scholarly journals Supervised exercise rehabilitation in survivors of critical illness: A randomised controlled trial

2018 ◽  
Vol 20 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Ceri Battle ◽  
Karen James ◽  
Paul Temblett ◽  
Hayley Hutchings
Keyword(s):  
Hospital Discharge ◽  
Controlled Trial ◽  
Unit Length ◽  
Exercise Programme ◽  
Anxiety And Depression ◽  
Six Minute Walk Test ◽  
Supervised Exercise ◽  
Randomised Controlled ◽  
Minute Walk

Objectives To investigate the impact of a six-week supervised exercise programme on cardiopulmonary fitness, balance, muscle strength and anxiety and depression in patients who have been discharged home from hospital following an intensive care unit length of stay of greater than 48 h. To investigate patients' perceptions of a six-week supervised exercise programme delivered at three months post hospital discharge. Design A single centre parallel, randomised controlled trial. Setting Outpatient department of a university teaching hospital in the UK. Participants Sixty adult survivors of critical illness, at three months post-hospital discharge. Intervention A six-week individually prescribed and supervised exercise program, with associated advice to home exercise modification. Twice weekly exercise sessions were individualised to participant's functional status and included cardiopulmonary, balance and strengthening exercises. Follow up at seven weeks, six months and 12 months. Outcome measures Six-Minute Walk Test, BERG balance test, grip strength and Hospital Anxiety and Depression Scale. A pre-designed survey was used to explore patient perceptions of the programme. Results Sixty participants ( n = 30 received allocated programme in both control and treatment groups) were randomised. Loss to follow up resulted in n = 34 participants for intention to treat analysis at 12 months follow up (leaving n = 19 in control group, n = 15 in treatment group). Median participant age at enrolment was 62 years (interquartile range: 49–72), with a median intensive care unit length of stay of nine days (interquartile range: 4–17). No significant differences were found for the Six-Minute Walk Test at any time point ( p > 0.05). Anxiety levels and balance were significantly improved in the treatment group at 12 months ( p = 0.006 and p = 0.040, respectively). Conclusions Further research is needed into appropriate interventions and outcome measures, target patient populations and timing of such intervention post-hospital discharge.

scholarly journals Exercise programme with telephone follow-up for people with hand osteoarthritis – protocol for a randomised controlled trial

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Nina Østerås ◽  
Kåre Birger Hagen ◽  
Margreth Grotle ◽  
Anne-Lene Sand-Svartrud ◽  
Petter Mowinckel ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Hand Osteoarthritis ◽  
Randomised Controlled

scholarly journals A supervised exercise intervention during cancer treatment for adolescents and young adults—FiGHTING F!T: study protocol of a randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Claire Munsie ◽  
Jay Ebert ◽  
Joanne Collins ◽  
Megan Plaster ◽  
David Joske ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Adolescent And Young Adult ◽  
Exercise Tests ◽  
Supervised Exercise ◽  
Wide Range ◽  
Patient Reported ◽  
Randomised Controlled

Abstract Background High-quality evidence supports the integration of exercise to mitigate treatment-related side effects in a wide range of paediatric and adult cancer cohorts. However, the implementation of exercise in adolescent and young adult (AYA) cancer patients is yet to be explored in depth. FiGHTINGF!T is a randomised controlled cross over trial designed to determine if a supervised, structured, and progressive exercise programme can reduce the decline in physical fitness (V02peak) associated with cancer treatment in AYAs from diagnosis. Methods/design A total of 40 AYAs recently diagnosed and due to commence systemic treatment (± 2 weeks) for a primary haematological malignancy or solid tumour will be recruited and randomised to either an immediate exercise intervention or usual care (delayed exercise) for 10 weeks. This randomised controlled crossover trial will see both groups engage in a supervised exercise intervention from either diagnosis (baseline assessment) for 10 weeks (0–10 weeks) or following an interim assessment to 20 weeks (10–20 weeks). The bi-weekly tailored exercise programme will combine aerobic and resistance exercises and be supervised by an Accredited Exercise Physiologist. Participants will complete a range of assessments at 0, 10, and 20 weeks including cardiopulmonary exercise tests, 1 repetition maximum strength measures, physical functioning, and self-reported quality of life measurements. Patient-reported treatment-related toxicities will be recorded on a weekly basis. Discussion The FiGHTINGF!T trial will provide insight into the potential benefits of a supervised exercise programme in AYAs undergoing cancer treatment. This trial will contribute to the evidence supporting the necessary integration of exercise during cancer treatment, specifically in the under-reported AYA cohort. Trial registration This trial was registered retrospectively with the Australia New Zealand Clinical Trial registry (ACTRN12620000663954). Registered on 10 June 2020

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

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.

scholarly journals Home-based pulmonary rehabilitation early after hospitalisation in COPD (early HomeBase): protocol for a randomised controlled trial

2021 ◽  
Vol 8 (1) ◽  
pp. e001107
Author(s):  
Narelle S Cox ◽  
Aroub Lahham ◽  
Christine F McDonald ◽  
Ajay Mahal ◽  
Paul O'Halloran ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Hospital Discharge ◽  
Hospital Readmission ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Control Group ◽  
Home Based ◽  
Randomised Controlled

IntroductionChronic obstructive pulmonary disease (COPD) is characterised by exacerbations of respiratory disease, frequently requiring hospital admission. Pulmonary rehabilitation can reduce the likelihood of future hospitalisation, but programme uptake is poor. This study aims to compare hospital readmission rates, clinical outcomes and costs between people with COPD who undertake a home-based programme of pulmonary rehabilitation commenced early (within 2 weeks) of hospital discharge with usual care.MethodsA multisite randomised controlled trial, powered for superiority, will be conducted in Australia. Eligible patients admitted to one of the participating sites for an exacerbation of COPD will be invited to participate. Participants will be randomised 1:1. Intervention group participants will undertake an 8-week programme of home-based pulmonary rehabilitation commencing within 2 weeks of hospital discharge. Control group participants will receive usual care and a weekly phone call for attention control. Outcomes will be measured by a blinded assessor at baseline, after the intervention (week 9–10 posthospital discharge), and at 12 months follow-up. The primary outcome is hospital readmission at 12 months follow-up.Ethics and disseminationHuman Research Ethics approval for all sites provided by Alfred Health (Project 51216). Findings will be published in peer-reviewed journals, conferences and lay publications.Trial registration numberACTRN12619001122145.

scholarly journals Prehabilitation for Frail Patients Undergoing Colorectal Surgery: Lessons Learnt From a Randomised Feasibility Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Claire Furyk ◽  
Siva Senthuran ◽  
Dia Nye ◽  
Yik H. Ho ◽  
Anthony S. Leicht
Keyword(s):  
Randomised Controlled Trial ◽  
Colorectal Surgery ◽  
Controlled Trial ◽  
Activity Level ◽  
Surgical Patients ◽  
Supervised Exercise ◽  
Frail Patients ◽  
Randomised Controlled ◽  
The Impact

There is substantial interest by clinicians to improve the health outcomes of older and frail patients following major surgery, with prehabilitation a potential and important component of future standard patient care. We studied the feasibility of a randomised controlled trial of pre-operative prehabilitation in frail patients scheduled for colorectal surgery in regional Australia. We conducted a single blind, parallel arm, randomised controlled trial in a regional referral centre where colorectal surgical patients aged over 50 were invited to participate and screened for frailty. Frail patients were randomised to undertake either a 4-week supervised exercise program with dietary advice, or usual care. The primary outcome was 6-min-walk-distance at baseline, pre-surgery (4 weeks later) and at follow-up (4–6 weeks post-operation). Secondary outcomes included physical activity level, health-related quality of life, and post-surgical complications. Feasibility outcomes were numbers of patients reaching each stage and barriers or reasons for withdrawal. Of 106 patients eligible for screening during the 2-year study period, only five were able to be randomised, of which one alone completed the entire study to follow-up. Fewer patients than expected met the frailty criteria (23.6%), and many (22.6%) were offered surgery in a shorter timeframe than the required 4 weeks. Physical and psychological aspects of frailty and logistical issues were key for patients declining study participation and/or not complying with the intervention and/or all outcome assessments. Feasibility for a large randomised controlled trial of prehabilitation for frail colorectal patients was poor (~5%) for our regional location. Addressing barriers, examination of a large, dense population base, and utilisation of a frailty-screening tool validated in surgical patients are necessary for future studies to identify the impact of prehabilitation for frail patients.

scholarly journals Treating anxiety and depression in older adults: randomised controlled trial comparing guided V. self-guided internet-delivered cognitive–behavioural therapy

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Nickolai Titov ◽  
Vincent J. Fogliati ◽  
Lauren G. Staples ◽  
Milena Gandy ◽  
Luke Johnston ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundSymptoms of anxiety and depression are prevalent in older adults.AimsTo compare clinician-guided and self-guided versions of a transdiagnostic internet-delivered cognitive–behavioural therapy (iCBT) intervention for adults aged 60 years and above.MethodAdults (n=433) with symptoms of anxiety and depression were randomly allocated to: (1) clinician-guided treatment (n=153); (2) initial clinician interview followed by self-guided treatment (n=140); or (3) self-guided treatment without interview (n=140).ResultsLarge reductions (d ≥1.00) in symptoms of depression and anxiety were observed across groups, and sustained at follow-up. No differences were observed in clinical outcomes or satisfaction ratings. Age did not affect outcomes.ConclusionsCarefully developed iCBT interventions may significantly reduce symptoms of anxiety and depression in older adults when delivered in either clinician-guided or self-guided formats.

scholarly journals Functional electrical stimulation in-bed cycle ergometry in mechanically ventilated patients: a multicentre randomised controlled trial

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215093
Author(s):  
Sue Berney ◽  
Ramona O Hopkins ◽  
Joleen Wyn Rose ◽  
Rene Koopman ◽  
Zudin Puthucheary ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Muscle Strength ◽  
Usual Care ◽  
Hospital Discharge ◽  
Controlled Trial ◽  
Cycle Ergometry ◽  
Control Group ◽  
Mechanically Ventilated ◽  
Randomised Controlled

PurposeTo investigate the effect of functional electrical stimulation-assisted cycle ergometry (FES-cycling) on muscle strength, cognitive impairment and related outcomes.MethodsMechanically ventilated patients aged ≥18 years with sepsis or systemic inflammatory response syndrome were randomised to either 60 min of FES-cycling >5 days/week while in the intensive care unit (ICU) plus usual care rehabilitation versus usual care rehabilitation alone, with evaluation of two primary outcomes: (1) muscle strength at hospital discharge and (2) cognitive impairment at 6-month follow-up.ResultsWe enrolled 162 participants, across four study sites experienced in ICU rehabilitation in Australia and the USA, to FES-cycling (n=80; mean age±SD 59±15) versus control (n=82; 56±14). Intervention participants received a median (IQR) of 5 (3–9) FES-cycling sessions with duration of 56 (34–63) min/day plus 15 (10–23) min/day of usual care rehabilitation. The control group received 15 (8–15) min/day of usual care rehabilitation. In the intervention versus control group, there was no significant differences for muscle strength at hospital discharge (mean difference (95% CI) 3.3 (−5.0 to 12.1) Nm), prevalence of cognitive impairment at 6 months (OR 1.1 (95% CI 0.30 to 3.8)) or secondary outcomes measured in-hospital and at 6 and 12 months follow-up.ConclusionIn this randomised controlled trial, undertaken at four centres with established rehabilitation programmes, the addition of FES-cycling to usual care rehabilitation did not substantially increase muscle strength at hospital discharge. At 6 months, the incidence of cognitive impairment was almost identical between groups, but potential benefit or harm of the intervention on cognition cannot be excluded due to imprecision of the estimated effect.Trial registration numberACTRN 12612000528853, NCT02214823.

The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in Polio survivors: a randomised controlled trial

2016 ◽  
Vol 31 (7) ◽  
pp. 913-925 ◽  
Author(s):  
D Murray ◽  
O Hardiman ◽  
A Campion ◽  
R Vance ◽  
F Horgan ◽  
...  
Keyword(s):  
Physical Fitness ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Home Based ◽  
Sf 36 ◽  
Arm Ergometry ◽  
Fatigue Severity ◽  
Randomised Controlled ◽  
Polio Survivors

Objective: To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors. Design: An assessor blinded randomised controlled trial. Setting: Home-based exercise. Subjects: Fifty-five Polio survivors randomised to exercise or control groups. Intervention: Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care. Main measures: The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks. Results: There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute ( P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg ( P=0.002)]. There were no between group differences in the Fatigue Severity Scale ( P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities ( P=0.49), with a small difference in SF-36 physical component score ( P=0.04). Conclusions: This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.

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