scholarly journals Feasibility of a directly supervised telehealth-based exercise training program in patients with nonalcoholic steatohepatitis (Preprint)

2021 ◽  
Author(s):  
Victoria Motz ◽  
Alison Faust ◽  
Jessica Dahmus ◽  
Benjamin Stern ◽  
Christopher Soriano ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Training Program ◽  
Real Time ◽  
Nonalcoholic Steatohepatitis ◽  
Aerobic Training ◽  
Moderate Intensity ◽  
Relative Reduction ◽  
Supervised Exercise ◽  
Exercise Training Program

BACKGROUND Most patients with nonalcoholic fatty liver disease (NAFLD) are physically inactive despite the well-known benefits of physical activity. Telehealth offers promise as a novel way to deliver an exercise training program and increase physical activity. However, the feasibility, safety and efficacy of telehealth-based exercise programs is unknown in patients with NAFLD. OBJECTIVE To determine the feasibility of a directly supervised exercise training program delivered to patients with nonalcoholic steatohepatitis (NASH), the progressive form of NAFLD, exclusively with telehealth. METHODS In response to COVID-19 research restrictions, we adapted an existing clinical trial and delivered 20-weeks of moderate-intensity aerobic training five days a week under real-time direct supervision using an audio-visual telehealth platform. Aerobic training was completed by walking outdoors or using a home treadmill. Fitness activity trackers with heart rate monitors ensured exercise was completed at the prescribed intensity with real-time feedback from an Exercise Physiologist. RESULTS Three patients with biopsy-proven NASH were enrolled with mean age of 52 +/- 14 years. Mean body mass index was 31.9 +/- 5.1 kg/m2. All subjects had metabolic syndrome. All subjects completed >80% of exercise sessions (mean 84 +/- 3%) and no adverse events occurred. Body weight (-5.1 +/- 3.7%), body fat (-4.4 +/- 2.3%) and waist circumference (-1.3 +/- 1.6 inches) all improved with exercise. Relative reduction in magnetic resonance imaging proton density fat fraction (MRI-PDFF) was 35.1 +/- 8.8%. Reductions in hemoglobin A1c -0.5 +/- 0.2% and HOMA-IR -4.0 +/- 1.2 were observed. Peak oxygen consumption (VO2 peak) improved by +9.9 +/- 6.6 mL/kg/min. CONCLUSIONS This proof of concept study found supervised exercise training delivered via telehealth is feasible and safe in patients with NASH. Telehealth-based exercise training also appears to be highly efficacious in patients with NASH but this will need to be confirmed by future large-scale trials. CLINICALTRIAL NCT03518294

Changes in Sedentary Time and Physical Activity in Response to an Exercise Training and/or Lifestyle Intervention

2014 ◽  
Vol 11 (7) ◽  
pp. 1324-1333 ◽  
Author(s):  
Sarah Kozey-Keadle ◽  
John Staudenmayer ◽  
Amanda Libertine ◽  
Marianna Mavilia ◽  
Kate Lyden ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Lifestyle Intervention ◽  
Sedentary Time ◽  
Moderate Intensity ◽  
Control Group ◽  
Activity Levels ◽  
Exercise Training Program ◽  
Quasi Experimental ◽  
Multiple Behaviors

Background:Individuals may compensate for exercise training by modifying nonexercise behavior (ie, increase sedentary time (ST) and decrease nonexercise physical activity [NEPA]).Purpose:To compare ST and NEPA during a 12-week exercise training and/or lifestyle intervention.Methods:Fifty-seven overweight/obese participants (19 M/39 F) completed the study (mean ± SD; age 43.6 ± 9.9 y, BMI 35.1 ± 4.6 kg/m2). There were no between-group differences in activity levels at baseline. Four-arm quasi-experimental intervention study 1) EX: exercise 5 days per week at a moderate intensity (40% to 65% VO2peak) 2) rST: reduce ST and increase NEPA, 3) EX-rST: combination of EX and rST and 4) CON: maintain habitual behavior.Results:For the EX group, ST did not decrease significantly (mean ((95% confidence interval) 0.48 (–2.2 to 3.1)% and there was no changes in NEPA at week-12 compared with baseline. The changes were variable, with approximately 50% of participants increasing ST and decreasing NEPA. The rST group decreased ST (–4.8 (0.8 to 7.9)% and increased NEPA. EX-rST significantly decreased ST (–5.1 (–2.2 to 7.9)% and increased time in NEPA at week-12 compared with baseline. The control group increased ST by 4.3 (0.8 to 7.9)%.Conclusions:Changes in nonexercise ST and NEPA are variable among participants in an exercise-training program, with nearly half decreasing NEPA compared with baseline. Interventions targeting multiple behaviors (ST and NEPA) may effectively reduce compensation and increase daily activity.

scholarly journals How to promote physical activity maintenance after an exercise-training program in cancer patients?

2016 ◽  
Vol 59 ◽  
pp. e55 ◽  
Author(s):  
Katia Reichhart ◽  
Mélissa Evesque ◽  
Marion M.C. Cavana ◽  
Pauline Muszynski ◽  
Marie-Madeleine Leclercq ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Training Program ◽  
Cancer Patients ◽  
Exercise Training Program ◽  
Physical Activity Maintenance

scholarly journals A Clinician Referral and 12-Week Exercise Training Program for Men With Prostate Cancer: Outcomes to 12 Months of the ENGAGE Cluster Randomized Controlled Trial

2017 ◽  
Vol 14 (5) ◽  
pp. 353-359 ◽  
Author(s):  
Cadeyrn J. Gaskin ◽  
Melinda Craike ◽  
Mohammadreza Mohebbi ◽  
Kerry S. Courneya ◽  
Patricia M. Livingston
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Exercise Training ◽  
Training Program ◽  
Controlled Trial ◽  
Vigorous Physical Activity ◽  
Randomized Controlled ◽  
Exercise Training Program ◽  
Cluster Randomized

Background:The ENGAGE (efficacy of a referral and physical activity program for survivors of prostate cancer) study established that a clinician referral and 12-week exercise training program increased vigorous physical activity at 12 weeks among men with prostate cancer. Here, we report the 6- and 12-month outcomes.Methods:In this multicenter cluster randomized controlled trial, we compared a clinician referral and exercise training program to usual care. Discounted gym membership was offered to men in the intervention condition on completion of the 12-week exercise program. Self-reported physical activity at 6 and 12 months was the primary outcome. Quality of life, anxiety, and depressive symptoms were secondary outcomes.Results:A total of 147 men meeting eligibility criteria agreed to participate (54 intervention, 93 control). A positive interaction effect for vigorous physical activity was observed at 6 months, but not 12 months. No significant effects for the secondary outcomes were found.Conclusions:A clinician referral and community-based supervised and unsupervised exercise training program, along with discounted gym membership, had a positive short-term effect on vigorous physical activity levels, but did not improve quality of life, in men with prostate cancer.

scholarly journals Effects of an 8-Month Exercise Training Program on Off-Exercise Physical Activity

2011 ◽  
Vol 43 (9) ◽  
pp. 1744-1751 ◽  
Author(s):  
VIKRAM V. RANGAN ◽  
LESLIE H. WILLIS ◽  
CRIS A. SLENTZ ◽  
LORI A. BATEMAN ◽  
A. TAMLYN SHIELDS ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Training Program ◽  
Exercise Training Program

scholarly journals Evaluation of an Occupational Exercise Training Program for Firefighters: Mixed Methods Pilot Study

10.2196/17835 ◽  
2020 ◽  
Vol 4 (9) ◽  
pp. e17835
Author(s):  
Miriam Leary ◽  
James Thomas ◽  
Ryan Hayes ◽  
Lori Sherlock
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Pilot Study ◽  
Exercise Training ◽  
Training Program ◽  
Performance Outcomes ◽  
Fat Percentage ◽  
Exercise Training Program ◽  
And Performance ◽  
Hamstring Flexibility

Background Occupational exercise training programs can improve overall health and fitness in firefighters, but evidence beyond clinical and performance outcomes is needed before fire departments invest in and successfully adopt health promotion programs. Objective This mixed methods pilot study sought to pair clinical and performance outcomes with participants’ qualitative feedback (eg, participants’ enjoyment, lifestyle behavior changes, and team structure) with the goal of informing recommendations for future programs. Methods Professional firefighters participated in a 14-week occupational exercise training program with assessments conducted pre- and posttraining. Clinical outcomes included weight, BMI, body fat percentage, resting heart rate, systolic blood pressure, and diastolic blood pressure. Performance outcomes included the sharpened Romberg balance test, 1-repetition maximum leg press and bench press, graded exercise test (estimated VO2max), knee range of motion, shoulder flexibility, and hamstring flexibility. Self-administered surveys (Short Form-36, International Physical Activity Questionnaire, Barriers Self-Efficacy Scale, and Barriers to Being Active Quiz) were completed. In 3 private focus groups of 3 to 4 participants, firefighters' experiences in the training program and their health behaviors were explored. Results Male firefighters (n=14; age: mean 36.4, SD 2.6 years) completed 20 training sessions. There were no significant changes to weight (P=.20), BMI (P=.15), body fat percentage (P=.16), systolic blood pressure (P=.12), estimated VO2max (P=.34), balance (P=.24), knee range of motion (left: P=.35; right: P=.31), or hamstring flexibility (P=.14). There was a significant decrease in diastolic blood pressure (P=.04) and significant increases in shoulder flexibility (P<.001) and leg press 1-repetition maximum volume (P=.04). Participants reported improvements in overall health, endurance, flexibility, and mood as well as improvements to team environment and health behaviors around the station; however, there was a decline in overcoming barriers to physical activity. Conclusions A 14-week program of exercise training in firefighters elicited improvements in clinical, performance, and self-reported physical activity outcomes. This occupational exercise training program for firefighters increased time spent exercising, improved team building, and led to physical and mental health benefits. Results from this pilot study set a broad, informed, and meaningful foundation for future efforts to increase firefighter participation in occupational fitness programs.

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