Supervised Exercise Group Research Articles

Health-related outcomes with supervised exercise and myofascial release versus only supervised exercise in subacromial pain syndrome: a randomized controlled single-blind study

BackgroundMyofascial tissue plays a critical role in shoulder joint mobility disorders. Myofascial release therapy (MFR) is frequently utilized to restore the extensibility of fascial tissue and is considered beneficial for various clinical conditions such as low back pain and ankle injuries. However, no studies have yet evaluated the effects of MFR on periscapular muscles activation and shoulder mobility in patients with subacromial pain syndrome(SAPS).ObjectiveThe purpose of this study was to compare the effectiveness of MFR combined with supervised exercise(SE) and SE alone in patients with SAPS.DesignAssessor-blinded randomized controlled trial.SettingSir Run Run Shaw Hospital, Zhejiang University School of Medicine.SubjectsSubacromial pain syndrome patients.MethodsFifty participants were divided into two groups: SE group and MFR + SE group, each group 25 cases. Both treatment methods were performed 5 times a week for 4 weeks.Main measuresShoulder pain severity was assessed by visual analog scale (VAS); shoulder range of motion (ROM) by a goniometer; functionality by shoulder Pain and Disability Index (SPADI); and periscapular muscles activation by sEMG. All measurements were evaluated both pre- and post-treatment.ResultsAn ANOVA analysis indicated no significant group by time interactions for flexion ROM and resting VAS (p > 0.05). However, significant group by time interactions were found for SPADI, abduction and external rotation ROM, and activity VAS (p < 0.05). Post-hoc tests revealed significant improvements in SPADI, abduction and external rotation ROM, and activity VAS in both groups compared to pre-treatment (p < 0.05). Additionally, there were significant group by time interactions for the sEMG values of the upper trapezius and serratus anterior (p < 0.05). Post-hoc tests showed that compared to pre-treatment, the MFR + SE group had decreased upper trapezius sEMG values and increased serratus anterior sEMG values(p < 0.05), while the SE group showed increased serratus anterior sEMG values(p < 0.05). After the 4-week intervention, there were significant between-group differences in SPADI, abduction and external rotation ROM, activity VAS, and sEMG values of the upper trapezius and serratus anterior(p < 0.05).ConclusionFour weeks of MFR combined with SE can increase shoulder ROM, improve pain, and thus enhancing functional activities in patients with SAPS. Additionally, it can further improve the balance between the upper trapezius and serratus anterior to improve the dynamics of the periscapular muscles.Trial registry numberChiCTR2200061054. Date of registration 15/06/2022.

Time-restricted eating and supervised exercise for improving hepatic steatosis and cardiometabolic health in adults with obesity: protocol for the TEMPUS randomised controlled trial

IntroductionMetabolic dysfunction-associated steatotic liver disease is a major public health problem considering its high prevalence and its strong association with extrahepatic diseases. Implementing strategies based on an intermittent fasting approach...

COST ANALYSIS OF MOBILE TECHNOLOGY AND SUPERVISED EXERCISE TRAINING IN TYPE 2 DIABETES MELLITUS

Amaç: Bu araştırmanın amacı, Tip-2 Diabetes Mellituslu (T2DM) kişilerin gözetimli egzersiz, akıllı telefon uygulaması ve akıllı saat kullanarak yaptıkları 12 haftalık egzersiz takibinin yapıldığı randomize kontrollü klinik çalışmanın maliyet analizinin yapılmasıdır.&#x0D; Yöntem: Denetimli egzersiz, akıllı telefon uygulaması ve akıllı saat yoluyla 12 hafta boyunca egzersiz uygulanan üç farklı T2DM grubu için Sosyal Sigortalar Kurumu tarafından yapılan ödemeler belirlenerek bütçe etkisi hesaplanmış ve maliyet etkinliği toplumsal bakış açısıyla hesaplanmıştır.&#x0D; Sonuç: Türk Lirası (TL) başına Kaliteye Ayarlanmış Yaşam Yıl (KAYY) değerleri denetimli egzersiz grubunda 14.863 TL; akıllı telefon uygulama grubunda 6056 TL, akıllı saat grubunda 7379 TL olarak bulundu. Maliyet etkinliği en yüksek olan yöntemin akıllı telefonla egzersiz uygulama yöntemi olduğu belirlendi. Maliyet analizinde KAYY değerlerindeki değişim denetimli egzersiz grubunda 0,11; akıllı telefon uygulama grubunda 0,12 ve akıllı saat grubunda 0,11 olarak hesaplandı.&#x0D; Tartışma: Maliyet etkinliği akıllı telefon uygulama grubunda yüksek, mobil uygulamalar grubunda orta ve denetimli egzersiz grubunda en düşük olup çalışmanın sonuçları literatür ile benzerlik göstermektedir.

Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis.

Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. Some studies show positive effects on PPD symptoms, while others find limited impact, suggesting various factors at play, such as exercise type, intensity, and individual differences. To address this gap, our study aims to comprehensively gather evidence on the preventive and therapeutic effects of aerobic exercise for PPD. We'll focus on differences in exercise program design and implementation, exploring how these factors impact intervention outcomes. By identifying effective exercise approaches, we aim to provide more comprehensive exercise prescription recommendations for this vulnerable population. We conducted a quantitative systematic review of the study in 5 representative databases for the effect of aerobic exercise on PPD. Meta-analysis and network meta-analysis were performed with Review-Manager.5.4 and Stata.16.0 software, respectively. This study has been registered on the official Prospero website, and the registration code is CRD42023398221. Twenty-six studies with 2,867 participants were eventually included and the efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care. (MD = -1.90; 95%CL: -2.58 to -1.21; I2 = 86%). Subgroup analysis suggests that the intervention objective (prevention vs. treatment) of exercise could potentially be a source of heterogeneity in this study, as the "Test for subgroup difference" revealed the presence of significant distinctions (p = 0.02<0.05). The "Test for subgroup difference" yielded non-significant results for both the supervised vs. unsupervised subgroup comparison (p = 0.55 > 0.05) and the individual vs. team subgroup comparison (p = 0.78 > 0.05). Nonetheless, when assessing their effect sizes [Subtotal (95%CL)], the supervised exercise group [-1.66 (-2.48, -0.85)] exhibited a slightly better performance than the unsupervised exercise group [-1.37 (-1.86, -0.88)], while the team exercise group [-1.43 (-1.94, -0.93)] slightly outperformed the individual exercise group [-1.28 (-2.23, -0.33)]. Network meta-analysis indicated that moderate intensity (35~45 min) group demonstrated a more pronounced intervention effect compared to low intensity (50~60 min) group [-2.63 (-4.05, -1.21)] and high intensity (20~30 min) group [-2.96 (-4.51, -1.41)], while the 3~4 times/week group had a more significant intervention effect compared to 1~2 times/week groups [-2.91 (-3.99, -1.83)] and 5~6 times/week groups [-3.28 (-4.75, -1.81)]. No significant differences were observed in pairwise comparisons of intervention effects among the five common types of aerobic exercises. (95%CL including 0). The Surface Under the Cumulative Ranking curve (SUCRA) results align with the findings mentioned above and will not be reiterated here. The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention. The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). Currently, several uncharted internal factors influence the optimal intervention effect of aerobic exercise, such as the potential enhancement brought by team-based and supervised exercise. Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.

Six-month effects of supervised exercise on walking ability and health-related factors in peripheral arterial disease: a pilot study.

In peripheral arterial disease (PAD) patients with intermittent claudication (IC), the combination of aerobic and resistance exercises could counteract muscle loss and attenuate disease progression. This study analyzed the effects of six months of a combined exercise program on walking ability, lower limb body composition, cardiovascular risk factors, and Ankle-Brachial Index (ABI). Twenty-three patients (age 63.2±1.5 years and ABI 0.58±0.07) with PAD and IC were allocated to a control group (CG) or a supervised exercise group (SUP). Ten patients underwent six months of treadmill walking combined with resistance exercises, three times a week. The CG (N.=13) received a recommendation for walking. All patients were measured at baseline (M0), after three months (M3), and six months (M6). During constant treadmill protocol, the claudication onset time/distance (COT/COD), absolute claudication time/distance (ACT/ACD), and number of pauses of overall patients significantly improved at M3 and M6. Between groups were found significant differences in COT and COD at M6 (P=0.005 and P=0.007, respectively); and in ACT and ACD at M3 (P=0.003 for both) and at M6 (P=0.005 and P=0.005, respectively), with major improvements in the SUP. Over the six months, a significant group effect was found in fat-free mass (P=0.041) and predicted muscle mass (P=0.039) of the lower ABI leg, with greater improvements in the SUP. A supervised exercise program that combines aerobic and resistance training improves PAD symptoms and has additional benefits for patients. Patients in the program showed improvements in walking ability, lower-limb body composition, perceived exertion, and heart rate during treadmill walking.

As we were and as we Should Be, Combined Exercise Training in Adults with Schizophrenia: CORTEX-SP Study Part I.

Given the health benefits and the role of exercise as an anti-inflammatory adjuvant program, this study aimed to determine the effectiveness of a combined exercise program on cardiorespiratory fitness (CRF), body composition, and biochemical levels in adults with schizophrenia (SZ) characterized at baseline as metabolically unhealthy overweight with low CRF. Participants diagnosed with SZ (n = 112, 41.3 ± 10.4 yr, 28.7% women) were randomly assigned into a Treatment-As-Usual (TAU) control group (n = 53) or a supervised exercise group (n = 59, 3 days/week). Each combined exercise session consisted of both a low-volume high-intensity interval training (less than 10 min of high-intensity time per session) and a resistance circuit-training program. All variables were assessed pre-and post-intervention (20 weeks). For the assessment of CRF, a peak cardiopulmonary exercise test on a cycle ergometer was used. Following the intervention, participants from the exercise group (n = 51) showed increases in CRF (P < 0.001) through peak oxygen uptake (L·min-1; Δ = 17.6%; mL·kg.1·min-1, Δ = 19.6%) and the metabolic equivalent of task (Δ = 19%), with no significant changes (P > 0.05) in body composition and biochemical variables. However, the TAU group (n = 38) did not show any significant change in the study variables (P > 0.05). Between-group significant differences (P ≤ 0.05) were observed in CRF, first ventilatory threshold, and heart rate peak after the intervention period favoring the exercise group. This study demonstrated that a supervised combined exercise program in people with SZ helps to maintain body composition values and improve CRF levels. This could lead to an important clinical change in the characterization from metabolically unhealthy overweight to a metabolically healthy overweight population. Hence, exercise should be considered a co-adjuvant program in the treatment of the SZ population.

The effect of a supervised online group exercise program on symptoms associated with patellofemoral pain syndrome in women.

Patellofemoral pain syndrome (PFPS) is one of the musculoskeletal system pathologies frequently encountered especially in women. The aim of the current study was to compare the efficacy of an online exercise program with a home exercise program including the same exercises, and a control group planned for females with PFPS. The study included 60 females with PFPS aged 33.17 ± 6.84. Participants were randomly divided into 3 groups. One of the groups was given a 6-week home program consisting of evidence-based exercises. Exercises consisting of the same exercises were supervised online to another group. The third group did not receive any intervention. Pain, knee joint range of motion, muscle strength in flexion and extension and hip posterolateral muscle group, patellofemoral joint functionality, quality of life, recurrence of injury and fear of movement were measured at preintervention and postintervention. Participation in the online supervised exercise group was seen to result in a greater decrease in pain during activity and kinesiophobia, and a greater increase in the quality of life mental health sub-dimension compared to the home exercise group. Online supervised exercise groups could be an alternative telerehabilitation method for exercise programs established for women with PFPS.

Efficacy and acceptability of supervised group exercise for mild to moderate major depressive disorder: A feasibility study

BackgroundExercise can efficiently reduce the symptoms of major depression disorder (MDD). This study aims to examine the efficacy and acceptability of supervised group exercise intervention among patients in an acute phase of mild to moderate MDD. MethodsWe enrolled patients in the psychiatric clinic of Beijing Anding Hospital affiliated to Capital Medical University in a prospective, single-arm objective performance criteria (OPC) trial. A total of 40 adults aged 18–50 who had a diagnosis of an episode of depression and the 17-item Hamilton Rating Scale for Depression (HRSD-17) score of 7–20 were recruited. Supervised exercise group intervention was applied on participants with a new episode of mild to moderate depression 3 times a week for 8 weeks without any other treatment. Every exercise session should meet the standard of moderate intensity, defined as approximately equal to 50 %–80 % of the maximal heart rate for 150 min every week. The primary end point was the clinical response at week 8, defined as a 50 % reduction in the baseline HRSD-17 score. Meanwhile, the secondary end points included the acceptability of the supervised group exercise intervention for both patients and investigators, remission rate (defined as an HRSD-17 score of 7 or less), the change of Patient Health Questionnaire (PHQ-9) and the Quality of Life, Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). ResultsAmong the 46 screened patients, 40 were enrolled. Of them, 4 people dropped out, while 36 received all the planned sessions of the supervised group exercise therapy and completed the week-8 assessment. At week 8, the response rate was 89 % (95 % confidence interval [CI] 74 % to 97 %) and the remission rate was 83 % (95%CI 67 % to 94 %). The overall acceptance of the supervised group exercise based on the VAS score (range 0–10) was 9.19 ± 1.27 for patients and 9.67 ± 0.62 for investigators. The least-squares mean (±SE) change from baseline at week 8 was-9.99 in the PHQ-9 score and 25.15 in the Q-LES-Q-SF score. No serious adverse events were reported during this trial. The percentage of any adverse event was 5 %. ConclusionSupervised group exercise intervention is effective in patients with acute mild to moderate MDD and has good acceptance rate among both patients and investigators.

Hippocampal neurochemicals are associated with exercise group and intensity, psychological health, and general cognition in older adults

Based on the premise that physical activity/exercise impacts hippocampal structure and function, we investigated if hippocampal metabolites for neuronal viability and cell membrane density (i.e., N-acetyl aspartate (NAA), choline (Cho), creatine (Cr)) were higher in older adults performing supervised exercise compared to following national physical activity guidelines. Sixty-three participants (75.3 ± 1.9 years after 3 years of intervention) recruited from the Generation 100 study (NCT01666340_date:08.16.2012) were randomized into a supervised exercise group (SEG) performing twice weekly moderate- to high-intensity training, and a control group (CG) following national physical activity guidelines of ≥ 30-min moderate physical activity ≥ 5 days/week. Hippocampal body and head volumes and NAA, Cho, and Cr levels were acquired at 3T with magnetic resonance imaging and spectroscopic imaging. Sociodemographic data, peak oxygen uptake (VO2peak), exercise characteristics, psychological health, and cognition were recorded. General linear models were used to assess group differences and associations corrected for age, sex, education, and hippocampal volume. Both groups adhered to their training, where SEG trained at higher intensity. SEG had significantly lower NAA/Cr in hippocampal body than CG (p = 0.04). Across participants, higher training intensity was associated with lower Cho/Cr in hippocampal body (p < 0.001). Change in VO2peak, increasing VO2peak from baseline to 3 years, or VO2peak at 3 years were not associated with hippocampal neurochemicals. Lower NAA/Cr in hippocampal body was associated with poorer psychological health and slightly higher cognitive scores. Thus, following the national physical activity guidelines and not training at the highest intensity level were associated with the best neurochemical profile in the hippocampus at 3 years.

Effectiveness of different behavioral interventions on gestational weight gain, post-partum weight retention and anthropometric measures in pregnancy: A randomized controlled trial.

Background: The antenatal and postnatal periods are critical stages in a woman's reproductive life. Many physical changes occur during pregnancy, such as water retention and excessive weight gain. The aim of the present study is to find out the effectiveness of various behavioral interventions during pregnancy to prevent excessive gestational weight gain (GWG) and postpartum weight retention (PPWR). Methods: In this parallel-group randomized controlled trial, 150 pregnant women with singleton pregnancy, aged 20-30 years, body mass index (BMI)≥18.5 kg/m2 and gestational age of less than 16 weeks were randomly allocated into five groups (N=30 in each group): Group A: Control; Group B: Supervised exercise; Group C: Pedometer; Group D: Text message; and Group E: Pedometer plus text message group. Group B received four supervised exercise sessions per month up to delivery; Groups C and E were urged to increase their levels of physical activity, focusing on pedometer-measured step counts of at least 5000-7500 steps per day on seven consecutive days each month. Group E along with group D also received standard SMS messages about physical activity, diet, motivation, and educational-specific topics. Results: The between-group comparisons revealed a statistically significant reduction in PPWR but insignificant difference in GWG. The greatest reduction in PPWR was found in the supervised exercise group (MD=3.25 kg, 95% CI: [1.75, 4.75], P=0.0001 with effect size (η2 )=0.155). Conclusion: The study found that the supervised exercise can be seen as an effective way of improving the physical activity level and reducing excessive PPWR in pregnant women.

Outcomes following supervised exercise and home-based exercise for patients with intermittent claudication

Intermittent claudication (IC) is the most common symptom of peripheral arterial disease (PAD) which presents as a consequence of muscle ischaemia resulting from the atherosclerotic obstruction to arterial flow. High-quality evidence (Lane etal., 2017) shows that exercise programmes provide important benefits compared with usual care in improving pain-free and maximum walking distance in people with IC, but do not improve ankle-brachial pressure index (ABPI). Retrospective data were analysed to examine walking and ABPI outcomes for participants who completed a 12-week course of supervised or home-based exercise. All participants had a history of IC. 46 participants (mean age 69±11 years; 76% male; 29% current smokers) referred for exercise were assessed, completed a 12-week course of exercise (home-based or supervised) and subsequently attended for re-assessment. Claudication onset distance (COD) increased by 363% (mean improvement 344.7±265.1m; p<.001) and peak walking distance (PWD) by 324.4% in the supervised exercise group; COD increased by 30.6% (mean improvement 32.8±57.2m; p=0.026) and PWD by 31.5% in the home-based exercise group. Resting ABPI for the total cohort significantly improved from 0.82±0.25 at A1 to 0.88±0.25 at A2 (p=0.027). A 12-week course of supervised exercise results in significantly greater walking distance outcomes (COD and PWD) than unmonitored home-based exercise. In contrast with previous findings (Lane etal. 2017), this retrospective study demonstrated a significant improvement in resting ABPI with both supervised exercise as well as home-based exercise. A 12-week programme of exercise favourably influenced walking and ABPI outcomes for patients with IC. Both home-based exercise and supervised individualised exercise increased walking distances, but the magnitude of the improvement in walking outcomes was greater in individuals who attended supervised exercise therapy.

Effects of concurrent training on cardiorespiratory fitness and body composition in adults with schizophrenia: CORTEX-SP study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Economy and Competitiveness “Fondo de Investigación Sanitaria del Insti-tuto de Salud Carlos III” Background Concurrent training (i.e. a combination of aerobic and resistance exercise in the same session) is emerging as a time-efficient exercise strategy for improving cardiorespiratory fitness and controlling body composition parameters. Purpose The purpose of this study was to determine the effectiveness of a concurrent exercise program on cardiorespiratory fitness and body composition in adults with schizophrenia (SP). Methods Participants (n=98, 20.4% women, 41.4±10.1 yr old) with SP were randomly assigned into an attention control group (usual care) or a supervised exercise group (concurrent training, 3 days/week). All variables were assessed pre- and post-intervention (20 weeks). For the assessment of cardiorespiratory fitness, a peak cardiopulmonary exercise test on a cycle ergometer and the Modified Shuttle Walk Test (MSWT) were used. Results Following the intervention, in the control group, there was a significant (P &amp;lt;0.05) increased in body mass (Δ = 2.54%), body mass index, BMI (Δ = 2.82%), waist circumference (Δ = 2.70%) and a decreased in MSWT (Δ = - 7.54%). However, in the exercise group, there was a significant (P&amp;lt;0.001) increased in first ventilatory threshold, VT1 (Δ = 28.69%), peak oxygen uptake, V̇O2peak (L∙min-1) (Δ = 19.58%), V̇O2peak (mL∙kg.1∙min-1) (Δ = 21.52%) and MSWT-distance (Δ = 11.43%), with no significant changes in body composition (P&amp;gt;0.05). When both groups were compared, body mass, and BMI was significantly (P&amp;lt;0.05) more reduced, and VT1, V̇O2peak, and MSWT more increased in the exercise group. Conclusion A supervised concurrent exercise program in people with SP helps to maintain body composition values and leads to improvements in cardiorespiratory fitness levels. Exercise should be considered as a co-adjuvant program in the treatment of population with SP.

Cardiovascular risk scores and vascular age before and after concurrent exercise training in adults with schizophrenia: CORTEX-SP study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Economy and Competitiveness “Fondo de Investigación Sanitaria del Insti-tuto de Salud Carlos III” Background Individuals with schizophrenia (SP) have a greater risk for cardiometabolic risk factors, cardiovascular diseases and mortality. This risky profile may be explained by the adverse effects of antipsychotic medications and an unhealthy lifestyle (i.e., low physical activity, smoking and poor diet). In the general population, physical activity has been shown to be the optimal strategy to improve both cardiometabolic parameters and cardiorespiratory fitness levels. These findings strongly suggest that targeting a comprehensive approach that includes non-pharmacological interventions, such as exercise and/or cognitive rehabilitation, could be effective and beneficial in the evolution of the disease. Purpose To estimate cardiovascular risk factors (CVR) and vascular age (VA) profiles before and after a concurrent exercise training intervention in adults with schizophrenia. Methods Participants (n=97, 20.4% women, 41.3±10.0 yr old) with SP had their CVR and VA determined using the SCORE2, relative risk and the Framingham method (FHS). The participants were randomly assigned into a control group (usual care) or a supervised exercise group (concurrent training, 3 days/week, 20-weeks). The variables for the CVR determination were: age, systolic blood pressure (SBP), total cholesterol (TC), non high-density lipoprotein (non HDL-C) cholesterol, HDL-C, diabetes mellitus, antihypertensive medication, and smoking status. Results At baseline, exercise group presented lower values (P&amp;lt;0.05) compared to control group in SBP (113.4 vs. 120.5 mmHg), whereas in the rest of the values no significant between-groups differences were found (P&amp;gt;0.05). In accordance with guidelines on cardiovascular disease prevention, considering SCORE2, both groups were classified as low risk; but taking into account FHS and relative chart, were considered to have moderate risk. At follow-up, there was no overall change for either group and between groups in the magnitude of change in any of the studied variables. Conclusion(s) People with SP presented a moderate CVR. A comprehensive approach including not only exercise but also nutrition intervention could be more effective in managing CVR in this population.

Minimal clinically important differences in daily physical activity outcomes following supervised and home-based exercise in peripheral artery disease.

Introduction: We estimated minimal clinically important differences (MCID) for small, moderate, and large changes in daily step counts and time spent in moderate-to-vigorous physical activity (MVPA) following both supervised and home-based exercise programs in symptomatic patients with peripheral artery disease (PAD). Methods: Patients were randomized to either 12 weeks of a supervised exercise program (n = 60), a home-based exercise program (n = 60), or an attention-control group (n = 60). Results: Using the anchor-based method to determine MCID, the MCID value for a large change in health-related quality of life (HRQoL) was an increase of 1211 total daily steps and an increase in 11 minutes in the time spent in MVPA following 12 weeks of exercise intervention. Using the distribution-based method, the MCID values for small, moderate, and large changes in total daily steps in the home-based exercise group were 558, 1396, and 2233 steps/d, respectively, and the corresponding changes in the time spent in MVPA were 6, 15, and 23 minutes. Similar distribution-based MCID scores were noted for the supervised exercise group. Conclusion: Following 3 months of home-based and supervised exercise programs for patients with PAD and claudication, increases of 11 minutes in time spent in MVPA and 1211 total daily steps were associated with large anchor-based MCID increases in HRQoL. The clinical implication is that patients with PAD and claudication should be encouraged to increase daily steps, particularly by walking an additional 11 minutes each day in MVPA, which is associated with a large meaningful increase in HRQoL.

Can Home Exercise Programs Be a Low-Cost Alternative to Multiple Sclerosis Treatment?

Aim: In this study, we aimed to compare the effect of aerobic exercise programs on patients with Multiple Sclerosis (MS) and healthy controls, and to show that home exercise programs can be as effective as supervised exercise programs. Materials and Methods: Eighty participants were included in this study and were divided into groups as the home-exercise group (outpatient), supervised exercise group (inpatient), and healthy controls. A 6-weeks aerobic exercise program was given to all participants. Before and after the exercise program, 6-minute Walking Test (6MWT), Fatigue Severity Scale (FSS), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), Extended Disability Scale (EDSS), Cardiopulmonary Exercise Test (CPET), and MS Quality of Life (MSQoL-54) were applied to participants. Results: When 6MWT and CPET data were evaluated, it was observed that the patient and control groups benefited from the exercise program. There was a significant improvement after treatment in the 6MWT, BBS, FSS, MSQoL-54, and KPET data of both the outpatient and inpatient groups, and there was no difference between the groups when the rates of change were compared. Conclusion: We have observed that the home-based exercise program is as effective as the supervised exercise program. We think that the home program should be recommended first when planning the exercise program in PwMS in terms of cost, effectiveness, and accessibility.

Comparison of the functional and cardiovascular effects of home-based versus supervised hospital circuit training exercises in male wheelchair users with chronic paraplegia.

Objectives The aim of this study was to compare the efficacy of home-based upper extremity circuit training exercises (CTEs) with supervised hospital program in male patients with traumatic complete paraplegia. Patients and methods Twenty men with paraplegia (mean age: 38±10.1 years; range, 30 to 43 years) between January 2007 and November 2007 were randomized into two groups. The first group had supervised hospital CTE program, whereas the second group had home-based CTE. The effects of the upper extremity CTE by using elastic bands 60 min per day, five days a week, for a total of eight weeks (70% maximal oxygen consumption [VO2max]) were examined. The Cybex was used for the isokinetic testing of the upper extremities. The VO2max and maximum heart rate (HR) were assessed using an arm ergometer. The Craig Handicap Report Technique Short Form (CHART-SF) was used for the evaluation of functional independence and mobility. Serum lipid profiles were measured. Results The mean injury duration was 7.9±2 years. The peak torque values of the upper extremities, VO2max, maximum HR, CHART-SF physical independence and mobility scores, and serum lipid profile were all improved in both groups (p<0.05). There were no significant differences in terms of the increase in the muscle strength and serum lipid levels between the groups (p>0.05). The improvement in the VO2max, physical independence, and mobility scores were greater in the supervised exercise group. Conclusion Upper extremity strength, cardiovascular endurance, and lipid profile were improved after supervised and home-based CTE in the men with paraplegia. Home-based exercise programs may be good alternatives to the hospital rehabilitation for this patient population.

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.

Supervised exercises versus telerehabilitation. Benefits for persons with multiple sclerosis.

The purpose of this study was to investigate the effectiveness of structured telerehabilitation on fatigue, health status, quality of life (QoL), and activities of daily living (ADL) and compare the possible effects with structured supervised exercise programs in patients with Multiple Sclerosis. This study was a randomized, single-blind trial. Thirty patients with relapsing-remitting Multiple Sclerosis were included in the study and randomly divided into two groups; structured supervised exercise group (Group 1) and telerehabilitation group (Group 2). Group 1 (n=15) completed a 12week structured supervised exercise program. Group 2 (n=15) completed a 12week structured home-based exercise program. Patients were evaluated with functional independence measure (FIM), first section of Nottingham Health Profile (NHP-I), fatigue severity scale (FSS), and quality of life scale (QoLS) before and after the intervention. Significant differences were found in all parameters in both groups after the treatment (p<.05). No significant difference was found between groups regarding FIM-total, FIM-motor, FIM-cognitive, NHP sub-parameters, and QoLS (p>.05). Between-group differences revealed a significant difference in FSS and NHP total in favor of Group 1 (p<.05). A structured home-based exercise program can be an alternative to supervised exercises with no side effects in patients with multiple sclerosis. Home-based rehabilitation exercises that are checked and controlled through telerehabilitation can help patients improve their health-related QoL and ADL. However, supervised exercises can be more beneficial regarding the fatigue and health profile compared to the home-based exercises.

A randomized controlled trial of a structured program combining aerobic and resistance exercise for adults with type 2 diabetes in Japan.

We assessed the effect of supervised, combined aerobic and resistance exercise on diabetic parameters in Japanese patients with type 2 diabetes mellitus (T2DM). This 12-week, multicenter (17 medical institutions), open-label, parallel-group study (clinicaltrials.jp; JapicCTI-184002), randomized (1:1) Japanese patients aged 20-75years with T2DM and hemoglobin A1c (HbA1c) of 7.0-10.0% to supervised exercise (n = 113) or standard therapy (n = 115). The supervised exercise group undertook supervised aerobic (30min) and resistance exercise 3 times/week (20 designated gyms). Primary endpoint was change in HbA1c from baseline at week 13. Secondary endpoints were change in fasting blood glucose (FBG), glycoalbumin, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and HOMA-β at week 13. Of 228 randomized patients, 97 (85.8%) in the supervised exercise group and 108 (93.9%) in the standard therapy group completed the study. Supervised exercise significantly lowered HbA1c at week 13 versus standard therapy (estimated difference in change from baseline [95% confidence interval]:- 0.44% [-0.61,-0.28], p < 0.001). Supervised exercise also significantly decreased FBG (estimated difference:-13.0 [-19.2,-6.7] mg/dL) and glycoalbumin (estimated difference: -1.52% [-2.10,-0.93]) compared with standard therapy. Fasting insulin (-0.5 µIU/mL) and HOMA-IR (-0.3) decreased with supervised exercise, but group differences were not significant. Treatment-emergent adverse events were more frequent in the supervised exercise group (42.5%) than in the standard therapy group (29.6%); however, no major safety concerns were identified. A structured, supervised, aerobic and resistance exercise program improved HbA1c and was well accepted among patients with T2DM. The online version contains supplementary material available at 10.1007/s13340-021-00506-5.

The effect of supervised dynamic exercise program on somatosensory temporal discrimination in patients with fibromyalgia syndrome.

Objectives This study aims to investigate the effect of a supervised dynamic exercise program on somatosensory temporal discrimination (STD) which indicates the central sensory processing ability.Patients and methods Forty-eight patients (mean age: 43 years; range, 19 to 64 years) with fibromyalgia syndrome (FMS) were included in this prospective, randomized study between April 2018 and October 2018. Demographics and clinical measurements were recorded. The STD threshold was measured by a researcher blinded to the treatment groups. After baseline assessments, the patients were randomized into two groups: the supervised exercise group (SEG) and the home exercise group (HEG) as the control group. The SEG performed submaximal aerobic exercise and low-medium resistant isotonic exercises under the supervision of a physiotherapist, 1-h per day, three days in a week for four weeks. The HEG was given a home-based exercise program consisting of low-to-medium resistance isotonic exercises and aerobic exercises 1-h per day, three days in a week for four weeks. After exercise program, clinical assessments and STD threshold measurement were repeated.Results Clinical and STD threshold measures improved significantly after four-week exercise program in both groups. The improvements in clinical measures were significantly higher in the SEG. However, there was no difference in the STD threshold improvement between the groups. No correlation was found between the STD threshold measure and clinical features in any patients.Conclusion Although a significant improvement was achieved in impaired STD threshold with SEG, it was not found to be superior to the amelioration observed with HEG.