The Use Of A Home-Based Exercise Program Using A Commercially Available Interactive Computer System In Patients With Moderate To Severe COPD: Its Feasibility And Effect On Exercise Performance, Physical Activity, Dyspnea And Health-Related Quality Of Life

Osteoarthritis is the most common condition to co-occur with other chronic health conditions and a broad exercise program on management of chronic conditions may be suitable for this group. This study evaluated the 12-week YMCA Move for Health exercise program among adults with osteoarthritis or with/at risk of chronic health conditions using a mixed-methods study design based on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Participants (n = 66) completed the exercise program at the YMCAs in Cambridge, Kitchener, and Waterloo. Assessments included physical function, health-related quality of life, symptoms of arthritis, and physical activity levels and were conducted at baseline (B), postprogram (PP), and 3-month postprogram. Due to interruption by COVID-19, a subgroup of participants completed the 3-month postprogram assessments after the onset of the pandemic. At PP, participants with OA showed significant improvements in level of disability (B = 0.63 ± 0.45 and PP = 0.55 ± 0.47; p = .049), pain (B = 4.3 ± 2.5 and PP = 3.6 ± 2.4; p = .026), fatigue (B = 3.9 ± 3.1 and PP = 2.8 ± 2.6; p = .003), and several domains related to health-related quality of life. Despite interruption by the COVID-19 pandemic and poor maintenance of physical activity levels, nearly all improvements related to level of disability, symptoms of arthritis, and health-related quality of life observed at PP were maintained 3-months postprogram. The Move for Health program proved to be a feasible and effective community program for people with osteoarthritis. Additional supports may be needed to maintain physical activity levels after the program.

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The “Super-Fontan” Phenotype: Characterizing Factors Associated With High Physical Performance

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.764273 ◽

2021 ◽

Vol 8 ◽

Author(s):

Derek L. Tran ◽

David S. Celermajer ◽

Julian Ayer ◽

Leeanne Grigg ◽

Carley Clendenning ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Physical Performance ◽

Exercise Performance ◽

Self Efficacy ◽

Work Rate ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Background: People with a Fontan circulation usually have moderately impaired exercise performance, although a subset have high physical performance (“Super-Fontan”), which may represent a low-risk phenotype.Methods: People with a “Super-Fontan” phenotype were defined as achieving normal exercise performance [≥80% predicted peak oxygen uptake (VO2) and work rate] during cardiopulmonary exercise testing (CPET) and were identified from the Australian and New Zealand Fontan Registry. A Fontan control group that included people with impaired exercise performance (<80% predicted VO2 or work rate) was also identified based on a 1:3 allocation ratio. A subset of participants were prospectively recruited and completed a series of physical activity, exercise self-efficacy, and health-related quality of life questionnaires.Results: Sixty CPETs (“Super-Fontan”, n = 15; control, n = 45) were included. A subset (“Super-Fontan”, n = 10; control, n = 13) completed a series of questionnaires. Average age was 29 ± 8 years; 48% were males. Exercise capacity reflected by percent predicted VO2 was 67 ± 17% in the entire cohort. Compared to the “Super-Fontan” phenotype, age at Fontan completion was higher in controls (4.0 ± 2.9 vs. 7.2 ± 5.3 years, p = 0.002). Only one (7%) person in the “Super-Fontan” group had a dominant right ventricle compared to 15 (33%) controls (p = 0.043). None of those in the “Super-Fontan” group were obese, while almost a quarter (22%) of controls were obese based on body mass index (p = 0.046). Lung function abnormalities were less prevalent in the “Super-Fontan” group (20 vs. 70%, p = 0.006). Exercise self-efficacy was greater in the “Super-Fontan” group (34.2 ± 3.6 vs. 27.9 ± 7.2, p = 0.02). Self-reported sports participation and physical activity levels during childhood and early adulthood were higher in the “Super-Fontan” group (p < 0.05). The total average time spent participating in structured sports and physical activity was 4.3 ± 2.6 h/wk in the “Super-Fontan” group compared to 2.0 ± 3.0 h/wk in controls, p = 0.003. There were no differences in self-reported current total physical activity score or health-related quality of life between groups (p ≥ 0.05).Conclusions: The “Super-Fontan” phenotype is associated with a healthy weight, lower age at Fontan completion, better exercise self-efficacy, and higher overall levels of sport and physical activity participation during physical development.

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