Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.319
Mr Jeff Doukakis, Associate Professor Kieron Rooney, Dr Sheila Sivam, Professor Brendon Yee, Professor Bandana Saini, Dr Elizabeth Machan (Cayanan)
Idiopathic hypersomnia (IH) is a debilitating sleep condition characterised by excessive daytime sleepiness. The potential to moderate symptoms through lifestyle factors such as physical activity has not been explored, and current management focuses on medication. Exercise reduces fatigue and increases energy in the general population, and while some publications note physical activity as a potential avenue to manage symptoms of IH, there is no specific evidence related to exercise in this condition. The aim of this project was to explore the experiences of people living with IH in relation to: self-efficacy and exercise, exercise for symptom management, diagnosis related sources of information to support exercise, perceived ideal exercise prescription and the interaction between exercise and current management strategies and treatment approaches. Qualitative data was collected through semi-structured interviews with 14 participants. This was transcribed and analysed using a modified codebook analysis to construct overarching themes and subthemes. Three overarching themes were constructed. The first theme described a lack of exercise advice, outlined the interaction between exercise and condition management strategies and symptoms and outlined the diverse range of activities people with IH engage with. The second theme explored the positive and negative factors of exercise self-efficacy, as well as reported barriers and facilitators of exercise. The third theme “A consumer-led exercise prescription” details a best practice (FITT) potential exercise prescription informed by the opinions and experiences of people with IH. This is the first study exploring exercise and physical activity in people living with IH. It provides valuable insight regarding potential future exercise interventions for clinicians, future researchers and people living with IH.
特发性嗜睡症（IH）是一种使人衰弱的睡眠疾病，其特点是白天过度嗜睡。通过体育锻炼等生活方式来缓解症状的可能性尚未得到探索，目前的治疗方法主要是药物治疗。在普通人群中，运动可减轻疲劳并增加能量，虽然一些出版物指出体育锻炼是控制 IH 症状的潜在途径，但目前还没有与运动相关的具体证据。本项目旨在探索 IH 患者在以下方面的经验：自我效能和运动、运动对症状的控制、与诊断相关的支持运动的信息来源、理想的运动处方以及运动与当前管理策略和治疗方法之间的相互作用。 通过对 14 名参与者进行半结构化访谈，收集了定性数据。对访谈内容进行了转录，并使用修改后的编码本分析法对其进行分析，以构建总体主题和次主题。 共构建了三个总体主题。第一个主题描述了缺乏运动建议的情况，概述了运动与病情管理策略和症状之间的相互作用，并概述了 IH 患者参与的各种活动。第二个主题探讨了运动自我效能的积极和消极因素，以及报告的运动障碍和促进因素。第三个主题 "消费者主导的运动处方 "详细介绍了根据 IH 患者的意见和经验制定的最佳实践（FITT）潜在运动处方。 这是第一项探讨 IH 患者运动和体育锻炼的研究。它为临床医生、未来的研究人员和 IH 患者提供了有关未来潜在运动干预措施的宝贵见解。
{"title":"“ANYTHING WOULD BE A WIN IF YOU’RE STRUGGLING.” – EXPLORING EXERCISE AND PHYSICAL ACTIVITY IN PEOPLE LIVING WITH IDIOPATHIC HYPERSOMNIA","authors":"Mr Jeff Doukakis, Associate Professor Kieron Rooney, Dr Sheila Sivam, Professor Brendon Yee, Professor Bandana Saini, Dr Elizabeth Machan (Cayanan)","doi":"10.31189/2165-7629-13-s2.319","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.319","url":null,"abstract":"\u0000 \u0000 Idiopathic hypersomnia (IH) is a debilitating sleep condition characterised by excessive daytime sleepiness. The potential to moderate symptoms through lifestyle factors such as physical activity has not been explored, and current management focuses on medication. Exercise reduces fatigue and increases energy in the general population, and while some publications note physical activity as a potential avenue to manage symptoms of IH, there is no specific evidence related to exercise in this condition. The aim of this project was to explore the experiences of people living with IH in relation to: self-efficacy and exercise, exercise for symptom management, diagnosis related sources of information to support exercise, perceived ideal exercise prescription and the interaction between exercise and current management strategies and treatment approaches.\u0000 \u0000 \u0000 \u0000 Qualitative data was collected through semi-structured interviews with 14 participants. This was transcribed and analysed using a modified codebook analysis to construct overarching themes and subthemes.\u0000 \u0000 \u0000 \u0000 Three overarching themes were constructed. The first theme described a lack of exercise advice, outlined the interaction between exercise and condition management strategies and symptoms and outlined the diverse range of activities people with IH engage with. The second theme explored the positive and negative factors of exercise self-efficacy, as well as reported barriers and facilitators of exercise. The third theme “A consumer-led exercise prescription” details a best practice (FITT) potential exercise prescription informed by the opinions and experiences of people with IH.\u0000 \u0000 \u0000 \u0000 This is the first study exploring exercise and physical activity in people living with IH. It provides valuable insight regarding potential future exercise interventions for clinicians, future researchers and people living with IH.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141038945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.484
Mr Tyler Osborne, Dr Grant Rowe, Associate Professor Dale Edgar, Associate Professor Mark Fear, Winthrop Professor Fiona Wood, Associate Professor Timothy Fairchild, Dr Brook Galna, Associate Professor Bradley Wall, P. Kenworthy
A burn is one of the most traumatic injuries a person can sustain, and along with mental and physical scars, trigger a greater and more persistent inflammatory and metabolic response than other trauma cases, with hypermetabolic and hyperinflammation being reported >3 years post-burn. Exercise has been shown to positively influence inflammatory and metabolic function in both healthy and diseased cohorts, however little is known about the influence of exercise on chronic inflammation and metabolism in burn survivors. The aim of this study was to determine the effects of an exercise intervention on inflammatory and metabolic markers in patients who had sustained a burn injury >1 year ago. In this study 15 participants were randomised in a cross over design into one of two conditions, either exercise-control, or control-exercise. The exercise condition comprised of six weeks of resistance and aerobic exercise, completed remotely or supervised in a hospital gym. A comprehensive battery of clinical and physiological assessments was completed at 0, 3 and 6 weeks of each exercise and control condition. The primary outcome measure for this study was TNF-alpha and how this changed in response to the exercise condition. Secondary measures included indirect calorimetry, metabolomic and lipidomic analysis, strength and aerobic fitness testing, body composition and questionnaires related to functional status and physical activity history. It is hoped that the results from this study will contribute to the future of post-burn rehabilitation and continue to develop the understanding surrounding the chronic post-response physiological response.
{"title":"DOES EXERCISE INFLUENCE CHRONIC INFLAMMATION IN BURNS >1 YEAR AFTER INJURY?","authors":"Mr Tyler Osborne, Dr Grant Rowe, Associate Professor Dale Edgar, Associate Professor Mark Fear, Winthrop Professor Fiona Wood, Associate Professor Timothy Fairchild, Dr Brook Galna, Associate Professor Bradley Wall, P. Kenworthy","doi":"10.31189/2165-7629-13-s2.484","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.484","url":null,"abstract":"A burn is one of the most traumatic injuries a person can sustain, and along with mental and physical scars, trigger a greater and more persistent inflammatory and metabolic response than other trauma cases, with hypermetabolic and hyperinflammation being reported >3 years post-burn. Exercise has been shown to positively influence inflammatory and metabolic function in both healthy and diseased cohorts, however little is known about the influence of exercise on chronic inflammation and metabolism in burn survivors. The aim of this study was to determine the effects of an exercise intervention on inflammatory and metabolic markers in patients who had sustained a burn injury >1 year ago. In this study 15 participants were randomised in a cross over design into one of two conditions, either exercise-control, or control-exercise. The exercise condition comprised of six weeks of resistance and aerobic exercise, completed remotely or supervised in a hospital gym. A comprehensive battery of clinical and physiological assessments was completed at 0, 3 and 6 weeks of each exercise and control condition. The primary outcome measure for this study was TNF-alpha and how this changed in response to the exercise condition. Secondary measures included indirect calorimetry, metabolomic and lipidomic analysis, strength and aerobic fitness testing, body composition and questionnaires related to functional status and physical activity history. It is hoped that the results from this study will contribute to the future of post-burn rehabilitation and continue to develop the understanding surrounding the chronic post-response physiological response.","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141043243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.487
Mr Nathan Reeves, Dr Kelly Clanchy, Mr Toby Atkins, Mr Matt Ternes
Community-based walking and running groups have become popular social phenomena in recent years. Integrating individuals with Parkinson’s disease into community-based walking and running events confers multiple socio-biological benefits, but may be problematic for individuals with Parkinson’s disease in the later stages of the disease progression. This research evaluates the participation of a group of individuals with Parkinson’s disease in a long-standing community running festival, the Gold Coast Marathon Festival. Evaluation of participation comprised: 1) description of the activities undertaken by the Exercise Physiologists to ensure the safe and effective participation of the interested parties; and 2) a qualitative evaluation of the participant’s experiences with the event. Ten adults with Parkinson’s disease (70% male), mean age 69.6 ± 7.8 years (range = 57-79) participated. Time post-diagnosis ranged 1 to 15 years (mean = 6.7 ± 4.4 years). Participants registered to complete one of two distances: 5.7 km (n = 9) or 700 m (n = 1). Activities undertaken by the Exercise Physiologist prior to participating were divided into three themes: participation, safety, and administrative requirements. Participant experiential data was divided into six themes: preparation prior to participating; pre participation planning and organisation; reasons/meaning for choosing to participate; barriers for participating; event recovery; and event suitability. The data collated was triangulated to provide recommendations to facilitate participation in similar events. The results of this study demonstrate that with effective planning and coordination, participation in community-based walking and running events confer physical and mental health benefits for individuals with Parkinson’s disease. However, significant barriers need to be addressed prior to participation to ensure meaningful participation. This paper provides recommendations for practicing Exercise Physiologists who wish to promote participation of their own clients with Parkinson’s disease in similar initiatives.
{"title":"PROMOTING PARTICIPATION IN COMMUNITY RUNNING FESTIVALS FOR INDIVIDUALS WITH PARKINSON’S DISEASE - A MODEL FOR MEANINGFUL PARTICIPATION","authors":"Mr Nathan Reeves, Dr Kelly Clanchy, Mr Toby Atkins, Mr Matt Ternes","doi":"10.31189/2165-7629-13-s2.487","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.487","url":null,"abstract":"\u0000 \u0000 Community-based walking and running groups have become popular social phenomena in recent years. Integrating individuals with Parkinson’s disease into community-based walking and running events confers multiple socio-biological benefits, but may be problematic for individuals with Parkinson’s disease in the later stages of the disease progression.\u0000 \u0000 \u0000 \u0000 This research evaluates the participation of a group of individuals with Parkinson’s disease in a long-standing community running festival, the Gold Coast Marathon Festival. Evaluation of participation comprised: 1) description of the activities undertaken by the Exercise Physiologists to ensure the safe and effective participation of the interested parties; and 2) a qualitative evaluation of the participant’s experiences with the event.\u0000 \u0000 \u0000 \u0000 Ten adults with Parkinson’s disease (70% male), mean age 69.6 ± 7.8 years (range = 57-79) participated. Time post-diagnosis ranged 1 to 15 years (mean = 6.7 ± 4.4 years). Participants registered to complete one of two distances: 5.7 km (n = 9) or 700 m (n = 1). Activities undertaken by the Exercise Physiologist prior to participating were divided into three themes: participation, safety, and administrative requirements. Participant experiential data was divided into six themes: preparation prior to participating; pre participation planning and organisation; reasons/meaning for choosing to participate; barriers for participating; event recovery; and event suitability. The data collated was triangulated to provide recommendations to facilitate participation in similar events.\u0000 \u0000 \u0000 \u0000 The results of this study demonstrate that with effective planning and coordination, participation in community-based walking and running events confer physical and mental health benefits for individuals with Parkinson’s disease. However, significant barriers need to be addressed prior to participation to ensure meaningful participation. This paper provides recommendations for practicing Exercise Physiologists who wish to promote participation of their own clients with Parkinson’s disease in similar initiatives.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.444
Associate Professor Belinda Brown, Dr Kelsey Sewell, Dr James Doecke, Professor Hamid Sohrabi, Professor Jeremiah Peifer, Associate Professor Stephanie Rainey-Smith, Professor Ralph Martins
Greater physical activity is associated with reduced risk for Alzheimer’s disease (AD), and lower levels of AD-related biomarkers, such as beta-amyloid (Aβ) and tau, measured in the cerebrospinal fluid (CSF) and brain. A small proportion of Alzheimer’s disease (<1%) cases are caused by a rare dominant genetic mutation. The aim of the current study was to examine associations between self-reported exercise participation and AD-related biomarkers (from CSF and brain imaging) over time, in individuals we know will develop Alzheimer’s disease at an early age (i.e., dominant AD mutation carriers). The sample included n = 308 mutation carriers from the Dominantly Inherited Alzheimer’s Network (DIAN) study with data available for self-reported exercise participation, brain imaging (hippocampal volume, total brain volume, gray matter volume, white matter hyperintensities, brain Aβ levels), and biomarkers quantified from CSF (several Aβ and tau species and ratios). Participants were assessed regularly (time interval depending on mutation type) from baseline to 10+ years post-baseline. Associations between exercise and AD biomarkers (i.e., from brain imaging and CSF) were examined using linear mixed models, corrected for various confounding variables. The sample had a mean age of 39.7 ± 10.8 years and were 56% female. Greater baseline exercise was associated with a slower decrease in right (B=0.06, p < 0.001) and left (B=0.06, p<0.05) hippocampal volume; and slower accumulation of brain Aβ (B=0.04, p<0.001). These findings demonstrate that exercise is associated with more favourable profiles of AD-related biomarkers in those with ADAD mutations. This work may have implications for our understanding of how exercise influences disease development in late-onset sporadic AD. Nevertheless, the causal direction of our findings is difficult to ascertain, and future study designs investigating the therapeutic potential of exercise in both ADAD and late-onset AD should be considered.
加强体育锻炼可降低阿尔茨海默病（AD）的患病风险，并降低脑脊液（CSF）和大脑中与阿尔茨海默病相关的生物标志物水平，如β-淀粉样蛋白（Aβ）和tau。一小部分阿尔茨海默病病例（<1%）是由罕见的显性基因突变引起的。本研究的目的是在我们已知会在早年罹患阿尔茨海默病的人（即显性阿尔茨海默病基因突变携带者）中，研究自我报告的运动参与情况与阿尔茨海默病相关生物标志物（来自脑脊液和脑成像）之间随着时间推移的关联。 样本包括来自显性遗传性阿尔茨海默氏症网络（DIAN）研究的 n = 308 个突变携带者，其数据包括自我报告的运动参与情况、脑成像（海马体体积、脑总体积、灰质体积、白质高密度、脑 Aβ 水平）以及从 CSF 定量的生物标志物（几种 Aβ 和 tau 的种类和比率）。对参与者从基线到基线后 10 多年的时间进行定期评估（时间间隔取决于突变类型）。采用线性混合模型对运动与注意力缺失症生物标志物（即脑成像和脑脊液）之间的关系进行了研究，并对各种混杂变量进行了校正。 样本的平均年龄为（39.7 ± 10.8）岁，56%为女性。基线运动量越大，右侧（B=0.06，p＜0.001）和左侧（B=0.06，p＜0.05）海马体积的减少速度越慢；脑Aβ的积累速度越慢（B=0.04，p＜0.001）。 这些研究结果表明，运动与ADAD基因突变者的AD相关生物标志物更有利。这项研究可能有助于我们了解运动如何影响晚发性散发性AD的疾病发展。尽管如此，我们的研究结果的因果方向还很难确定，未来应考虑对运动在ADAD和晚发性AD中的治疗潜力进行研究设计。
{"title":"THE POTENTIAL ROLE OF EXERCISE IN DELAYING GENETIC DESTINY: EXAMINING THE RELATIONSHIP BETWEEN EXERCISE AND KEY BIOMARKERS IN DOMINANTLY INHERITED ALZHEIMER’S DISEASE","authors":"Associate Professor Belinda Brown, Dr Kelsey Sewell, Dr James Doecke, Professor Hamid Sohrabi, Professor Jeremiah Peifer, Associate Professor Stephanie Rainey-Smith, Professor Ralph Martins","doi":"10.31189/2165-7629-13-s2.444","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.444","url":null,"abstract":"\u0000 \u0000 Greater physical activity is associated with reduced risk for Alzheimer’s disease (AD), and lower levels of AD-related biomarkers, such as beta-amyloid (Aβ) and tau, measured in the cerebrospinal fluid (CSF) and brain. A small proportion of Alzheimer’s disease (<1%) cases are caused by a rare dominant genetic mutation. The aim of the current study was to examine associations between self-reported exercise participation and AD-related biomarkers (from CSF and brain imaging) over time, in individuals we know will develop Alzheimer’s disease at an early age (i.e., dominant AD mutation carriers).\u0000 \u0000 \u0000 \u0000 The sample included n = 308 mutation carriers from the Dominantly Inherited Alzheimer’s Network (DIAN) study with data available for self-reported exercise participation, brain imaging (hippocampal volume, total brain volume, gray matter volume, white matter hyperintensities, brain Aβ levels), and biomarkers quantified from CSF (several Aβ and tau species and ratios). Participants were assessed regularly (time interval depending on mutation type) from baseline to 10+ years post-baseline. Associations between exercise and AD biomarkers (i.e., from brain imaging and CSF) were examined using linear mixed models, corrected for various confounding variables.\u0000 \u0000 \u0000 \u0000 The sample had a mean age of 39.7 ± 10.8 years and were 56% female. Greater baseline exercise was associated with a slower decrease in right (B=0.06, p < 0.001) and left (B=0.06, p<0.05) hippocampal volume; and slower accumulation of brain Aβ (B=0.04, p<0.001).\u0000 \u0000 \u0000 \u0000 These findings demonstrate that exercise is associated with more favourable profiles of AD-related biomarkers in those with ADAD mutations. This work may have implications for our understanding of how exercise influences disease development in late-onset sporadic AD. Nevertheless, the causal direction of our findings is difficult to ascertain, and future study designs investigating the therapeutic potential of exercise in both ADAD and late-onset AD should be considered.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.379
Ms Suzie Mate, Dr Nicholas Corr, Daniel Hackett, Professor Michael Barnett, P. Am, Dr Ché Fornusek
Lower limb muscle weakness and reduced balance due to disease progression in multiple sclerosis (MS) may make robust aerobic exercise difficult. Functional electrical stimulation (FES) cycling combined with voluntary cycling may allow people with advanced MS to enhance the intensity of aerobic exercise. The aim of this study was to investigate the cardiorespiratory, power, and participant perceptions during acute bouts of FES cycling, voluntary cycling, and FES cycling combined with voluntary cycling (FES assist cycling). Participants with advanced MS (Expanded Disability Status Scale [EDSS] ≥ 6.0) undertook three exercise trials on a leg cycle ergometer. Trial 1: 30 minutes of FES cycling; Trial 2: two 10-minute bouts of voluntary cycling separated by 10 minutes rest; and Trial 3: a combination of trials 1 and 2 (FES assist cycling). Outcome measures included VO2, cycle power output, heart rate, exertion, and post-exercise perceptions of fatigue. Ten people with advanced MS participated (9 female; age 52.4±9.98 y; EDSS 7.1±0.6). Average VO2 during the 30-minute trials was significantly higher for FES assist cycling compared to voluntary cycling (429.7 ± 111.0 vs 388.5 ± 101.0 mL/min, 95% CI 23.4 to 113.0 mL/min, p=0.01), with a large effect size (Hedges’ g=1.04). Participants reported similar perceptions of exertion at the end of each trial (p=0.14). There was no difference in self-reported fatigue at the end of each trial (p=0.21). This study found FES assist cycling produced significantly higher VO2 values than voluntary cycling, although the clinical significance of these differences is unknown. Participants performed FES assist cycling at a self-reported levels of exertion consistent with moderate to vigorous intensity, however it was considered light-intensity exercise when expressed by METS. FES assist cycling was no more fatiguing post-exercise than the other modes.
{"title":"FUNCTIONAL ELECTRICAL STIMULATION COMBINED WITH VOLUNTARY CYCLING ACCENTUATES VO2 RESPONSE IN PEOPLE WITH ADVANCED MULTIPLE SCLEROSIS: A PILOT STUDY","authors":"Ms Suzie Mate, Dr Nicholas Corr, Daniel Hackett, Professor Michael Barnett, P. Am, Dr Ché Fornusek","doi":"10.31189/2165-7629-13-s2.379","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.379","url":null,"abstract":"\u0000 \u0000 Lower limb muscle weakness and reduced balance due to disease progression in multiple sclerosis (MS) may make robust aerobic exercise difficult. Functional electrical stimulation (FES) cycling combined with voluntary cycling may allow people with advanced MS to enhance the intensity of aerobic exercise. The aim of this study was to investigate the cardiorespiratory, power, and participant perceptions during acute bouts of FES cycling, voluntary cycling, and FES cycling combined with voluntary cycling (FES assist cycling).\u0000 \u0000 \u0000 \u0000 Participants with advanced MS (Expanded Disability Status Scale [EDSS] ≥ 6.0) undertook three exercise trials on a leg cycle ergometer. Trial 1: 30 minutes of FES cycling; Trial 2: two 10-minute bouts of voluntary cycling separated by 10 minutes rest; and Trial 3: a combination of trials 1 and 2 (FES assist cycling). Outcome measures included VO2, cycle power output, heart rate, exertion, and post-exercise perceptions of fatigue.\u0000 \u0000 \u0000 \u0000 Ten people with advanced MS participated (9 female; age 52.4±9.98 y; EDSS 7.1±0.6). Average VO2 during the 30-minute trials was significantly higher for FES assist cycling compared to voluntary cycling (429.7 ± 111.0 vs 388.5 ± 101.0 mL/min, 95% CI 23.4 to 113.0 mL/min, p=0.01), with a large effect size (Hedges’ g=1.04). Participants reported similar perceptions of exertion at the end of each trial (p=0.14). There was no difference in self-reported fatigue at the end of each trial (p=0.21).\u0000 \u0000 \u0000 \u0000 This study found FES assist cycling produced significantly higher VO2 values than voluntary cycling, although the clinical significance of these differences is unknown. Participants performed FES assist cycling at a self-reported levels of exertion consistent with moderate to vigorous intensity, however it was considered light-intensity exercise when expressed by METS. FES assist cycling was no more fatiguing post-exercise than the other modes.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.497
Prof Belinda Beck, Prof Stephen Lord, Robin M Daly, AProf Benjamin Weeks, Dr Steven Watson, Dr Weiwen Chen
Low bone density, which includes osteopenia and osteoporosis, leads to roughly 183,000 fractures annually in Australia, with associated direct costs of $2.59B. Osteoporosis is underdiagnosed. Exercise is effective therapy but is underutilised due to a lack of knowledge and unfounded concerns about risk of injury. The aim of the newly developed Exercise Prescription for the Prevention of Osteoporosis Fracture National Statement is to provide clear, actionable, evidence-based exercise advice to improve the bone health of people living with osteopenia and osteoporosis. The project was led and supported by Healthy Bones Australia with funding awarded by the Australian Government Department of Health, Public Health and Chronic Disease Program Osteoporosis – Education and Prevention. An expert working group (scientists, AEP, physiotherapist, endocrinologist and orthopaedic resident) and advisory committee (practising AEPs and physiotherapists) reviewed current evidence and existing guidelines to formulate recommendations for a national statement in the Australian context. A National Exercise Roundtable was convened, including consumers and stakeholders across multiple disciplines, to adapt the recommendations for clinical practice and consumer acceptability. The final statement is presented as an evidence-based document, and a 2-page user summary. The Statement outlines the general principles of osteogenic loading and falls prevention, then presents a comprehensive exercise prescription based on those principles, along with special considerations for comorbid conditions. Level A consensus was achieved on five summary statements. Bone health is an essential part of general health. While exercise prescription for other chronic diseases, such as, heart health and diabetes, is quite well established, there is a care gap for bone which we have addressed. Our National Statement, informed by high level evidence and expert insight, delivers best practice for prescribing exercise for osteoporosis to achieve best patient outcomes. We will present the document to the intended end users – exercise physiologists.
{"title":"EXERCISE PRESCRIPTION TO SUPPORT THE MANAGEMENT OF OSTEOPOROSIS: AN EXPERT STATEMENT FOR EXERCISE PHYSIOLOGISTS","authors":"Prof Belinda Beck, Prof Stephen Lord, Robin M Daly, AProf Benjamin Weeks, Dr Steven Watson, Dr Weiwen Chen","doi":"10.31189/2165-7629-13-s2.497","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.497","url":null,"abstract":"\u0000 \u0000 Low bone density, which includes osteopenia and osteoporosis, leads to roughly 183,000 fractures annually in Australia, with associated direct costs of $2.59B. Osteoporosis is underdiagnosed. Exercise is effective therapy but is underutilised due to a lack of knowledge and unfounded concerns about risk of injury. The aim of the newly developed Exercise Prescription for the Prevention of Osteoporosis Fracture National Statement is to provide clear, actionable, evidence-based exercise advice to improve the bone health of people living with osteopenia and osteoporosis. The project was led and supported by Healthy Bones Australia with funding awarded by the Australian Government Department of Health, Public Health and Chronic Disease Program Osteoporosis – Education and Prevention.\u0000 \u0000 \u0000 \u0000 An expert working group (scientists, AEP, physiotherapist, endocrinologist and orthopaedic resident) and advisory committee (practising AEPs and physiotherapists) reviewed current evidence and existing guidelines to formulate recommendations for a national statement in the Australian context. A National Exercise Roundtable was convened, including consumers and stakeholders across multiple disciplines, to adapt the recommendations for clinical practice and consumer acceptability.\u0000 \u0000 \u0000 \u0000 The final statement is presented as an evidence-based document, and a 2-page user summary. The Statement outlines the general principles of osteogenic loading and falls prevention, then presents a comprehensive exercise prescription based on those principles, along with special considerations for comorbid conditions. Level A consensus was achieved on five summary statements.\u0000 \u0000 \u0000 \u0000 Bone health is an essential part of general health. While exercise prescription for other chronic diseases, such as, heart health and diabetes, is quite well established, there is a care gap for bone which we have addressed. Our National Statement, informed by high level evidence and expert insight, delivers best practice for prescribing exercise for osteoporosis to achieve best patient outcomes. We will present the document to the intended end users – exercise physiologists.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141058148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.429
Dr Rhiannon Dowla, Mrs Carolyn Stubley, Miss Scarlett Hardy, Miss Phoebe Fraser, Assoc. Prof Bridin Murnion, Dr Elizabeth Machan, Dr Yorgi Mavros, Assoc. Prof Kieron Rooney
Opioid use disorder has the lowest quality of life (QOL) and highest disease burden of all substance use disorders (SUD). While opioid treatment does improve QOL, it remains below that of the general population. Previous reviews have indicated that exercise offers benefits for QOL, however the evidence in an opioid treatment population is lacking. This study investigates the feasibility and impact of a 10-week exercise intervention on QOL and mood in a residential rehabilitation program. Participants admitted to an opioid substitution program within the We Help Ourselves (WHOS) rehabilitation service in Sydney, NSW Australia were invited to participate in a 10-week exercise intervention. Participants completed baseline screening assessing QOL, mood, exercise habits, and a fitness assessment. Willing participants then completed a twice weekly program delivered as part of the group therapy program. Sessions typically consisted of bodyweight exercises such as squats and push ups, and boxing. Following the completion of the training program assessments were repeated. Within group pre-post measures for QOL and mood outcomes were analysed using two-way ANOVA. This clinical trial was registered with Australia New Zealand clinical trial registry (ACTRN12622000213741). 45 Participants completed baseline assessments with nine participants completing the intervention and follow up assessment. Significant improvements were seen in QOL (p=0.005), Psychological distress (p<.001), and PCL-5 scores (p=.011). Participants performed well in grip strength, but below norms in all other exercise assessments. Exercise capacity improved following the intervention. Exercise programs are both feasible and beneficial when run as part of SUD improving a range of QOL and mood outcomes. Exercise capacity was generally poor, however improved through the course of the study, often nearing population norms. Exercise should be integrated widely as an adjunct therapy for SUD.
在所有药物使用失调症（SUD）中，阿片类药物使用失调症的生活质量（QOL）最低，疾病负担最高。虽然阿片类药物治疗确实提高了患者的生活质量，但仍低于普通人群。以往的研究表明，运动可提高生活质量，但在阿片类药物治疗人群中缺乏相关证据。本研究调查了一项为期 10 周的运动干预对住院康复计划中的 QOL 和情绪的可行性和影响。 澳大利亚新南威尔士州悉尼市 "我们帮助我们自己"（WHOS）康复服务机构的阿片类药物替代项目邀请参与者参加为期10周的运动干预。参与者完成基线筛查，评估生活质量、情绪、运动习惯和体能评估。然后，有意愿的参与者完成每周两次的计划，该计划是集体治疗计划的一部分。课程通常包括负重练习（如深蹲和俯卧撑）和拳击。训练计划结束后，重复进行评估。使用双向方差分析法对组内的 QOL 和情绪结果进行前后测量。该临床试验已在澳大利亚-新西兰临床试验注册中心注册（ACTRN12622000213741）。 45 名参与者完成了基线评估，9 名参与者完成了干预和随访评估。患者的 QOL（p=0.005）、心理压力（p<.001）和 PCL-5 评分（p=.011）均有显著改善。参与者在握力方面表现良好，但在所有其他运动评估中均低于标准。干预后，运动能力有所提高。 作为 SUD 的一部分，运动计划既可行又有益，可改善一系列 QOL 和情绪结果。运动能力普遍较差，但在研究过程中有所改善，通常接近人群标准。运动应作为 SUD 的辅助疗法被广泛采用。
{"title":"FITNESS FOR RECOVERY- FEASABILITY AND IMPACT OF AN EXERCISE PROGRAM DURING RESIDENTIAL REHABILITATION","authors":"Dr Rhiannon Dowla, Mrs Carolyn Stubley, Miss Scarlett Hardy, Miss Phoebe Fraser, Assoc. Prof Bridin Murnion, Dr Elizabeth Machan, Dr Yorgi Mavros, Assoc. Prof Kieron Rooney","doi":"10.31189/2165-7629-13-s2.429","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.429","url":null,"abstract":"\u0000 \u0000 Opioid use disorder has the lowest quality of life (QOL) and highest disease burden of all substance use disorders (SUD). While opioid treatment does improve QOL, it remains below that of the general population. Previous reviews have indicated that exercise offers benefits for QOL, however the evidence in an opioid treatment population is lacking. This study investigates the feasibility and impact of a 10-week exercise intervention on QOL and mood in a residential rehabilitation program.\u0000 \u0000 \u0000 \u0000 Participants admitted to an opioid substitution program within the We Help Ourselves (WHOS) rehabilitation service in Sydney, NSW Australia were invited to participate in a 10-week exercise intervention. Participants completed baseline screening assessing QOL, mood, exercise habits, and a fitness assessment. Willing participants then completed a twice weekly program delivered as part of the group therapy program. Sessions typically consisted of bodyweight exercises such as squats and push ups, and boxing. Following the completion of the training program assessments were repeated. Within group pre-post measures for QOL and mood outcomes were analysed using two-way ANOVA. This clinical trial was registered with Australia New Zealand clinical trial registry (ACTRN12622000213741).\u0000 \u0000 \u0000 \u0000 45 Participants completed baseline assessments with nine participants completing the intervention and follow up assessment. Significant improvements were seen in QOL (p=0.005), Psychological distress (p<.001), and PCL-5 scores (p=.011). Participants performed well in grip strength, but below norms in all other exercise assessments. Exercise capacity improved following the intervention.\u0000 \u0000 \u0000 \u0000 Exercise programs are both feasible and beneficial when run as part of SUD improving a range of QOL and mood outcomes. Exercise capacity was generally poor, however improved through the course of the study, often nearing population norms. Exercise should be integrated widely as an adjunct therapy for SUD.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141046378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.409
Dr Michael Inskip, Dr Trinidad Valenzuela Arteaga, Mrs Carolina Almendrales Rangel, Sr Chidiamara Njoku, A/Prof Fiona Barnett, Ms Isabel Shih, Ms Sally Dahl, Mrs Leonie O’Neill, Y. Mavros, M. Am
Virtually all adults in aged care are frail, contributing to falls, cognitive decline, hospitalisation, and mortality. polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. Asia-Pacific Frailty treatment guidelines recommend anabolic exercise, medication and dietary optimisation. However, no study has evaluated this best practice intervention in aged care. AIM: Evaluate institutional translation of best-practice frailty treatment in aged care residents. The Frailty Reduction via Implementation of Exercise, Nutritional support and Deprescribing (FRIEND) trial (ANZCTR#:ACTRN12622000926730p) is a 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge and institutional translation in a Townsville aged care facility. Residents received high-intensity resistance and balance training, medication and nutrition optimisation co-implemented by investigators (AEP, geriatrician, pharmacist, nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report resident outcomes for Phase-one (6 months exercise with staggered implementation of medication/nutritional arms) in preparation for full implementation (Phase-two). 29 residents (21 female, age:88.6±6.3yrs) were recruited. At baseline, residents were frail (FRAIL-NH;6.3±2.4/14), cognitively-impaired (MoCA;13.8±6.8/30), had low physical function/capacity (SPPB;4.9±3.1/12, 6MWT;222.2±104.4m) and numerous prescribed medications (15.5±5.9). Two residents died & one withdrew before intervention, and nine residents declined exercise intervention. Exercising residents’ adherence was 73.4±18.3% (28±7/38 sessions), with non-significant baseline differences compared to decliners (p>0.05). FRAIL-NH worsened significantly across the entire sample (0.93±1.87,p=.019), however this progression was attenuated in exercisers (0.71±1.83,p=0.35). Furthermore, clinically meaningful improvements in frailty (Fried phenotype;-0.73±1.09,p=.022), Leg press (median{IQR}:40.9%{26.5%)) and knee extension strength (median{IQR):61.9%(259%),p<0.001), 6MWD (35.4±45.8m,p=0.022;30m-MCID), Physical Function (SPPB;1.9±2.3,p=0.007;1-point MCID), and cognition (MoCA;1.31±3.4,p=.131;1.22-point MCID) were observed in exercisers. Only 1 minor exercise-related adverse event occurred. Six months of AEP-led high-intensity exercise with preliminary, staggered implementation of medication and nutrition optimisation in aged care improved frailty and risk factors in residents. Phase-two results following 6-months of full, concurrent implementation of exercise, medication and nutrition arms are anticipated May, 2024.
{"title":"FRAILTY REDUCTION VIA IMPLEMENTATION OF EXERCISE, NUTRITION AND DEPRESCRIBING (FRIEND) TRIAL: NOVEL IMPLEMENTATION OF THE ASIA-PACIFIC FRAILTY GUIDELINES IN AGED CARE","authors":"Dr Michael Inskip, Dr Trinidad Valenzuela Arteaga, Mrs Carolina Almendrales Rangel, Sr Chidiamara Njoku, A/Prof Fiona Barnett, Ms Isabel Shih, Ms Sally Dahl, Mrs Leonie O’Neill, Y. Mavros, M. Am","doi":"10.31189/2165-7629-13-s2.409","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.409","url":null,"abstract":"\u0000 \u0000 Virtually all adults in aged care are frail, contributing to falls, cognitive decline, hospitalisation, and mortality. polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. Asia-Pacific Frailty treatment guidelines recommend anabolic exercise, medication and dietary optimisation. However, no study has evaluated this best practice intervention in aged care. AIM: Evaluate institutional translation of best-practice frailty treatment in aged care residents.\u0000 \u0000 \u0000 \u0000 The Frailty Reduction via Implementation of Exercise, Nutritional support and Deprescribing (FRIEND) trial (ANZCTR#:ACTRN12622000926730p) is a 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge and institutional translation in a Townsville aged care facility. Residents received high-intensity resistance and balance training, medication and nutrition optimisation co-implemented by investigators (AEP, geriatrician, pharmacist, nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report resident outcomes for Phase-one (6 months exercise with staggered implementation of medication/nutritional arms) in preparation for full implementation (Phase-two).\u0000 \u0000 \u0000 \u0000 29 residents (21 female, age:88.6±6.3yrs) were recruited. At baseline, residents were frail (FRAIL-NH;6.3±2.4/14), cognitively-impaired (MoCA;13.8±6.8/30), had low physical function/capacity (SPPB;4.9±3.1/12, 6MWT;222.2±104.4m) and numerous prescribed medications (15.5±5.9). Two residents died & one withdrew before intervention, and nine residents declined exercise intervention. Exercising residents’ adherence was 73.4±18.3% (28±7/38 sessions), with non-significant baseline differences compared to decliners (p>0.05). FRAIL-NH worsened significantly across the entire sample (0.93±1.87,p=.019), however this progression was attenuated in exercisers (0.71±1.83,p=0.35). Furthermore, clinically meaningful improvements in frailty (Fried phenotype;-0.73±1.09,p=.022), Leg press (median{IQR}:40.9%{26.5%)) and knee extension strength (median{IQR):61.9%(259%),p<0.001), 6MWD (35.4±45.8m,p=0.022;30m-MCID), Physical Function (SPPB;1.9±2.3,p=0.007;1-point MCID), and cognition (MoCA;1.31±3.4,p=.131;1.22-point MCID) were observed in exercisers. Only 1 minor exercise-related adverse event occurred.\u0000 \u0000 \u0000 \u0000 Six months of AEP-led high-intensity exercise with preliminary, staggered implementation of medication and nutrition optimisation in aged care improved frailty and risk factors in residents. Phase-two results following 6-months of full, concurrent implementation of exercise, medication and nutrition arms are anticipated May, 2024.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141042435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.390
Dr Isaac Selva Raj, Dr Kieran Marston, Mr James Mckee, Ms Kristen De Marco, Mr Michael Beere, Prof Ken Nosaka, P. J. Peiffer, Dr Brook Galna, Brendan Scott
Low-load resistance training (RT) with blood flow restriction (BFR; 20–40% of 1-repetition maximum [1RM]) increases muscle mass and strength comparably to unrestricted high-load RT. As healthy populations are not limited to low-loads, some researchers have also examined whether the adaptations to high-load RT could be enhanced with BFR, though results are inconsistent. Therefore, we conducted a systematic review to investigate whether moderate to high-load resistance training (M-HL RT) with BFR increases muscle mass or strength more than the equivalent training without BFR. Studies involving M-HL RT (≥60% 1RM) with BFR applied during exercise sets or rest intervals were included. The following databases were searched: PubMed, Web of Science, Scopus, ScienceDirect, ProQuest Central, and Google Scholar. Two researchers independently screened the titles and abstracts for eligibility based on the inclusion and exclusion criteria. The full texts of included studies were then independently screened by two researchers. Conflicts were resolved by a third researcher. Following screening, study and participant characteristics, intervention protocol for each group and outcome measures were extracted for each included study. Ten studies met the criteria for inclusion in this review. All included studies measured muscle strength, with only three reporting greater strength increases after M-HL RT with BFR compared to equivalent training without BFR. Five studies assessed muscle mass, with four reporting similar increases after M-HL RT with and without BFR. One observed a smaller increase in mass after M-HL RT with BFR than without. Most studies did not observe additional benefit of applying BFR during M-HL RT for muscle strength or mass. Studies which did report benefits of BFR may be limited by methodological issues, impacting the applicability of their findings. Overall, this review does not support using BFR during M-HL RT for additional improvements in muscle strength or mass.
{"title":"THE EFFECTS OF MODERATE TO HIGH-LOAD RESISTANCE TRAINING WITH BLOOD FLOW RESTRICTION IN HEALTHY ADULTS: A SYSTEMATIC REVIEW","authors":"Dr Isaac Selva Raj, Dr Kieran Marston, Mr James Mckee, Ms Kristen De Marco, Mr Michael Beere, Prof Ken Nosaka, P. J. Peiffer, Dr Brook Galna, Brendan Scott","doi":"10.31189/2165-7629-13-s2.390","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.390","url":null,"abstract":"\u0000 \u0000 Low-load resistance training (RT) with blood flow restriction (BFR; 20–40% of 1-repetition maximum [1RM]) increases muscle mass and strength comparably to unrestricted high-load RT. As healthy populations are not limited to low-loads, some researchers have also examined whether the adaptations to high-load RT could be enhanced with BFR, though results are inconsistent. Therefore, we conducted a systematic review to investigate whether moderate to high-load resistance training (M-HL RT) with BFR increases muscle mass or strength more than the equivalent training without BFR.\u0000 \u0000 \u0000 \u0000 Studies involving M-HL RT (≥60% 1RM) with BFR applied during exercise sets or rest intervals were included. The following databases were searched: PubMed, Web of Science, Scopus, ScienceDirect, ProQuest Central, and Google Scholar. Two researchers independently screened the titles and abstracts for eligibility based on the inclusion and exclusion criteria. The full texts of included studies were then independently screened by two researchers. Conflicts were resolved by a third researcher. Following screening, study and participant characteristics, intervention protocol for each group and outcome measures were extracted for each included study.\u0000 \u0000 \u0000 \u0000 Ten studies met the criteria for inclusion in this review. All included studies measured muscle strength, with only three reporting greater strength increases after M-HL RT with BFR compared to equivalent training without BFR. Five studies assessed muscle mass, with four reporting similar increases after M-HL RT with and without BFR. One observed a smaller increase in mass after M-HL RT with BFR than without.\u0000 \u0000 \u0000 \u0000 Most studies did not observe additional benefit of applying BFR during M-HL RT for muscle strength or mass. Studies which did report benefits of BFR may be limited by methodological issues, impacting the applicability of their findings. Overall, this review does not support using BFR during M-HL RT for additional improvements in muscle strength or mass.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141051188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.31189/2165-7629-13-s2.470
Mr Ray Seaby, Dr Jay Ebert, Dr Brendan Joss, Dr Peter Edwards, Prof Tim Ackland
Rehabilitation following total knee arthroplasty (TKA) is essential to mitigate delay in physical recovery and facilitate optimum patient outcomes. Telehealth is emerging as a cost-effective and efficacious delivery method. The aim of this study was to investigate the early post-operative outcomes of patients following a telehealth-delivered rehabilitation program (Tele) compared with those following conventional outpatient rehabilitation (Clinic) in patients following TKA. A single-blinded, randomized controlled non-inferiority trial was conducted, with 108 participants scheduled for primary TKA randomly allocated to a 6-week, telehealth-delivered rehabilitation program (n=54) or a 6-week supervised, in-person rehabilitation program (n=54). Knee flexion range of motion (KF-ROM) and the Quality of Life subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-QOL) were collected pre-surgery and 7-weeks post-surgery. A linear mixed-effect model was used to assess differences between groups over time for both outcome measures. Change in KOOS-QOL of greater than 10 points was used to establish minimally clinically important change (MCIC), with chi square analyses used to assess between-group differences. Baseline KF-ROM measures were 124.1° and 122.2° for telehealth-delivered and in-person groups respectively; and 108.7° and 111.6° at 7-week post-surgery. KOOS-QOL scores were 32.7 and 33.3 at baseline for the respective groups; and 60.9 and 62.9 at week-7. There were no significant differences in between group changes over time for both KF-ROM (mean difference = -2.9°, 95% CI = -7.7 to 1.8; p=0.226) and KOOS-QOL (mean difference = -2.1, 95% CI: -10.0 to 5.9; p=0.611). Chi square analyses revealed no differences between groups meeting the MCIC (Tele = 71%; Clinic = 79%) in KF-ROM (X2 = 0.78, p = 0.377). Short term outcomes following TKA are not different between telehealth-delivered and conventional supervised rehabilitation. Telehealth may provide an effective rehabilitation option for patients undergoing TKA.
{"title":"EARLY POST-OPERATIVE CLINICAL OUTCOMES IN PATIENTS UNDERGOING TOTAL KNEE ARTHROPLASTY COMPARING IN-PERSON CLINIC VERSUS TELEHEALTH-DELIVERED REHABILITATION PROGRAM: A NON-INFERIORITY TRIAL","authors":"Mr Ray Seaby, Dr Jay Ebert, Dr Brendan Joss, Dr Peter Edwards, Prof Tim Ackland","doi":"10.31189/2165-7629-13-s2.470","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.470","url":null,"abstract":"\u0000 \u0000 Rehabilitation following total knee arthroplasty (TKA) is essential to mitigate delay in physical recovery and facilitate optimum patient outcomes. Telehealth is emerging as a cost-effective and efficacious delivery method. The aim of this study was to investigate the early post-operative outcomes of patients following a telehealth-delivered rehabilitation program (Tele) compared with those following conventional outpatient rehabilitation (Clinic) in patients following TKA.\u0000 \u0000 \u0000 \u0000 A single-blinded, randomized controlled non-inferiority trial was conducted, with 108 participants scheduled for primary TKA randomly allocated to a 6-week, telehealth-delivered rehabilitation program (n=54) or a 6-week supervised, in-person rehabilitation program (n=54). Knee flexion range of motion (KF-ROM) and the Quality of Life subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-QOL) were collected pre-surgery and 7-weeks post-surgery. A linear mixed-effect model was used to assess differences between groups over time for both outcome measures. Change in KOOS-QOL of greater than 10 points was used to establish minimally clinically important change (MCIC), with chi square analyses used to assess between-group differences.\u0000 \u0000 \u0000 \u0000 Baseline KF-ROM measures were 124.1° and 122.2° for telehealth-delivered and in-person groups respectively; and 108.7° and 111.6° at 7-week post-surgery. KOOS-QOL scores were 32.7 and 33.3 at baseline for the respective groups; and 60.9 and 62.9 at week-7. There were no significant differences in between group changes over time for both KF-ROM (mean difference = -2.9°, 95% CI = -7.7 to 1.8; p=0.226) and KOOS-QOL (mean difference = -2.1, 95% CI: -10.0 to 5.9; p=0.611). Chi square analyses revealed no differences between groups meeting the MCIC (Tele = 71%; Clinic = 79%) in KF-ROM (X2 = 0.78, p = 0.377).\u0000 \u0000 \u0000 \u0000 Short term outcomes following TKA are not different between telehealth-delivered and conventional supervised rehabilitation. Telehealth may provide an effective rehabilitation option for patients undergoing TKA.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141044590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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