologies. In this study, the authors describe the treatment protocol and discuss the results of individually delivered VR in combination with a home exercise programme in patients initiating therapy 2 months or more post-onset of a UVH. Retrospectively, the data were analysed of patients presenting with > 25% hypofunction on caloric irrigation who were referred by an ear, nose and throat (ENT) specialist in the period of January 2021 until January 2023. The patients received individualized therapy sessions of 45 minutes in combination with a home exercise programme. The following outcome measures were used: Dizziness Handicap Inventory (DHI), Functional Gait Assessment (FGA), Foam Stance Eyes Closed (FSEC), Dynamic Visual Acuity Test-Non Instrumented (DVAT-NI) and comfortable gait speed. Twelve patients (9 men and 3 women) with a mean percentual hypofunction of 81% were included (6 right- and 6 left-sided). The study found clinically relevant improvements for DHI and FGA, based on the minimally clinically important difference (MCID) of these tests. The mean DVAT-NI and FSEC scores normalized towards an age-appropriate level. VR leads to clinically relevant changes on different outcome measures in UVH patients. A centre for ambulatory rehabilitation (CAR) where multidisciplinary rehabilitation for people with hearing loss is provided, is a suitable setting to offer VR because of the longstanding cooperation between ENT specialists and physiotherapists. Nevertheless, there are challenges that need consideration when implementing VR into a CAR.

Long-term effects of a home exercise program in patients with acute myocardial infarction and percutaneous coronary intervention: prospective observational study

OBJECTIVE: Our aim was to evaluate the effects of home physical training (HPT) in patients with acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI) in 1 year and the long-term period.
 MATERIALS AND METHODS: A prospective observational study was conducted. Ninety-seven patients after AMI and PCI were included: Group 1 (n=51) patients exercising at home for the next year after PCI (HPT+), and Group 2 (n=46) no exercises (HPT). The evaluation was performed at baseline, in 1 year, and 8.90.9 years. The long-term response rate was 42 patients (82.4%) in the HPT+ group and 36 (78.3%) in the HPT- group.
 RESULTS: Patients in the HPT+ group had significantly higher physical performance at the cycle ergometer exercise test in 1 and 8.90.9 years: exercise time increased by 31.4% (p 0.001) and 40% (p 0.001), respectively, and the load increased by 15.6% (p 0.001) and 32.2% (p 0.001), whereas these indicators did not change significantly in HPT- group. Daily physical activity (PA) increased by 21.9% (p 0.01) in 1 year and 19.6% (p 0.01) in 8.90.9 years in the HPT+ group. PA did not change in the HPT- group in 1 year and decreased by 23.1% (p 0.001) in 8.90.9 years to a low level. The left ventricle ejection fraction in the HPT+ group increased by 2.4% (p 0.05) in 1 year and 6.8% (p 0.05) in 8.90.9 years with no changes in HPT- group. Quality of life increased more significantly in the HPT+ group by 50.6% (p 0.05) in 1 year and 71.6% (p 0.01) in 8.90.9 years versus 25.4% (p 0.05) and 46.9% (p 0.05), respectively, in the HPT- group. In the long-term period, the HPT+ group had fewer adverse clinical outcomes, with 22 patients compared with 28 (52.4 vs 77.8%, p 0.05).
 CONCLUSION: Patients with AMI and PCI who participated in a one-year HPT program had positively affected exercise tolerance, myocardial contractility, QoL, and adverse events in the long-term follow-up period.

The effect of adding whole-body vibration exercises to home exercise program on muscle strength in patients with post-polio syndrome.

Objectives This study aims to understand the effectiveness of whole-body vibration (WBV) exercises performed with home exercise program in patients with post-polio syndrome (PPS) in terms of muscle strength, fatigue, the quality of life, and laboratory parameters. Patients and methods Between October 2015 and March 2016, a total of 14 patients (7 males, 7 females; mean age: 45.1±6.6 years; range, 34 to 57 years) who were diagnosed with PPS were included in the study. The patients were randomized into two groups: the first group received WBV, home exercise program and patient education while the second (control) group received home exercise program and patient education. The patients were evaluated by knee isometric and isokinetic peak torque, Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), Nottingham Health Profile (NHP), serum creatine kinase, aspartate aminotransferase, and alanine aminotransferase at baseline and at the end of the treatment. Results At the end of the treatment, the exercise program administered to the patients was found to be effective in increasing knee muscle strength in PPS patients (p<0.05). This difference was more apparent on the sequela side, isometric extension peak torque in the group with WBV. There was no significant change in the markers of muscle damage or NHP in both groups. Conclusion Inclusion of WBV in home exercise program in PPS patients does not seem to be superior, except for reducing the effect of fatigue on the patient's life.

Scientific critique on the effects of supervised exercise program and home exercise program in patients with systemic sclerosis: A randomized controlled trial

Dear Editor, We read with great interest the article by Yakut et al,1 which focused on comparing the effects of a supervised exercise program and a home-based exercise program in people with systemic sclerosis (SSc). The study concludes that both exercise programs can improve functional capacity and health status in people with SSc. Nevertheless, we remain sceptical about the validity of this study's conclusions, because of the number of important limitations that this study has. First, the study is based on an incomplete literature review. Namely, the authors mention that there is “limited evidence of the effectiveness and safety of exercise in people with SSc”, and that there is “no study that has examined the effects of supervised exercise on aerobic and resistance training”. This is incorrect, as at least our group has published three, open-access papers,2-4 dated between 2018 and 2020, which establish the feasibility and safety of a supervised exercise program consisting of aerobic and resistance training in people with SSc, papers that also hint at elements of effectiveness as well. Second, the study's aim remains generic, exploring the effects of exercise through multiple baseline assessments, rather than focusing on the SSc-specific pathology and the pragmatic needs of people with this clinical condition. Third, the study design itself presents several limitations. (a) The age range is limited to between 35 and 65 years, therefore excluding a significant number of age groups of people with SSc; this raises ethical as well as applicability questions for the current results. (b) The applicability and reliability of the results is challenged further by the absence of a control group. (c) The article notes that the exercise intervention was created based on relevant literature and exercise programs that have been implemented in people with rheumatic and respiratory diseases. However, the included references are not related to any exercise interventions or recommendations of people with rheumatic diseases. We are surprised that your reviewers failed to notice such an important omission. (d) The training intensity, and concomitantly the training dose, both in resistance and aerobic training seems arbitrary with a large deviation of a 30% (eg, 50%-80% of one-repetition maximum; 1RM) and 45% (eg, 40%-85% of heart rate reserve), respectively. This challenges the consistency and replicability of the final outcomes. For example, an individual who would perform a resistance exercise at 50% of 1RM would rest for 2 minutes, questioning the aim, effectiveness, and progression of this resistance protocol, supporting this concern on the basic training principles of resistance training.5 (e) Another concern is in relation to the assessment of progression to greater resistance levels, which was assessed by the individual's ability to perform 12 or more repetitions. Common good practice suggests that in order to track progression based on the repetition there should be a stable resting period and intensity.5 This did not happen in this study, as the implemented resistance protocol (50%-80% of 1RM) suggests. Fourthly, the selection of 20 minutes walking on the treadmill and 10 minutes on the cycle ergometer, totalling 30 minutes of aerobic exercise, has not been substantiated based on physiological responses, disease pathology, and previous literature. The prescribed intensity of 40%-85% indicates that some participants were exercised above the anaerobic threshold (AT) and others were below the AT.6 Different exercise intensities are associated not only with a shift in blood lactate responses but also with changes in ventilation, oxygen uptake kinetics, and catecholamine responses. For example, constant-intensity exercise within the AT is characterized by a continuous increase in ventilation and Vo2, progressive acidosis, and metabolite accumulation, whereas constant-intensity exercise equal to or below the AT is associated with a physiological steady state. Apparently, the physiological responses varied widely between participants, questioning the applicability and replicability of the current results in this clinical condition. Finally, the current study concludes that the supervised exercise training is superior to a home-based exercise programme; nevertheless, these two exercise programmes cannot be balanced (eg, intensity, modality) and therefore are not comparable. To summarize, the current study: (a) has not included recent literature, (b) lacks a clear rationale of specific outcomes, (c) excludes important (for this condition) age groups, (d) does not have a control group, (e) lacks a specific, training dose that could be replicated, and (f) implements exercise programmes that are not comparable concerning the effects of exercise in people with SSc. Therefore, although we encourage future research clinical trials exploring the effects of exercise in people with SSc, aiming to improve their health-related quality of life, we would like to express our concerns on the conclusions, applicability, and replicability of the current study's results.

Effects of supervised exercise program and home exercise program in patients with systemic sclerosis: A randomized controlled trial.

To compare the effects of supervised exercise and home exercise program in patients with systemic sclerosis (SSc). Thirty-seven SSc patients were included. Patients with SSc were allocated into 2 groups as supervised and home exercise. Breathing, aerobic and resistance exercises were performed with a physiotherapist for 12weeks in the supervised exercise group. Breathing, posture and aerobic exercises were given to the home exercise group as a home program for 12weeks. All patients were assessed at baseline and 12weeks later in terms of functional capacity, pulmonary functions, respiratory-peripheral muscle strength, dyspnea severity, health-related quality of life (HRQoL) and fatigue level. Significant improvements were observed in the functional capacity, measured by 6minute walking test in the supervised exercise group (before=376.21±65.50, after=518.78±75.84m) and home exercise group (before=384.44±68.14, after=432.7±70.8m; (P<.05). Respiratory-peripheral muscle strength (with the exception of inspiratory muscle strength and upper limb strength in the home exercise group) and HRQoL were significantly increased and fatigue level was significantly decreased in the supervised exercise and home exercise groups (P<.05). However, pulmonary functions and dyspnea severity were significantly improved only in the supervised exercise group (P<.05). The supervised exercise program was found superior to the home exercise program for change in all parameters (P<.05). This study suggests that exercise interventions should be applied in addition to the medical treatments of patients with SSc as supervised and home exercise programs play an important role in the functionality and health status of these patients.

POS1471-HPR EVALUATION OF THE EFFECTIVENESS OF MOBILE APP-BASED EXERCISES PROGRAMME IN PATIENTS WITH NECK PAIN: THE RANDOMIZED CONTROLLED TRIAL

Background:Mobile health applications are frequently used to increase exercise adherence in patients with musculoskeletal problems. However, the usability of these health mobile applications mostly has not been proven. In our previous study, the usability of the mobile app, which includes postural correction and neck spinal stabilization exercises, has been proven. (M.U-NeckExercise application)Objectives:The aim of this study is to evaluate the effectiveness of the mobile application-based home exercise program for patients with chronic neck pain.Methods:60 people with chronic neck pain were participated in the our study. They were randomized into two groups. The first group (n:30) received home exercises via the novel mobile app, and the second group (n:30) received the same home exercises via the brochure. The exercise program consisted of neck and thoracic postural correction and neck spinal stabilization exercises. Participants has been requested to do the exercises 3 days in a week for 6 weeks. Participants’ pain levels were assessed by using the Visual Analogue Scale (VAS), their neck-related functional limitations were evaluated by Neck Pain and Disability Index (BADI). Exercise adherence was meausered with a ratio of total participated sessions compared with the target defined by patient activation monitor and exercise adherance questionnaire. Targeted participation were %60 of total sessions.Results:In both groups, the improvement in VAS and BADI scores was statistically significant (p&lt;0.05). It was found that the pain parameters of VAS score decreased statistically more in the mobile application-based exercise group (p&lt;0.05). While there was no statistically significant difference between the groups in the BADI score, the effect size results was higher in the mobile app group (effect size= 0.411). Our exercise commitment target in the mobile app group was an average of 10.5 sessions. The target session number has been reached 11.25 sessions.Conclusion:It has been observed that the mobile application-based exercise program is effective in reducing pain and increasing exercise adherence in people with chronic neck pain. The findings support M.U-NeckExercise-App could be recommended to health professionals for exercise prescription in patients with cronic neck pain.

Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial.

Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short- and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short- to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction.

Effectiveness of the Out-Patient Rehabilitation and Home Exercise Program to the Patients with Lumbar Disc Herniation

In scientific literature there are few studies dealing with the effectiveness of home exercise program in patients with low back pain. These issues are very important since the out-patient institutions provide just temporal and short-term physical therapy. Patients having gone through it are left without the supervision of physical therapist and depend only on the effectiveness of home exercise program. There is also lack of studies in which the effectiveness of out-patient treatment and home exercise program is compared. The aim of the study was to assess the effectiveness of the out-patient rehabilitation and home exercise program for patients with lumbar disc herniation. Contingent: there were 60 patients from 20 to 60 years of age (average age 40.7 ± 2.2) investigated, 27 women and 33 men. The patients with strong low back pain had been treated in the Department of Vertebroneurology and in the Department of Physical Medicine and Rehabilitation of Kaunas Clinical Hospital. All the patients were diagnosed with the intervertebral disc herniation, no surgical treatment was applied before. After in-patient rehabilitation one group was pointed to the out-patient rehabilitation (30 patients), the second group participated in home treatment (30 patients, too). This group was called home exercise program group. These patients were motivated to do exercises 14 days, once a day at home and agreed to participate in home rehabilitation program. Home exercise program for these patients was composed. Methods of the investigation: low back pain (using numerical analogue pain scale), the level of functional disability (using RolandMorris questionnaire) and the quality of life (EQ-5D questionnaire) before and after treatment were evaluated.Results: after out-patient rehabilitation, low back pain and functional disability decreased and the quality of life increased more than after home exercise program. Conclusion: 1. After out-patient rehabilitation, low back pain and the level of functional disability decreased and the quality of live increased more than after home exercise program. 2. Home exercise program reduced low back pain and the level of functional disability, but it did not change the quality of life (p &gt; 0.05). Practical recommendation: low back pain, the level of functional disability decreased and quality of life after out-patient rehabilitation improved more in comparison to those patients, who applied home exercise program and it is recommended to continue out-patient rehabilitation after in-patient treatment.Keywords: low back pain, intervertebral disc herniation, out-patient rehabilitation, home exercise program.

The Self-Efficacy for Home Exercise Programs Scale: Development and Psychometric Properties.

The Self-Efficacy for Home Exercise Programs Scale (SEHEPS) was developed to help clinicians evaluate patients' self-efficacy for performing prescribed home exercise programs. Prior to clinical adoption, the scale's psychometric properties need to be examined. To determine the psychometric properties of the SEHEPS. Eighty-one patients (32 men, 49 women; mean ± SD age, 42 ± 17 years) with varying musculoskeletal conditions participated in this cohort study. Patients were given a home exercise program at the initial physical therapy visit and completed the SEHEPS and a modified Self-Efficacy for Exercise (SEE) scale. The SEHEPS is a 12-item patient-reported questionnaire designed to assess self-efficacy for prescribed home exercise. Patients rated their confidence on a 7-point scale that ranged from 0 (not confident) to 6 (very confident). Total scores ranged from 0 (low self-efficacy) to 72 (high self-efficacy). We assessed the internal consistency of the SEHEPS using Cronbach's alpha and its test-retest reliability using an intraclass correlation coefficient. Convergent validity between the SEHEPS and SEE scale was evaluated with a Spearman correlation. High internal consistency (α = .96) and good test-retest reliability (intraclass correlation coefficient = 0.88; SEM, 4; minimal detectable change at the 95% confidence level, 12) were demonstrated. The SEHEPS was strongly correlated with the SEE scale (ρ = 0.83, P<.01), indicating strong convergent validity. The SEHEPS demonstrates excellent internal consistency and convergent validity with the SEE scale. Overall, the SEHEPS is a clinically useful tool to evaluate a patient's self-efficacy in home-based musculoskeletal exercise programs. This scale can be used prior to prescribing a home exercise program for patients with musculoskeletal conditions. Therapy, level 4. J Orthop Sports Phys Ther 2019;49(9):647-655. Epub 10 Jul 2019. doi:10.2519/jospt.2019.8779.

Comparison of virtual reality exergaming and home exercise programs in patients with subacromial impingement syndrome and scapular dyskinesis: Short term effect

ObjectiveThe aim of this study was to compare the short term effects of home exercise program and virtual reality exergaming in patients with subacromial impingement syndrome (SAIS). MethodsA total of 30 patients with SAIS were randomized into two groups which are Home Exercise Program (EX Group) (mean age: 40.6 ± 11.7 years) and Virtual Reality Exergaming Program (WII Group) (mean age: 40.33 ± 13.2 years). Subjects were assessed at the first session, at the end of the treatment (6 weeks) and at 1 month follow-up. The groups were assessed and compared with Visual Analogue Scale (based on rest, activity and night pain), Neer and Hawkins Tests, Scapular Retraction Test (SRT), Scapular Assistance Test (SAT), Lateral Scapular Slide Test (LSST) and shoulder disability (Shoulder Pain and Disability Index (SPADI)). ResultsIntensity of pain was significantly decreased in both groups with the treatment (p < 0.05). The WII Group had significantly better results for all Neer test, SRT and SAT than the EX Group (p < 0.05). ConclusionVirtual reality exergaming programs with these programs were found more effective than home exercise programs at short term in subjects with SAIS. Level of EvidenceLevel I, Therapeutic study.

Compliance and safety of a novel home exercise program for patients with high-grade brain tumors, a prospective observational study.

The purpose of this study is to evaluate compliance with and safety of a novel independent home exercise program for patients with high-grade brain tumors. We designed this program around the preferences and individual capabilities of this population as well as the potential barriers to exercise in cancer patients. Demographics were collected to better understand those that persisted with exercise. Subjects with high-grade brain tumor received one-time training that included watching an exercise video and live demonstration of resistance band exercises, a balance exercise, and recommendations for walking. Subjects were instructed to do the exercises every day for 1month. Main outcome measures were percentage of subjects who exercised throughout the month, frequency of exercising, demographic factors, quality of life scores (assessed by FACT-BR), and self report of adverse events. Fourteen of the 15 (93%) subjects started the exercises during the course of the month. Nine of the fifteen (60%) continued the exercises throughout the month. Three additional subjects would have continued to exercise if formal or supervised rehabilitation had been offered. Among the subjects who continued the exercises regularly, higher frequency of exercising was significantly associated with living as married (p=0.033), annual income >$50,000 (p=0.047), scores of physical well-being (p=0.047), and brain cancer specific well-being (p=0.054) subscales. Among those who exercised frequently, there was also a trend towards increase in total FACT-BR scores (p=0.059). The subjects who scored higher on the social well-being subscale of the FACT-BR at baseline self-reported a higher likelihood to continue the exercises after 1month of participation in the study (p=0.018). No adverse events were reported. Our small group of subjects with high-grade brain tumors demonstrated compliance with and safety of a novel independent strength and balance exercise program in the home setting. Higher frequency of exercising was associated with life quality parameters as well as marriage and income.

Supervised physical therapy vs home exercise program for patients with distal radius fracture: A single-blind randomized clinical study

Study DesignRandomized clinical study. IntroductionSupervised physical therapy (PT) and home exercise programs (HEPs) are frequently used in the rehabilitation of patients with distal radius fracture (DRF). However, there is no consensus as to whether unsupervised HEP provides comparable benefits to those achieved by supervised PT. Purpose of the StudyTo compare the improvements in pain and functional status between a supervised PT program and unsupervised HEP in DRF patients older than 60 years. MethodsA total of 74 patients were randomized into 2 groups. One group received 12 sessions of supervised PT (n = 37), and the other group followed an exercise program at home (n = 37). Three evaluations were performed, before the initiation of treatment, at 6-week, and 6-month follow-up. The study conducted a statistical power analysis to detect an intergroup difference score of 15 points on the Patient-Rated Wrist Evaluation (PRWE). The t-test or Mann-Whitney test was used, and it was set with a significance level of .05. ResultsThe supervised PT group showed clinically significant differences in the total PRWE score at 6 weeks (17.67 points, P = .000) in the PRWE function score (15.2 points, P = .000) and in the PRWE pain score (5.6 points, P = .039). There was also a significant difference in the total PRWE score at 6-month follow-up (17.05 points, P = .000) in the PRWE function score (14.5 points, P = .000) and in the PRWE pain score (2.5 points, P = .35). ConclusionsA supervised PT program is more effective for improving function in the short- and medium-term when compared with HEP in patients older than 60 years with DRF extraarticular without immediate complications. Level of Evidence1b

A randomized comparison of supervised clinical exercise versus a home exercise program in patients with chronic low back pain

Abstract Objective: The purpose of this study was to compare between the effects of clinically supervised exercises and HEP on pain, disability and physical function in patients with chronic low back pain

Feasibility and Safety of a Home Exercise Program for Patients With High Grade Brain Tumors

Feasibility and Safety of a Home Exercise Program for Patients With High Grade Brain Tumors

Intraarticular corticosteroid injection in adhesive capsulitis: are two doses better than a single dose? a randomized prospective study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The present study aimed to compare the effectiveness of a single dose and two doses of intraarticular corticosteroids injections followed by home exercise programme in patients with adhesive capsulitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study was done over two years. Eighty four patients with adhesive capsulitis were enrolled in the study. The patients were randomly assigned to two groups: In group I 38 patients were given a single dose of intraarticular corticosteroid injection (1 mL, 40 mg methylprednisolone acetate) followed by a twelve-week home exercise programme. In group II 46 patients were given two doses of intraarticular corticosteroid injection (1 mL, 40 mg methylprednisolone acetate) at first and third week followed by home exercise programme. All the patients were assed for functional out come at six and twelve weeks using Shoulder pain and disability index (SPADI) and Constant Moore’s shoulder score (CMS).&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Both groups showed considerable improvement from the baseline, but no significant differences were found between the two groups at twelve weeks. Mean changes in range of motion and shoulder pain and disability index–pain score were statistically no different between the two groups at the twelve weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Intraarticular corticosteroids have the additive effect of providing rapid pain relief when combined with home exercise program in adhesive capsulitis. No significant differences in outcome were found in patients treated with a single or two doses of corticosteroid injection.&lt;/p&gt;

The influence of home exercise programs for patients with non-specific or specific neck pain: a systematic review of the literature

Study design: Systematic review of randomized controlled trials (RCT).Objectives: To examine the effects of a therapeutic home exercise program (HEP) for patients with neck pain (associated with whiplash, non-specific, or specific neck pain, with or without radiculopathy, or cervicogenic headache) on pain, function, and disability. Our secondary aim was to describe the design, dosage, and adherence of the prescribed HEPs.Background: Neck pain is a leading cause of disability that affects 22–70% of the population. Different techniques have been found effective for the treatment of neck pain. However, there is conflicting evidence to support the role of a therapeutic HEP to reduce pain, disability, and improve function and quality of life (QOL).Methods: A systematic review in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement for reporting systematic reviews. The full-text review utilized the Maastricht–Amsterdam assessment tool to assess quality among RCTs.Results: A total of 1927 subjects included within seven full-text articles met our specific search strategy. It was found that HEPs with a focus on strength and endurance-training exercises, as well as self- mobilization, have a positive effect when used in combination with other conservative treatments or alone.Conclusions: Home exercise programs that utilize either self-mobilizations within an augmented HEP to address specific spinal levels, or strengthening, and/or endurance exercise are effective at reducing neck pain, function, and disability and improving QOL. The benefit of HEPs in combination with other conservative interventions yields some benefit with a range of effect sizes.

Effect of Home Exercise Program in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis.

The Osteoarthritis Research Society International recommended that nonpharmacological methods include patient education programs, weight reduction, coping strategies, and exercise programs for the management of knee osteoarthritis (OA). However, neither a systematic review nor a meta-analysis has been published regarding the effectiveness of home exercise programs for the management of knee OA. The purpose of this systematic review was to examine the evidence regarding the effect of home exercise programs with and without supervised clinic-based exercises in the management of knee OA. We searched PubMed, CINAHL, Embase, Scopus, and PEDro for research articles published prior to September 2014 using key words such as pain, exercise, home exercise program, rehabilitation, supervised exercise program, and physiotherapy in combination with Medical Subject Headings "Osteoarthritis knee." We selected randomized and case-controlled trials published in English language. To verify the quality of the selected studies, we applied the PEDro Scale. Two evaluators individually selected the studies based on titles, excluding those articles that were not related to the objectives of this review. One evaluator extracted data from the included studies. A second evaluator independently verified extracted data for accuracy. A total of 31 studies were found in the search. Of these, 19 studies met the inclusion criteria and were further analyzed. Seventeen of these 19 studies reached high methodological quality on the PEDro scale. Although the methods and home exercise program interventions varied widely in these studies, most found significant improvements in pain and function in individuals with knee OA. The analysis indicated that both home exercise programs with and without supervised clinic-based exercises were beneficial in the management of knee OA. The large evidence of high-quality trials supports the effectiveness of home exercise programs with and without supervised clinic-based exercises in the rehabilitation of knee OA. In addition, small but growing evidence supports the effectiveness of other types of exercise such as tai chi, balance, and proprioceptive training for individuals with knee OA.

The Effect of a Written and Pictorial Home Exercise Prescription on Adherence for People with Stroke

Background/Objective Functional recovery for stroke survivors begins with rehabilitation. It may not be feasible for therapists to supervise all rehabilitation, especially in the home environment. Therefore, adherence to prescribed exercise programmes is important. The objective of this study was to determine the effect of a written and pictorial home exercise prescription on adherence to a home exercise programme in patients with stroke. Methods This was a randomised controlled trial with a blinded assessor. The control group received a home exercise programme with verbal instructions, while the intervention group received the same home exercise programme with verbal instructions but with additional written and pictorial instructions for the exercises. An exercise logbook was used to monitor adherence. The Modified Rivermead Mobility Index (MRMI) and Barthel Index (BI) were used to establish mobility and activities of daily living. Results There were a total of 42 participants, with 21 in each group; mean age was 60.8 ± 15.5 years. Forty (95%) of the participants had suffered a stroke less than 4 months prior to the study. Both control and intervention groups had similar outcomes: there was no significant difference between groups with regard to functional ability (MRMI, p = .40; Bl, p = .65) and adherence (p = .53). The relationship between functional ability (MRMI and Bl) and the level of adherence for both the control and intervention groups was not statistically significant. Conclusion The addition of a written and pictorial home exercise prescription does not lead to better adherence to a home exercise programme compared to having no written and pictorial instructions. Possible reasons may be that patients had caregivers as a support system, and the exercise logbook served as a reminder and motivational track record for patients. There also does not appear to be a relationship between functional ability and level of adherence, which may be due to most of the study participants being within the optimal time frame for spontaneous functional recovery. Further study at different time frames in stroke rehabilitation in different contexts is recommended.

Predictors of Ambulatory Improvement Following a Home Exercise Program in Patients with Peripheral Artery Disease

PURPOSE: We recently reported the efficacy of home exercise therapy for patients with peripheral artery disease (PAD), which represented new exercise training using a step monitor (NEXT Step). Because the NEXT Step exercise program is less standardized than a center-based, supervised exercise program, more variability in responsiveness to the program and in completing the exercise sessions may exist. Our aim was to determine whether baseline clinical characteristics and both the duration and intensity of exercise training were predictive of the change in 6-minute walk distance (6MWD) at completion of the NEXT Step program in symptomatic patients with PAD. METHODS: Forty-six patients (22 men and 24 women) completed the NEXT Step exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for three months. The primary outcome measure was the 6MWD recorded during a 6-minute walk test. RESULTS: For women, the average cadence of performing the training sessions in the NEXT Step program (35.4 ± 8.4 strides/min) was the strongest predictor variable (R2=0.21, p = 0.022) selected in the multivariate model for change in 6MWD (56 ± 47 m, p< 0.001) at completion of the NEXT Step exercise intervention program. In contrast, for men the ankle/brachial index (0.71± 0.19) was the strongest predictor variable (R2=0.32, p<0.001) for change in 6MWD (42 ± 64 m, p< 0.01). CONCLUSIONS: Faster ambulatory cadence during the NEXT Step exercise program was predictive of greater improvements in 6MWD in women, whereas having less severe PAD was predictive of greater improvements in 6MWD in men. The clinical significance is that home exercise therapy for patients with PAD may be most efficacious in women who train at faster ambulatory cadence and in men who have less severe PAD.