scholarly journals Implementation of a Remote Fidelity Oversight Program for a Multi-Site Exercise Intervention

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 296-297
Author(s):  
Jennifer Stevens-Lapsley
Keyword(s):  
Exercise Intervention ◽  
Full Range ◽  
Monitoring Program ◽  
Exercise Program ◽  
Exercise Protocol ◽  
Repetition Maximum ◽  
Direct Observations ◽  
Written Examination ◽  
Resistance Training Exercise ◽  
Fidelity Monitoring

Abstract The STEP-HI exercise protocol is a supervised, 2 phase, multimodal, high-intensity exercise program that emphasizes resistance training. Exercise sessions are conducted at an exercise facility and occur on two non-consecutive days/week for 6 months. During specified exercises, the exercise interventionist targets the participant’s eight-repetition maximum (8-RM), defined as the greatest resistance that can be moved 8 times through full range of motion with good form. A rigorous, remote fidelity monitoring program maximizes consistency of the intervention across sites. This fidelity oversight program is a model for future exercise studies because of its unique remote, hierarchical structure. All exercise interventionists are initially certified by written examination and direct observations. Some exercise sessions are also video recorded and reviewed using fidelity checklists. After initial certification, repeated direct observation and video-based verification of fidelity are repeated at prescribed intervals for each interventionist to ensure sustained consistency of implementation across sites.

Adherence to a Dysphagia Exercise Program by Oropharyngeal Cancer Survivors

2019 ◽  
Author(s):  
Stephanie Knollhoff ◽  
Jeff Searle
Keyword(s):  
Oropharyngeal Cancer ◽  
Tongue Cancer ◽  
Exercise Program ◽  
Exercise Protocol ◽  
Sense Of Effort ◽  
Oral Pain ◽  
History Of ◽  
Post Radiation ◽  
Therapy Completion ◽  
Swallowing Exercises

Abstract Introduction: Adherence to a swallowing exercise protocol and a common compliance barrier, oral pain, was evaluated and described. Methods: A four-week dysphagia exercise program was completed by 12 individuals with a history of base of tongue cancer who were experiencing latent dysphagia. Adherence to a dysphagia exercise program was quantified. Focused outcome measures on oral pain related to dysphagia exercises and exercise related sense of effort were also included. Results: Moderate to strong adherence was reported by 75% of participants. Overall, 78.9% of exercise sessions were completed. Individuals reported little to no pain associated with dysphagia exercises throughout protocol participation. Conclusions: Routine reminders and establishment of a tracking method supported adherence with a dysphagia exercise protocol. Oral pain and sense of effort associated with completing oral and dysphagia exercises were not demonstrated to be barriers to participation in a dysphagia exercise program in people who are several years post radiation therapy completion. Keywords: dysphagia, oropharyngeal cancer, latent dysphagia, swallowing exercises

Effects of a motor imagery-based exercise protocol on chronic pain and emotional distress in patients with fibromyalgia syndrome: A pilot study

2021 ◽  
pp. 1-10
Author(s):  
Teresa Paolucci ◽  
Francesco Agostini ◽  
Massimiliano Mangone ◽  
Andrea Torquati ◽  
Simona Scienza ◽  
...  
Keyword(s):  
Motor Imagery ◽  
Fibromyalgia Syndrome ◽  
Coping Behavior ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
The Body ◽  
Control Group ◽  
Exercise Protocol ◽  
And Coping

BACKGROUND: Fibromyalgia (FM) is a chronic condition characterized by widespread muscular or musculoskeletal pain of at least 3 months’ duration, occurring above and below the waist, on both sides of the body. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a rehabilitation program based on motor imagery versus a conventional exercise program in FM in terms of pain, functional and psychological outcomes. METHODS: Twenty-nine female subjects were randomly assigned to a group receiving motor imagery-based rehabilitation (MIG) or to a control group (CG) performing conventional rehabilitation. Outcome assessments were performed before (T0) and after 10 sessions of treatment (T1) and at a 12-week follow-up (T2). Pain, function and psychological measurements were conducted by means of different questionnaires. RESULTS: Both treatments improved all outcomes at post-treatment (T1) and follow-up (T2). The MIG showed a significant improvement in anxiety disorder associated with FM with respect to the CG, as well as improvements in coping strategies. CONCLUSIONS: Rehabilitation treatment based on motor imagery showed a stronger effect on anxiety and coping behavior than traditional physiotherapy in patients with FM. Integrated psychological support would be desirable in this setting. Further research is needed to explore the aspects investigated in more depth.

scholarly journals OP0159 EFFICACY OF COMPREHENSIVE TECHNOLOGY-ASSISTED HOME-BASED EXERCISE IN ANKYLOSING SPONDYLITIS: A RANDOMIZED, CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Group Differences ◽  
Control Group ◽  
Home Based ◽  
The Mean

Background:Clinical practice guidelines recommend that exercise is an essential component in the self-management of Ankylosing Spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be burdensome and patients may decline participation, whereas, effective home-based exercise interventions that do not need regular medical center visits are likely to be more accessible and acceptable for patients with AS. Recently, increasing evidences have been accumulated that the wearable devices could facilitate patients with inflammatory arthritis by giving exercise instructions and improving self-efficacy. Therefore, patients with AS may benefit from an effective technology-assisted home-based exercise intervention.Objectives:To investigate the efficacy of a comprehensive technology-assisted home-based exercise intervention on disease activity in patients with AS.Methods:This study was a 16-week assessor-blinded, randomized, waiting-list controlled trial (ChiCTR1900024244). Patients with AS were randomly allocated to the home-based exercise intervention group and the waiting-list control group. A 16-week comprehensive exercise program consisting of a moderate intensity (64%-76% HRmax) aerobic training for 30min on 5 days/week and a functional training for 60min on 3 days/week was given to patients in the intervention group immediately after randomization, with 1.5h training sessions for two consecutive days by a study physical therapist at baseline and Week 8. The aerobic exercise intensity was controlled by a Mio FUSE Wristband with a smartphone application. The functional training consisted of the posture training, range of motion exercises, strength training, stability training and stretching exercises. Patients in control group received standard care during the 16-week follow-up and started to receive the exercise program at Week 16. The primary outcome was ASDAS at Week 16. The secondary outcomes were BASDAI, BASFI, BASMI, ASAS HI, peak oxygen uptake, body composition and muscle endurance tests. The mean difference between groups in change from baseline was analyzed with the analysis of covariance.Results:A total of 54 patients with AS were enrolled (26 in intervention group and 28 in control group) and 46 (85.2%) patients completed the 16-week follow-up. The mean difference of ASDAS between groups in change from baseline to 16-week follow-up was −0.2 (95% CI, −0.4 to 0.003, P = 0.032), and the mean change from baseline was -0.4 (95% CI, -0.5 to -0.2) in the intervention group vs -0.1 (95% CI, -0.3 to 0.01) in the control group, respectively. Significant between-group differences were found between groups for BASDAI (−0.5 [95% CI, −0.9 to −0.2], P = 0.004), BASMI (−0.7 [95% CI, −1.1 to −0.4], P <0.001), BASFI (−0.3 [95% CI, −0.6 to 0.01], P=0.035), peak oxygen uptake (2.7 [95% CI, 0.02 to 5.3] ml/kg/min, P=0.048) and extensor endurance test (17.8 [95% CI, 0.5 to 35.2]s, P=0.044) at Week 16. Between-group differences were detected in ASAS HI (−0.9 [95% CI, −1.7 to −0.1], P=0.030), body fat percentage (−1.0 [95% CI, −2.0 to −0.01] %, P=0.048) and visceral adipose tissue (−4.9 [95% CI, −8.5 to −1.4] cm2, P=0.008) at Week 8, but not at Week 16. No significant between-group differences were detected in the total lean mass, time up and go test and the flexor endurance test during the follow-up.Conclusion:Comprehensive technology-assisted home-based exercise has been shown to have beneficial effects on disease activity, physical function, spinal mobility, aerobic capacity, and body composition as well as in improving fatigue and morning stiffness of patients with AS.References:[1]van der Heijde D, Ramiro S, Landewé R, et al. Ann Rheum Dis 2017;76:978–991.Disclosure of Interests:None declared

scholarly journals The Effect of Structured Exercise on Sleep During the Corresponding Night Among Older Women in an Exercise Program

2019 ◽  
Vol 27 (4) ◽  
pp. 482-488
Author(s):  
Charity B. Breneman ◽  
Christopher E. Kline ◽  
Delia West ◽  
Xuemei Sui ◽  
Xuewen Wang
Keyword(s):  
Exercise Training ◽  
Sleep Quality ◽  
Older Women ◽  
Exercise Intervention ◽  
Multilevel Models ◽  
Exercise Program ◽  
Acute Effect ◽  
Treadmill Walking ◽  
Acute Bout ◽  
Sleep Parameters

This study investigated the acute effect of exercise on sleep outcomes among healthy older women by comparing days with structured exercise versus days without structured exercise during 4 months of exercise training. Participants (n = 51) in this study had wrist-worn actigraphic sleep data available following at least 3 days with structured exercise and 3 days without structured exercise at mid-intervention and at the end of intervention. The exercise intervention was treadmill walking. Multilevel models were used to examine whether structured exercise impacted sleep outcomes during the corresponding night. Overall, 1,362 nights of data were included in the analyses. In unadjusted and adjusted models, bedtimes were significantly earlier on evenings following an acute bout of structured exercise than on evenings without structured exercise. No other sleep parameters differed between exercise and nonexercise days. Understanding the effects of exercise on sleep in this understudied population may help to improve their overall sleep quality.

scholarly journals Delivering an In-Home Exercise Program via Telerehabilitation: A Pilot Study of Lung Transplant Go (LTGO)

2016 ◽  
Vol 8 (2) ◽  
pp. 15-26 ◽  
Author(s):  
JiYeon Choi ◽  
Andrea L. Hergenroeder ◽  
Lora Burke ◽  
Annette DeVito Dabbs ◽  
Matthew Morrell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Function ◽  
Lung Transplant ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Integrated System ◽  
Home Exercise ◽  
Transplant Recipients ◽  
Walk Distance ◽  
Lung Transplant Recipients

We evaluated the feasibility, safety, system usability, and intervention acceptability of Lung Transplant Go (LTGO), an 8-week in-home exercise intervention for lung transplant recipients using a telerehabilitation platform, and described changes in physical function and physical activity from baseline to post-intervention. The intervention was delivered to lung transplant recipients in their home via the Versatile and Integrated System for TeleRehabilitation (VISYTER). The intervention focused on aerobic and strengthening exercises tailored to baseline physical function. Participants improved walk distance (6-minute walk distance), balance (Berg Balance Scale), lower body strength (30-second chair stand test) and steps walked (SenseWear Armband®). No adverse events were reported. Participants rated the program highly positively in regard to the technology and intervention. The telerehabilitation exercise program was feasible, safe, and acceptable. Our findings provide preliminary support for the LTGO intervention to improve physical function and promote physical activity in lung transplant recipients. 

Effect of a Musicians’ Exercise Intervention on Performance-Related Musculoskeletal Disorders

2014 ◽  
Vol 29 (4) ◽  
pp. 181-188 ◽  
Author(s):  
Cliffton Chan ◽  
Tim Driscoll ◽  
Bronwen J Ackermann
Keyword(s):  
Musculoskeletal Disorders ◽  
Private Practice ◽  
Perceived Exertion ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Exercise Group ◽  
Control Group ◽  
Full Time ◽  
Related Factors ◽  
And Performance

PURPOSE: To evaluate the effect of a purpose-designed exercise program on performance-related musculoskeletal disorders (PRMDs) and associated risk factors in a sample of professional orchestral musicians. METHODS: A 10-week exercise program was made available to full-time musicians employed by the eight premier symphony orchestras of Australia. Questionnaires were administered before, immediately after (T1), and 6 months after interventions (T2) containing questions relating to change in frequency and severity of PRMDs, ratings of perceived exertion (RPE) during rehearsal, private practice, and performance, as well as nine performance-related factors. Participants were also asked to rate whether these performance-related factors affected their overall playing capacity during different playing situations. A comparative control group of musicians had no intervention and completed a modified questionnaire at the same time points. RESULTS: Exercise participants (n=30) reported a reduction in frequency (p<0.05) and severity (p<0.05) of PRMDs at T1 but not at T2 compared to controls (n=23). The exercise group reported a significant improvement in RPE during private practice at T1 (p<0.01) and T2 (p<0.01), but not during rehearsal and performance. At T1, the intervention was rated to be moderately to highly effective for three performance-related factors: strengthening muscles that support playing, learning techniques that support playing, and posture. Further, participants reported an intervention effect on overall playing capacity during rehearsal at T1 and T2. CONCLUSIONS: A tailored exercise program for musicians was effective at managing PRMDs, especially in reducing the frequency and severity of PRMDs. Physical therapy exercises should be considered in modifying performance-related factors that have been reported to be predictors of PRMDs.

scholarly journals Benefits of exercise in older persons at primary level

1998 ◽  
Vol 54 (4) ◽  
pp. 21-24
Author(s):  
Annie Kunda ◽  
Seyi L. Amosun
Keyword(s):  
Physical Inactivity ◽  
Older Persons ◽  
Local Community ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Dominant Hand ◽  
Primary Level ◽  
Department Of Health ◽  
The Individual ◽  
The Impact

The National Department of Health invited comments on proposed policy guidelines on the prevention of physical inactivity in older persons at primary level. The guidelines recommended the use of exercises which are dynamic, interesting, fun, easily implemented, safe and tailored to suit the individual needs. In order to make informed comments on the policy, the aim of this study was to evaluate the impact of the recommended exercise program among older persons in a local community over a six-week period. Promoting physical activity among the participants in the study resulted in marked improvements in systolic and diastolic blood pressures, and dominant hand grip strength. The time taken to perform some selected functional tasks also improved. The findings gave credence to the need to discourage physical inactivity among older persons, but there is need to overcome formidable methodological problems in evaluating the effects of exercise intervention among older persons in the community.

scholarly journals Community-Based Adaptive Physical Activity Program for Chronic Stroke: Feasibility, Safety, and Efficacy of the Empoli Model

2009 ◽  
Vol 23 (7) ◽  
pp. 726-734 ◽  
Author(s):  
Mary Stuart ◽  
Francesco Benvenuti ◽  
Richard Macko ◽  
Antonio Taviani ◽  
Lucianna Segenni ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Intervention ◽  
Rating Scale ◽  
Intervention Group ◽  
Exercise Program ◽  
Gait Velocity ◽  
Controlled Study ◽  
Oral Glucose ◽  
Community Based ◽  
Hemiparetic Stroke

Objective. To determine whether Adaptive Physical Activity (APA-stroke), a community-based exercise program for participants with hemiparetic stroke, improves function in the community. Methods. Nonrandomized controlled study in Tuscany, Italy, of participants with mild to moderate hemiparesis at least 9 months after stroke. Forty-nine participants in a geographic health authority (Empoli) were offered APA-stroke (40 completed the study). Forty-four control participants in neighboring health authorities (Florence and Pisa) received usual care (38 completed the study). The APA intervention was a community-based progressive group exercise regimen that included walking, strength, and balance training for 1 hour, thrice a week, in local gyms, supervised by gym instructors. No serious adverse clinical events occurred during the exercise intervention. Outcome measures included the following: 6-month change in gait velocity (6-Minute Timed Walk), Short Physical Performance Battery (SPPB), Berg Balance Scale, Stroke Impact Scale (SIS), Barthel Index, Hamilton Rating Scale for Depression, and Index of Caregivers Strain. Results. After 6 months, the intervention group improved whereas controls declined in gait velocity, balance, SPPB, and SIS social participation domains. These between-group comparisons were statistically significant at P < .00015. Individuals with depressive symptoms at baseline improved whereas controls were unchanged ( P < .003). Oral glucose tolerance tests were performed on a subset of participants in the intervention group. For these individuals, insulin secretion declined 29% after 6 months ( P = .01). Conclusion. APA-stroke appears to be safe, feasible, and efficacious in a community setting.

Serum Myostatin Levels Are Higher in Fitter, More Active, and Non-Frail Long-Term Nursing Home Residents and Increase after a Physical Exercise Intervention

Gerontology ◽  
2018 ◽  
Vol 65 (3) ◽  
pp. 229-239 ◽  
Author(s):  
Haritz Arrieta ◽  
Gotzone Hervás ◽  
Chloe Rezola-Pardo ◽  
Fátima Ruiz-Litago ◽  
Miren Iturburu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Nursing Home ◽  
Physical Fitness ◽  
Physical Activity Level ◽  
Exercise Intervention ◽  
Nursing Home Residents ◽  
Exercise Program ◽  
Activity Level

Background: Myostatin has been proposed as a candidate biomarker for frailty and sarcopenia. However, the relationship of myostatin with these conditions remains inconclusive. Objective: To determine the association of serum myostatin concentration with body composition, physical fitness, physical activity level, and frailty in long-term nursing home residents. We also aimed to ascertain the effect of an exercise program on myostatin levels. Methods: We obtained study data on 112 participants from long-term nursing homes. Participants were randomly assigned to a control or an intervention group and performed a 6-month multicomponent exercise program. Serum myostatin levels were analyzed by ELISA. Assessments also included body composition (anthropometry and bioelectrical impedance), physical fitness (Senior Fitness Test), physical activity level (accelerometry), and frailty (Fried frailty criteria, Clinical Frailty Scale, and Tilburg frailty indicator). Results: The concentration of myostatin at baseline was positively correlated with: a leaner body composition (p < 0.05), and a higher number of steps per day and light and moderate-vigorous physical activity in women (p < 0.005); greater upper and lower limb strength, endurance, and poorer flexibility (p < 0.05) in men; and better performance (less time) in the 8-ft timed up-and-go test in both women (p < 0.01) and men (p < 0.005). We observed higher concentrations of serum myostatin in non-frail than in frail participants (p < 0.05). Additionally, we found that the implemented physical exercise intervention, which was effective to improve physical fitness, increased myostatin concentration in men (p < 0.05) but not in women. The improvements in physical condition were related with increases in serum myostatin only in men (p < 0.05–0.01). Conclusions: Higher serum levels of myostatin were found to be associated with better physical fitness. The improvements in physical fitness after the intervention were positively related to increases in myostatin concentrations in men. These results seem to rule out the idea that high serum myostatin levels are indicative of frailty in long-term nursing home residents. However, although the direction of association was opposite to that expected for the function of myostatin, the use of this protein as a biomarker for physical fitness, rather than frailty, merits further study.

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