Can an online exercise prescription tool improve adherence to home exercise programmes in children with cerebral palsy and other neurodevelopmental disabilities? A randomised controlled trial

ObjectiveDetermine the adherence to and effectiveness of an 8-week home exercise programme for children with disabilities delivered using Physitrack, an online exercise prescription tool, compared with traditional paper-based methods.DesignSingle-blinded, parallel-groups, randomised controlled trial (RCT).SettingIntervention took place in participants’ homes in Western Australia.ParticipantsChildren aged 6 to 17 years, with neurodevelopmental disabilities including cerebral palsy (CP), receiving community therapy services.InterventionAll participants completed an individualised home exercise programme, which was delivered to the intervention group using Physitrack and conventional paper-based methods for the control group.Primary outcome measuresAdherence to exercise programme, goal achievement and exercise performance.Secondary outcome measuresEnjoyment, confidence and usability of Physitrack.ResultsFifty-four participants with CP (n=37) or other neurodevelopmental disabilities (n=17) were recruited. Fifty-three were randomised after one early withdrawal. Forty-six completed the 8-week programme, with 24 in the intervention group and 22 in the control group. There was no difference between the two groups for percentage of exercises completed (intervention (n=22): 62.8% (SD 27.7), control (n=22): 55.8% (SD 19.4), between group mean difference −7.0% (95% CI: −21.6 to 7.5, p=0.34)). Both groups showed significant improvement in their self-rated performance of individualised goal activities, however there was no statistically significant difference between groups for goal achievement, quality of exercise performance, enjoyment, confidence or preferred method of delivery. There were no adverse events.ConclusionPhysitrack provides a therapist with a new means of providing an exercise programme with online tools such as exercise videos, but our preliminary findings indicate that it may be no better than a traditional paper-based method for improving exercise adherence or the other outcomes measured. Exercise programmes remain an intervention supported by evidence, but a larger RCT is required to fully evaluate online delivery methods.Trial registration detailsAustralian New Zealand Clinical Trials Registry; ACTRN12616000743460.

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Evaluating the effectiveness of home exercise programmes using an online exercise prescription tool in children with cerebral palsy: protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2017-018316 ◽

2018 ◽

Vol 8 (1) ◽

pp. e018316 ◽

Cited By ~ 2

Author(s):

Rowan W Johnson ◽

Sian A Williams ◽

Daniel F Gucciardi ◽

Natasha Bear ◽

Noula Gibson

Keyword(s):

Cerebral Palsy ◽

Randomised Controlled Trial ◽

Exercise Prescription ◽

Controlled Trial ◽

Home Exercise ◽

Children With Cerebral Palsy ◽

Exercise Programmes ◽

Randomised Controlled

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Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215516680856 ◽

2016 ◽

Vol 31 (8) ◽

pp. 1068-1077 ◽

Cited By ~ 18

Author(s):

Kellie B Emmerson ◽

Katherine E Harding ◽

Nicholas F Taylor

Keyword(s):

Randomized Controlled Trial ◽

Upper Limb ◽

Controlled Trial ◽

Exercise Programme ◽

Home Exercise ◽

Smart Technology ◽

Randomized Controlled ◽

Home Exercise Programme ◽

Standard Paper ◽

Exercise Programmes

Objective: To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Design: Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. Setting: A community rehabilitation programme within a large metropolitan health service. Subjects: Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Interventions: Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. Main measures: The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. Results: A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI −12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI −0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). Conclusions: The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx

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86 Developing the Adapted Lifestyle - Integrated Functional Exercise Programme in Thai Context (TLIFE) to Prevent Falls among Older Adults in Thailand: A Mixed Methods Study

Age and Ageing ◽

10.1093/ageing/afz164.86 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Sasiporn Ounjaichon ◽

Chris Todd ◽

Emma Stanmore ◽

Elisabeth Boulton

Keyword(s):

Older Adults ◽

Randomised Controlled Trial ◽

Retention Rate ◽

Controlled Trial ◽

Intervention Group ◽

Exercise Programme ◽

Community Dwelling ◽

Control Group ◽

Functional Exercise ◽

Randomised Controlled

Abstract Introduction Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in Thai context (TLiFE) among older Thai adults. Methods Based on the findings of a prior qualitative study, a feasibility randomised controlled trial (RCT) of TLiFE was conducted among community-dwelling older adults, comparing the TLiFE intervention group with a usual care control group. Outcome measures were analysed at baseline, 3 months, and after 6 months of the intervention. Results We recruited a total of 72 older adults into the RCT, randomised to TLiFE (n=36) and control (n=36). The retention rate at 6 months was 91.7%. Attendance in the intervention group (3 home visits and 4 follow-up calls) was 82.9%. There were no differences in fall incidence between the groups. The acceptability survey reveals TLiFE is easy to perform in daily life, safe, and useful. No adverse events were reported. Conclusion The TLiFE programme appears to be acceptable and feasible to deliver to community-dwelling older Thai adults. This feasibility study was not powered to detect a difference between groups. A further fully powered definitive randomised controlled trial of TLiFE is needed to evaluate long-term outcomes and cost-effectiveness before it is integrated within the healthcare system in Thailand.

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Evaluating the efficacy of Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis (iBEAT-OA) in the community: a study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-030564 ◽

2019 ◽

Vol 9 (10) ◽

pp. e030564

Author(s):

Sameer Akram Gohir ◽

Paul Greenhaff ◽

Abhishek Abhishek ◽

Ana M. Valdes

Keyword(s):

Randomised Controlled Trial ◽

Knee Osteoarthritis ◽

Rating Scale ◽

Controlled Trial ◽

Maximum Voluntary Contraction ◽

Intervention Group ◽

Exercise Programme ◽

Control Group ◽

Knee Oa ◽

Randomised Controlled

IntroductionKnee osteoarthritis (OA) is the most common joint disease worldwide. As of today, there are no disease-modifying drugs, but there is evidence that muscle strengthening exercises can substantially reduce pain and improve function in this disorder, and one very well tested physiotherapy protocol is the ‘Better Management of Patients with Osteoarthritis’ developed in Sweden. Given the high prevalence of knee OA, a potentially cost-effective, digitally delivered approach to treat knee OA should be trialled. This study aims to explore the benefits of iBEAT-OA (Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis) in modulating pain, function and other health-related outcomes in individuals with knee OA.Methods and analysisA randomised controlled trial was designed to evaluate the efficacy of a web-based exercise programme in a population with knee OA compared with standard community care provided by general practitioners (GPs) in the UK. We anticipate recruiting participants into equal groups. The intervention group (n=67) will exercise for 20–30 min daily for six consecutive weeks, whereas the control group (n=67) will follow GP-recommended routine care. The participants will be assessed using a Numerical Rating Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the Arthritis Research UK Musculoskeletal Health Questionnaire, the Pittsburgh Sleep Quality Index, 30 s sit to stand test, timed up and go test, quantitative sensory testing, musculoskeletal ultrasound scan, muscle thickness assessment of the vastus lateralis, and quadriceps muscles force generation during an isokinetic maximum voluntary contraction (MVC). Samples of urine, blood, faeces and synovial fluid will be collected to establish biomarkers associated with changes in pain and sleep patterns in individuals affected with knee OA. Standard parametric regression methods will be used for statistical analysis.Ethics and disseminationEthical approval was obtained from the Research Ethics Committee (ref: 18/EM/0154) and the Health Research Authority (protocol no: 18021). The study was registered in June 2018. The results of the trial will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03545048

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Follow-up of a Wuqinxi exercise at home programme to reduce pain and improve function for knee osteoarthritis in older people: a randomised controlled trial

Age and Ageing ◽

10.1093/ageing/afaa179 ◽

2020 ◽

Author(s):

Chun Mei Xiao ◽

Jing Jing LI ◽

Yong Kang ◽

Yong Chang Zhuang

Keyword(s):

Older Adults ◽

Controlled Trial ◽

Exercise Programme ◽

Home Exercise ◽

Womac Pain ◽

Home Exercise Programme ◽

High Adherence ◽

Post Test ◽

Randomised Controlled

Abstract Background Exercise therapy is a key intervention in the management of knee osteoarthritis (KOA) and recommended in international guidelines on KOA management. An effective home-exercise programme for frail older adults with KOA was successful in achieving high adherence. This randomised controlled trial was to compare the adherence to the exercise and lasting effects of follow-up 3 months. Methods Sixty-eight participants in the original Wuqinxi (WQX) exercise study were community dwelling older adults (age = 70.95 ± 9.85 years) with KOA were categorised into 34 controls group, 34 WQX group adherers. The Western Ontario and Mc Master Universities Osteoarthritis Index questionnaire score (WOMAC) pain and Berg Balance Scale, Timed Up and Go Test, 6-min Walk Test, 30-s chair stand test, isokinetic muscle strength testing of knee flexion and extension measured at pre-test and post-test of the intervention period and follow-up for two groups. Results The WQX group maintained or improved in all nine measures from post-test to follow-up, whereas the control group significantly declined in WOMAC pain, Knee extensor strength and Knee flexor strength. Conclusion The WQX programme was an effective home-exercise programme that achieves high adherence in older adults with KOA who lived in these communities.

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Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial

BMJ ◽

10.1136/bmj.322.7288.697 ◽

2001 ◽

Vol 322 (7288) ◽

pp. 697-697 ◽

Cited By ~ 283

Author(s):

M C. Robertson

Keyword(s):

Economic Evaluation ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Exercise Programme ◽

Home Exercise ◽

Home Exercise Programme ◽

Randomised Controlled

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Effect of exercise-based management on multidirectional instability of the glenohumeral joint: a pilot randomised controlled trial protocol

BMJ Open ◽

10.1136/bmjopen-2016-013083 ◽

2016 ◽

Vol 6 (9) ◽

pp. e013083 ◽

Cited By ~ 4

Author(s):

Sarah A Warby ◽

Jon J Ford ◽

Andrew J Hahne ◽

Lyn Watson ◽

Simon Balster ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Glenohumeral Joint ◽

Controlled Trial ◽

Exercise Programme ◽

Home Exercise ◽

Limiting Factor ◽

Pilot Randomised Controlled Trial ◽

Multidirectional Instability ◽

Home Exercise Programme ◽

Randomised Controlled

IntroductionThe most commonly recommended treatment for multidirectional instability (MDI) of the shoulder is exercise. Despite this recommendation, there is limited evidence to support the effectiveness of exercise. The aim of this paper is to describe a pilot randomised controlled trial comparing the effectiveness of 2 exercise programmes on outcomes of participants with MDI.Methods and analysisConsenting participants between 12 and 35 years, with non-traumatic MDI will be randomly allocated to participate in either the Rockwood Instability programme or the Watson MDI programme. Both programmes involve 1 consultation per week for 12 weeks with a physiotherapist to prescribe and progress a home exercise programme. Outcomes will be assessed at baseline, 6, 12, 24 and 52 weeks. Primary outcome measures include the Melbourne Instability Shoulder Score and Western Ontario Shoulder Index. Secondary outcomes include scapular coordinates, scapular upward rotation angles, muscle strength, symptomatic onset, limiting factor and angle of limiting factor in abduction range, incidence of complete glenohumeral joint dislocation, global rating of change, satisfaction scores, the Orebro Musculoskeletal Pain Questionnaire, adverse events and compliance with the home exercise programme. Data will be analysed on intention-to-treat principles and a per protocol basis.DiscussionThis trial will evaluate whether there are differences in outcomes between the Rockwood and the Watson MDI programmes for participants with MDI.Ethics and disseminationParticipant confidentiality will be maintained with publication of results. Ethics approval: Faculty of Health Sciences (FHEC12/201).Trial registration numberACTRN12613001240730; Pre-results.

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Manual therapy of infants with postural and movement asymmetries and positional preference

Manuelle Medizin ◽

10.1007/s00337-020-00760-9 ◽

2021 ◽

Author(s):

Robby Sacher ◽

Martin Knüdeler ◽

Marc Wuttke ◽

Nadine Wüstkamp ◽

Steffen Derlien ◽

...

Keyword(s):

Intervention Group ◽

Exercise Programme ◽

Manual Medicine ◽

Home Exercise ◽

Control Group ◽

Double Blind ◽

Positional Preference ◽

Home Exercise Programme ◽

The Difference ◽

And Control

Abstract Background There are different therapeutic approaches to persistent positional preference (kinematic imbalance due to suboccipital strain, KISS) in infants. There are no evidence-based or controlled studies investigating the effect of manual medicine treatment in children aged 3–6 months, particularly in combination with a home exercise programme. The presented monocentric study on one-time manual medicine treatment of infants aged 14–24 exhibiting these symptoms aims to close this gap. Methods This study comprises a controlled double-blind trial and per-protocol-analysis. Primary outcome was the 4-item symmetry score (4–17 points). The second measurement was performed after 4–6 weeks. Results A total of 62 infants were treated and evaluated (mean age 17 weeks). The intervention and control groups started with a symmetry score of 12.9 ± 2.1 and 12.5 ± 1.7 points, respectively. In the intervention group the score improved by 4.9 ± 2.4 to 8.0 ± 2.7 points, in the control group it improved by 2.9 ± 2.9 to 9.6 ± 3.0 points. The difference between the groups was statistically significant (p = 0.03). Both groups had significantly better values over time (p < 0.001). No adverse events or side effects were observed. Conclusion Manual medicine treatment of infants with postural and movement asymmetries as well as positional preference in combination with a home exercise programme is superior to a home exercise programme alone. Both treatment concepts achieved significant improvements. However, the manual medicine treatment played an important role in reducing the symmetry score value for the affected children, such they were no longer in need of treatment.

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