scholarly journals Evaluation of the Implementation of a Home-Based Exercise Training Program for People With COPD: A Mixed-Methods Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Tamara Cerini ◽  
Ramona Kunz ◽  
Kaba Dalla Lana ◽  
Thomas Radtke ◽  
Ashley Polhemus ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Exercise Training ◽  
Training Program ◽  
Intervention Group ◽  
Mixed Methods Study ◽  
Chronic Obstructive ◽  
Daily Routine ◽  
Home Based ◽  
Exercise Training Program

Introduction: Recently, we developed a home-based, minimal-equipment exercise training program HOMEX for people with chronic obstructive pulmonary disease (COPD) and tested its effectiveness over 1 year in a randomized controlled trial. The aims of the current study were to evaluate the implementation of HOMEX from the perspectives of all involved persons and to optimize the program to ensure its long-term sustainability.Methods: In this mixed-methods study, we used qualitative and quantitative approaches to evaluate the implementation of the intervention on the level of patients with COPD and coaches who provided the intervention and relevant stakeholders. To assess the implementation outcomes dose, reach, fidelity, and adherence, we summarized information recorded in the notes of the coaches and the diaries of patients, complemented with results from qualitative assessments. To assess acceptability and appropriateness, we conducted surveys with patients and coaches, and semistructured interviews with selected patients, coaches, and stakeholders.Results: The coaches delivered the three home visits with one exception according to the protocol (fidelity). Of the 53 intervention group participants, 37 (70%) conducted HOMEX training until the end of the study and 43 (79%) trained for at least 10 months. The exercise behaviors of the participants could be separated into the phases “Starting the training and stabilizing into regular training routine” and “Managing training disruptions” (adherence). Overall, patients, coaches, and stakeholders conveyed a very high “acceptability” of HOMEX, noting the home-based aspect as a particular strength and interaction with other patients as future need. All involved groups perceived the strength-training exercises as appropriate, efficient for people with COPD, and relevant to maintain improvements after pulmonary rehabilitation. The most important facilitators of the patients for long-term motivation were self-perceived improvement in strength, supervision by a coach, and integration of the training in daily routine. Based on these insights, we redesigned and reworded the exercise cards, introduced three new exercises, and refined the training book.Discussion: The results of this study provided insights of the involved persons in the frame of the HOMEX intervention implementation with a particular focus on the long-term training behavior of the participants and their perception and experience with the exercise program. These findings enabled us to optimize the training material and adapt the structure of the program for sustainable further use in clinical and other settings.

scholarly journals Effectiveness of Non-Presential Individualized Exercise Training PrOgram(NIETO) in Lower Limb Physical Performance in Advanced COPD

2021 ◽  
Vol 10 (5) ◽  
pp. 1010
Author(s):  
Juan Miguel Sánchez-Nieto ◽  
Irene Fernández-Muñoz ◽  
Andrés Carrillo-Alcaraz ◽  
Roberto Bernabeu-Mora
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Physical Performance ◽  
Intervention Group ◽  
Quadriceps Strength ◽  
Lower Limbs ◽  
Control Group ◽  
Chronic Obstructive ◽  
Muscle Training ◽  
Exercise Training Program

Muscle training, a component of pulmonary rehabilitation (PR), improves the physical performance of patients with chronic obstructive pulmonary disease (COPD). Despite the existing evidence, the traditional center-based PR model is applied to a small percentage of patients and presents numerous problems of accessibility, adherence, and costs. This study presents a home model of simple muscle training, non-presential, monitored by telephone and individualized, according to the severity of the COPD. In addition, to evaluate the results, simple tests associated with the physical performance of the lower limbs, previously validated in COPD, have been used, such as the four-meter walk, speed test (4MGS) and the five-repetition test sitting and standing (5STS). The objective was to evaluate whether the Individualized Non-Presential Exercise Training PrOgram (NIETO) induces improvements in the 4MGS, 5STS and quadriceps muscle strength (QMS) tests in outpatients with advanced COPD (FEV1 ≤ 50%). After one year, the QMS was significantly higher in the intervention group (IG) than in the control group (CG) (2.44 ± 4.07 vs. 0.05 ± 4.26 kg; p = 0.009). The 4MGS and 5STS tests were significantly shorter in IG than in CG (−0.39 ± 0.86 vs. 0.37 ± 0.96 s; p = 0.001) and (−1.55 ± 2.83 vs. 0.60 ± 2.06 s; p = 0.001), respectively. A home model of simple muscle training monitored by telephone such as NIETO, can improve 4MGS, 5STS, and quadriceps strength tests in outpatients with advanced COPD.

Effectiveness of a long-term home-based exercise training program in COPD patients: The HOMEX-1 RCT

2021 ◽  
Author(s):  
Anja Frei ◽  
Thomas Radtke ◽  
Kaba Dalla Lana ◽  
Patrick Brun ◽  
Thomas Sigrist ◽  
...  
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Home Based ◽  
Copd Patients ◽  
Exercise Training Program

scholarly journals How to Improve the Functional Capacity of Frail and Pre-Frail Elderly People? Health, Nutritional Status and Exercise Intervention. The EXERNET-Elder 3.0 Project

2020 ◽  
Vol 12 (15) ◽  
pp. 6246 ◽  
Author(s):  
Ángel Iván Fernández-García ◽  
Alba Gómez-Cabello ◽  
Ana Moradell ◽  
David Navarrete-Villanueva ◽  
Jorge Pérez-Gómez ◽  
...  
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Functional Capacity ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Residual Effects ◽  
Control Group ◽  
Healthy Habits ◽  
Exercise Training Program ◽  
Frail Elderly People

Aging is associated with the impairment of health and functional capacity, and physical exercise seems to be an effective tool in frailty prevention and treatment. The purpose of this study was to present the methodology used in the EXERNET-Elder 3.0 project that aims to evaluate the immediate and residual effects and of a multicomponent exercise training program called Elder-fit on frailty, fitness, body composition and quality of life, and also to analyse a possible dietary intake interaction according to health and metabolic status. A total of 110 frail and pre-frail elders participated in this study and were divided into a control group (CG = 52) and an intervention group (IG = 58). The IG performed a supervised multicomponent exercise training program of 6 months and 3 days per week, which included strength, endurance, balance, coordination and flexibility exercises, while the CG continued with their usual daily activities. Both groups received four speeches about healthy habits along the project. Four evaluations were performed: at baseline, after 3 months of training, at the end of the training program (6 months) and 4 months after the program had ended to examine the effects of detraining. Evaluating the efficacy, safety and feasibility of this program will help to develop efficacious physical interventions against frailty. Further, protocols should be described accurately to allow exercise programs to be successfully replicated.

Effectiveness of a Home-Based Telehealth Exercise Training Program for Patients With Cardiometabolic Multimorbidity

2020 ◽  
Vol 35 (5) ◽  
pp. 491-501
Author(s):  
Shang-Lin Chiang ◽  
Chien-Lung Shen ◽  
Liang-Cheng Chen ◽  
Yi-Pang Lo ◽  
Chueh-Ho Lin ◽  
...  
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Home Based ◽  
Exercise Training Program

Effects of structured home-based exercise training on circulating endothelial progenitor cells and endothelial function in patients with intermittent claudication

2021 ◽  
pp. 1358863X2110208
Author(s):  
Leonella Pasqualini ◽  
Francesco Bagaglia ◽  
Stefano Ministrini ◽  
Maria Rosaria Frangione ◽  
Christian Leli ◽  
...  
Keyword(s):  
Exercise Training ◽  
Endothelial Function ◽  
Training Program ◽  
Progenitor Cells ◽  
Intermittent Claudication ◽  
Treadmill Test ◽  
Home Based ◽  
Exercise Training Program ◽  
Walking Capacity ◽  
Walking Time

Introduction: Exercise training improves walking capacity in patients with intermittent claudication (IC). Endothelial progenitor cells (EPCs), endothelial microparticles (EMPs), and endothelial dysfunction could play a role in this process. Methods: We measured EPCs and EMPs in a group of 60 patients with IC, and in a control group of 20 individuals without IC, before a treadmill test and 2, 24, and 48 hours after the test. Thirty patients with IC were randomly assigned to perform a 12-week home-based exercise training program. The EPC count, flow-mediated dilation (FMD) of the brachial artery, pain-free walking time (PFWT), and maximum walking time (MWT) were measured at the baseline and after the exercise training program. Results: In patients with IC, EMPs significantly increased 2 hours after the treadmill test, whereas EPCs significantly increased after 24 hours. Among the subjects assigned to complete the training program, we observed a significant increase in the number of EPCs after 12 weeks, as well as an improvement in FMD, PFWT, and MWT. A significant correlation between the variation of EPCs, FMD, and MWT was found. The increase of EPCs and FMD were independent determinants of the walking capacity improvement, without significant interaction. Conclusion: Our results suggest that EPCs mobilization contributes to the improvement of walking capacity in patients with IC undergoing structured physical training. A number of different, partly independent, mechanisms are involved in this process, and our results highlight the potential role of EMPs release and endothelial function improvement. ClinicalTrials.gov Identifier: NCT04302571

scholarly journals Home-based telehealth exercise training program in Chinese patients with heart failure

Medicine ◽  
2018 ◽  
Vol 97 (35) ◽  
pp. e12069 ◽  
Author(s):  
Xingchen Peng ◽  
Yonglin Su ◽  
Zhonghua Hu ◽  
Xiye Sun ◽  
Xiaoping Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Training Program ◽  
Chinese Patients ◽  
Home Based ◽  
Exercise Training Program ◽  
Patients With Heart Failure

scholarly journals Increased VO2 peak after a structured exercise-training program is associated with reduced levels of cardiac myosin binding protein C in patients with symptomatic chronic heart failure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E.A Riveland ◽  
T Valborgland ◽  
A Ushakova ◽  
T Karlsen ◽  
C Delagardelle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Training Program ◽  
Plasma Levels ◽  
Intervention Group ◽  
Cardiac Myosin ◽  
Myosin Binding Protein ◽  
Myosin Binding Protein C ◽  
Exercise Training Program ◽  
Myosin Binding

Abstract Background Cardiac myosin-binding protein C (cMyC), a cardiac contractile protein, is a novel biomarker of myocardial injury, rising earlier and disappearing faster than cardiac troponins. It is a promising biomarker for use in triage of patients with chest pain presenting in the emergency department. It also has prognostic significance in patients with heart failure. However, the effects of systematic exercise training on plasma levels of cMyC has previously not been evaluated. Purpose The aim of this study was to assess the effect of a 12-week exercise training program on changes in plasma levels of cMyC in patients with chronic symptomatic heart failure with reduced ejection fraction (HFrEF). The changes in plasma levels of cMyC in an intervention group, performing structured exercise programs, were compared to those in a control group, instructed to perform regular recommended exercise (RRE) according to current guidelines. Methods This was a post hoc analysis of the SMARTEX-HF trial in 215 patients with symptomatic HF with Left Ventricular Ejection Fraction (LVEF) <35% and NYHA II-III. The patients were randomly assigned to High Intensity Interval Training (HIIT, n=77), Moderate Continuous Training (MCT, n=65) or RRE, (n=73) for 12 weeks. HIIT and MCT groups constituted the intervention group (IG). Measurements and clinical data were acquired before and after the 12-week intervention. Statistical analysis We divided the patients in two groups with Δ VO2Peak above and below the median of the sample. The absolute changes of cMyC were then compared between the two groups. Mann-Whitney U test was used to compare continuous variables between the groups. Chi-squared test and Fisher exact test were used to compare categorical variables, as appropriate. A two-tailed p<0.05 was considered significant. Results There were no differences in changes of cMyC plasma levels, measured at baseline and after the intervention, between patients in the IG and RRE-group (p=0.580). When dividing the entire study population according to Δ VO2Peak higher or lower than median value 0.48 ml/kg/min, we found a statistically significant greater reduction of cMyC values after 12 weeks of exercise training for those with higher than median Delta VO2Peak values compared to those with lower values (p=0.012). This finding was even stronger for the percentage change in cMyC levels (p=0.004 between groups). Conclusion In patients with symptomatic chronic HFrEF performing a structured 12-week exercise training program, a greater increase in Δ VO2Peak is significantly associated with a reduction in cMyC, suggesting cMyC may provide a dynamic measure of cardiorespiratory state. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Central Norwegian Health authority,Norwegian University of Science and Technology Baseline characteristics Boxplot cMyC vs peak VO2

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