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Simmich J, Ross MH, Russell T. Real-time video telerehabilitation shows comparable satisfaction and similar or better attendance and adherence compared with in-person physiotherapy: a systematic review. J Physiother 2024; 70:181-192. [PMID: 38879432 DOI: 10.1016/j.jphys.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/13/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
QUESTION How does physiotherapy delivered by real-time, video-based telerehabilitation compare with in-person delivery for the outcomes of attendance, adherence and satisfaction? DESIGN Systematic review of randomised control trials indexed in PubMed, CINAHL, Embase, Cochrane and PEDro on 12 March 2024. PARTICIPANTS Adults aged > 18 years. INTERVENTION Physiotherapy delivered via real-time video telerehabilitation. OUTCOME MEASURES Attendance, adherence and satisfaction. RESULTS Eight studies were included for attendance (n = 1,110), nine studies for adherence (n = 1,190) and 12 studies for satisfaction (n = 1,247). Telerehabilitation resulted in attendance at treatment sessions that was 8% higher (95% CI -1 to 18) and adherence to exercise programs that was 9% higher (95% CI 2 to 16) when compared with in-person physiotherapy. Satisfaction was similar with both modes of delivery (SMD 0.03 in favour of telerehabilitation, 95% CI -0.23 to 0.28). The level of certainty assessed by GRADE ranged from very low to low, primarily due to inconsistency and high risk of bias. DISCUSSION Attendance at appointments among participants assigned to telerehabilitation was somewhere between similar to and considerably higher than among control participants. Adherence to self-management with telerehabilitation was better than with in-person delivery, although with some uncertainty about the magnitude of the effect. Reported satisfaction levels were similar between the two modes of treatment delivery. Given the significance of attendance, adherence and satisfaction for successful outcomes, telerehabilitation offers a valuable alternative mode for physiotherapy delivery. CONCLUSION Real-time telerehabilitation has potentially favourable effects on attendance at treatment appointments and adherence to exercise programs, with similar satisfaction when compared with traditional in-person physiotherapy. REGISTRATION PROSPERO CRD42022329906.
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Affiliation(s)
- Joshua Simmich
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.
| | - Megan H Ross
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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Laakso J, Kopra J, Koivumaa-Honkanen H, Sirola J, Honkanen R, Kröger H, Rikkonen T. Physical and mental health predicts better adherence to exercise intervention in older women: A post-hoc analysis. Heliyon 2024; 10:e32128. [PMID: 38882273 PMCID: PMC11180318 DOI: 10.1016/j.heliyon.2024.e32128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024] Open
Abstract
Background Adherence to exercise is crucial for promoting health and maintaining functioning. Aims To investigate predictors of adherence to exercise in the initially free supervised fall prevention RCT and its low-cost, self-sustained continuation among elderly women. Methods In the 2-year Kuopio Fall Prevention Study RCT, 457 women (aged 71-84) were offered a free initial 6-month supervised weekly training program (gym, Tai Chi) in the municipal facilities. Women's adherence during this period was categorized into high (≥80 %) and low (<80 %). In the next six months, their free access to the premises continued without supervision. For the second year, low-cost access was offered with unsupervised independent training in these facilities. The second-year adherence was based on purchasing(yes/no) a gym card to continue exercising. Information on baseline health, functioning, and lifestyle was obtained by mailed questionnaires and physical tests. Results For the first six months, over 60 % of the women had high adherence. Only 26 % continued into the second year. For both follow-up years, active training history was related to better adherence. Initial predictors were related to mental health i.e. having less often fear of falls limiting one's mobility, ability to cope with external, not internal hostility, and being in a loving relationship. In the second year, predictors were related to younger age, having less frequent fear of falls, better functional capacity i.e. better strengths (grip and leg extension) and faster Timed "Up and Go" -test. Conclusion Better mental and physical health, better functional capacity and active training background were associated with higher adherence to exercise intervention in older women.
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Affiliation(s)
- J Laakso
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
| | - J Kopra
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- School of Computing, University of Eastern Finland, Kuopio, Finland
| | - H Koivumaa-Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland (UEF), Kuopio, Finland
- Mental Health and Wellbeing Center, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - J Sirola
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - R Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
| | - H Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - T Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland
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Nam JS, Kim HA, Kwak T, Cho KH, Jung IY, Moon CW. Feasibility of Mobile Health App-Based Home Aerobic Exercise for Physical Performance in Healthy Young Adults. Ann Rehabil Med 2024; 48:75-85. [PMID: 38433008 PMCID: PMC10915298 DOI: 10.5535/arm.230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/16/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE To investigate the feasibility and effects of a mobile app-based home cycling exercise program compared to home cycling exercise without additional monitoring system. Compared with fitness facilities or outdoor exercise, home-based exercise programs effectively improve physical performance in an indwelling community. However, a flexible, informal environment may decrease motivation and impair adherence to physical exercise. Mobile devices for aerobic exercise and mobile applications provide real-time monitoring, immediate feedback, and encouragement to increase motivation and promote physical performance. We investigated the feasibility and effects of a mobile app-based home exercise program on body composition, muscular strength, and cardiopulmonary function. METHODS Between February and May 2023, 20 participants were randomly allocated to the intervention (mobile application with a tablet) and control groups, and they performed aerobic exercise using a stationary bicycle for ≥150 minutes per week for 6 weeks (≤30-minute exercise session, with 3-minute warm-up and 3-minute cool-down). Karvonen formula-based heartrate defined the weekly increase in exercise intensity. Outcome measures included body-composition parameters, isokinetic knee flexor and extensor strength tests, cardiopulmonary exercise test results, and rate of target heart rate (HR) achievement. Participants were assessed at baseline and after the intervention. RESULTS Unrelated personal events led two participants to drop out. The intervention and control groups had similar baseline characteristics. Compared with the control group, in the post-intervention isokinetic strength test, bilateral knee flexor and extensor power, and time to target HR achievement significantly increased each week in the intervention group. CONCLUSION Home-based exercise to achieve long-term cardiovascular fitness with portable electronic/mobile devices facilitates individualized exercise using real-time feedback to improve motivation and adherence.
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Affiliation(s)
- Je Shik Nam
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hyun-Ah Kim
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | | | - Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Il-Young Jung
- Department of Rehabilitation Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Chang-Won Moon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
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Zmerly H, Milanese C, El Ghoch M, Itani L, Tannir H, Kreidieh D, Yumuk V, Pellegrini M. Personalized Physical Activity Programs for the Management of Knee Osteoarthritis in Individuals with Obesity: A Patient-Centered Approach. Diseases 2023; 11:182. [PMID: 38131988 PMCID: PMC10742871 DOI: 10.3390/diseases11040182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Physical activity (PA) plays a vital role in knee osteoarthritis (KOA) management. However, engaging individuals with KOA in regular exercise is challenging, especially when they are affected by obesity. The aim of the current review is to elucidate how to increase adherence to exercise in this population. When implementing a PA program with patients with KOA and obesity, a specific multi-step approach can be adopted. In phase I (the baseline assessment), the patients' eligibility for exercise is ascertained and a physical fitness assessment, sarcopenic obesity screening and quantification of the pain experienced are undertaken. Phase II adopts a patient-centered approach in implementing a PA program that combines an active lifestyle (>6000 steps/day) with land- or water-based exercise programs performed over eight to twelve weeks, with a frequency of three to five sessions per week, each lasting 60 min. In phase III, several strategies can be used to increase the patients' adherence to higher levels of PA, including the following: (i) personalizing PA goal-setting and real-time monitoring; (ii) enhancing physical fitness and the management of sarcopenic obesity; (iii) building a sustainable environment and a supportive social network for an active lifestyle; and (iv) reducing pain, which can ameliorate the clinical severity of KOA and help with weight management in this population.
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Affiliation(s)
- Hassan Zmerly
- Orthopaedics and Traumatology Unit, Villa Erbosa Hospital, 40129 Bologna, Italy;
- Ludes Campus, 6912 Lugano, Switzerland
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37131 Verona, Italy;
| | - Marwan El Ghoch
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 34363 Istanbul, Türkiye;
| | - Massimo Pellegrini
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
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Danielsen MB, Andersen S, Ryg J, Bruun NH, Madeleine P, Jorgensen MG. Effect of a home-based isometric handgrip training programme on systolic blood pressure in adults: A randomised assessor-blinded trial. J Sports Sci 2023; 41:1815-1823. [PMID: 38166533 DOI: 10.1080/02640414.2023.2300566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/20/2023] [Indexed: 01/04/2024]
Abstract
OBJECTIVES To evaluate the effects of 20 weeks of home-based isometric handgrip training (IHT) compared with usual care on systolic blood pressure (SBP) in adults. DESIGN AND PARTICIPANTS This was a randomised, controlled, assessor-blinded trial. Participants were randomised to either IHT (intervention group) or usual care (control group). INTERVENTIONS Participants randomised to the intervention group performed a session of 16 min of effective workout home-based IHT three times per week for 20 weeks. Participants randomised to the control group were asked to continue their daily activities as usual. OUTCOMES The primary outcome was the difference in SBP between groups over 20 weeks. Secondary outcomes were diastolic blood pressure, heart rate, handgrip strength, and self-administered home blood pressure measures. RESULTS Forty-eight adults (mean [SD] age, 64 [8] years) were included in this trial. The adjusted between-group mean difference in SBP was 8.12 mmHg (95% CI 0.24 to 16.01, p = 0.04) - favouring the usual care group. No differences between groups were found in any of the home blood pressure measurements. CONCLUSIONS This trial showed that 20 weeks of home-based isometric handgrip training was not superior compared to the usual care in lowering SBP.
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Affiliation(s)
- Mathias Brix Danielsen
- Department of Geriatric Medicine, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Pascal Madeleine
- Department of Health Sciences and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Martin Gronbech Jorgensen
- Department of Geriatric Medicine, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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