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

Chiang, Shang Lin; Shen, Chien Lung; Chen, Liang Cheng; Lo, Yi Pang; Lin, Chueh Ho; Lin, Chao Chun

doi:10.1097/jcn.0000000000000693

Cited by 12 publications

(13 citation statements)

References 30 publications

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“…However, no details of the comparison group were provided; the assumption was that the comparison group was UMC. The VO 2 peak (34,45,46,48,49,51,52,55,57) was reported in 6 studies (9 reports), of which 3 (46,48,52) were included in metaanalysis. Meta-analysis showed a WMD of 2.74 mL/ kg/min (95% CI -3.32 to 8.79) in favour of exercise rehabilitation (Fig.…”

Section: Exercise Rehabilitation Vs Usual Medical Carementioning

confidence: 99%

“…One study (50) applied the chronic respiratory disease questionnaire (CRDQ); the water-based rehabilitation group compared with UMC showed significant difference in change for 3 out of 4 domains (dyspnoea, fatigue and emotion) in favour of exercise rehabilitation; however, it was not possible to calculate ESs. One study (55) applied the Short Form-26, with exercise training improving both the physical and mental composite score, with ESs of 0.49 and 0.39, respectively.…”

Section: Subgroup Analysismentioning

confidence: 99%

“…The step count showed a small ES of 0.09, while the physical activity questionnaire had a large ES of 1.24, favouring exercise rehabilitation. Two studies (55,57) reported improvements in total physical activity with exercise training compared with control, with ESs of 0.13-0.89.…”

Section: Subgroup Analysismentioning

confidence: 99%

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Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review

Barker

Holland

Skinner

et al. 2023

JRM

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Objective: To determine the effectiveness of exercise rehabilitation in people with multimorbidity. Exercise capacity was the primary outcome. Secondary outcomes were: health-related quality of life, activities of daily living, cardiometabolic outcomes, mental health outcomes, symptom scores, resource utilization, health behaviours, economic outcomes, and adverse events.Data sources: A search was conducted in MEDLINE, CINHAL, EMBASE, and Cochrane Central Register of Controlled Trials databases. Study selection and extraction: Randomized and non-randomized controlled trials and cohort studies of exercise rehabilitation vs any comparison in people with multimorbidity.Data synthesis: Forty-four reports (38 studies) were included. Rehabilitation ranged from 8 weeks to 4 years, with 1–7 sessions of rehabilitation weekly. Exercise included aerobic and resistance, limb training, aquatic exercises and tai chi. Compared with usual care, exercise rehabilitation improved 6-min walk distance (weighted mean difference (WMD) 64 m, 95% CI 45–82) and peak oxygen consumption (WMD 2.74 mL/kg/min, 95% CI –3.32 to 8.79). Effects on cardiometabolic outcomes and health-related quality of life also favoured rehabilitation; however; few data were available for other secondary outcomes.Conclusion: In people with multimorbidity, exercise rehabilitation improved exercise capacity, health-related quality of life, and cardiometabolic outcomes. LAY ABSTRACTChronic disease is a common health problem worldwide. It is increasingly common for people to have more than 1 chronic disease, which is called multimorbidity, and the interaction of their multiple health problems may worsen their health outcomes. Exercise rehabilitation is an effective and established treatment to improve health for people with different chronic diseases, such as heart and lung disease; however, the benefit of structured rehabilitation in people with multimorbidity has not been systematically reviewed. A literature search was performed to investigate the clinical outcomes following exercise rehabilitation in people with multimorbidity. Compared with usual medical care, the results showed that exercise rehabilitation improved exercise capacity, measured by walking distance in a formal test, health-related quality of life and the body’s ability to use oxygen, in people with multimorbidity. There were few data regarding the benefit of rehabilitation on other outcomes, and more well-designed robust trials are needed.

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Section: Exercise Rehabilitation Vs Usual Medical Carementioning

confidence: 99%

Section: Subgroup Analysismentioning

confidence: 99%

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Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review

Barker

Holland

Skinner

et al. 2023

JRM

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“…The positive impact of regular moderate-to vigorous-intensity aerobic exercise on cardiometabolic health has been well-documented [34,35]. Therefore, the cardiometabolic factors, consisting of resting heart rate (beat/min), blood pressure (systolic and diastolic blood pressure [mmHg]), fasting blood glucose (mg/dL), serum lipids (cholesterol [mg/dL] and triglyceride [mg/dL]), and uric acid (mg/dL) were assessed at baseline and 12 weeks, as secondary outcomes.…”

Section: Cardiometabolic Factorsmentioning

confidence: 99%

Effects of Intradialytic Exercise on Dialytic Parameters, Health-Related Quality of Life, and Depression Status in Hemodialysis Patients: A Randomized Controlled Trial

Lin

Hsu

et al. 2021

IJERPH

Self Cite

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Exercise is fundamentally important in managing chronic diseases and improving health-related quality of life (HRQL). However, whether intradialytic exercise is safe through assessment of changes in dialytic parameters and has a positive impact on HRQL and depression status of hemodialysis patients requires further research with diverse racial and cultural populations to identify. This study aimed to evaluate the effects of intradialytic exercise on dialytic parameters, HRQL, and depression status in hemodialysis patients. A randomized controlled trial was conducted at a medical center in Northern Taiwan. Sixty-four hemodialysis patients were recruited using stratified random sampling. Participants were randomized into an experimental group (EG, n = 32) or a control group (CG, n = 32). The EG received a 12-week intradialytic exercise program while the CG maintained their usual lifestyles. Dialytic parameters, HRQL, and depression status were collected at baseline and at 12 weeks. The results indicated no differences in the dialytic parameters from the baseline between both groups. However, the EG had increased HRQL (ß = 22.6, p < 0.001) and reduced depression status (ß = −7.5, p = 0.02) at 12 weeks compared to the CG. Therefore, a 12-week intradialytic exercise regime is safe and effective in improving HRQL and reducing depression status for hemodialysis patients.

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“…Emerging evidence indicates that telehealth and center‐based cardiac rehabilitation are comparably effective in reducing cardiovascular risk factors among patients with cardiovascular disease (Piotrowicz, 2017; Piotrowicz et al, 2016). In addition, various guidelines and evidence claim that home‐based tele‐exercise is well accepted, safe, and has high adherence (Chiang et al, 2020; Piotrowicz et al, 2020). Tele‐exercise appears to be a promising option to overcome barriers concerning center‐based exercise training, providing guideline‐consistent monitoring of physical training in moderate‐to‐high risk patients (i.e., those with cardiometabolic multimorbidity; Neubeck et al, 2020; Piotrowicz et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a 12‐week tele‐exercise training program on cardiorespiratory fitness and heart rate recovery in patients with cardiometabolic multimorbidity

Chiang

Shen

Lee

et al. 2022

Worldviews Ev Based Nurs

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BackgroundExercise has positive impacts on cardiometabolic health. However, evidence regarding the effectiveness of tele‐exercise training on cardiorespiratory fitness and heart rate recovery in patients with cardiometabolic multimorbidity remains limited.AimsThe aim of this study was to assess whether an assumed increase in physical activity (PA) after a 12‐week tele‐exercise training program improved cardiorespiratory fitness and heart rate recovery of patients with cardiometabolic multimorbidity.MethodsA parallel‐group randomized controlled trial was conducted. Eligible patients with cardiometabolic multimorbidity (n = 83) were randomized 1:1 to either an experimental group (EG, received a 12‐week tele‐exercise training program with 3 sessions/week and 30 min/session and weekly remote monitoring for maintenance of exercise) or a control group (CG, usual care only). PA, cardiorespiratory fitness, and heart rate recovery were assessed at baseline and 12 weeks. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group.ResultsSixty‐eight participants (81.9%) completed the study, and 83 were included in the intention‐to‐treat analysis. The EG with higher vigorous‐intensity PA (β = 714, p = .037), walking behavior (β = 750, p = .0007), and total amount of PA (β = 1748, p = .001) after the intervention had significantly elevated cardiorespiratory fitness, including VO2peak (β = 3.9, p = .042), workload (β = 17.9, p = .034), and anaerobic threshold (β = 2.1, p = .041), and increased one‐min heart rate recovery (β = 5.3, p = .025), compared with the CG.Linking evidence to actionA 12‐week tele‐exercise training program was effective for increased PA, elevated cardiorespiratory fitness, and improved heart rate recovery for patients with cardiometabolic multimorbidity. These findings highlight the feasibility of better delivering lifestyle interventions for cardiometabolic health management.

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

Cited by 12 publications

References 30 publications

Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review

Clinical Outcomes Following Exercise Rehabilitation in People with Multimorbidity: A Systematic Review

Effects of Intradialytic Exercise on Dialytic Parameters, Health-Related Quality of Life, and Depression Status in Hemodialysis Patients: A Randomized Controlled Trial

Effectiveness of a 12‐week tele‐exercise training program on cardiorespiratory fitness and heart rate recovery in patients with cardiometabolic multimorbidity

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