Feasibility and Efficacy of Telehealth-Based Resistance Exercise Training in Adolescents with Cystic Fibrosis and Glucose Intolerance

Abstract

The aims of this study were to (1) determine the feasibility of a home-based resistance exercise training (RET) program in patients with cystic fibrosis and impaired glucose tolerance using virtual personal training and (2) observe the effects completion of the RET program had on glucose metabolism, pulmonary function, body composition, and physical fitness. The feasibility of the program was defined as 80% compliance. Ten participants (15.80 ± 2.20 yr, 25.1 ± 7.4 kg/m2) began a home-based resistance training program consisting of 36 sessions supervised via online videoconferencing. Compliance scores of 78.9% (all participants) and 81.8% (without one outlier) were observed. A significant increase was observed in 2-h C-peptide levels (2.1 ng/mL; p = 0.04), with a moderate decrease in fasting glucose (−5.2 mg/dL; p = 0.11) and a moderate increase in 2-h insulin (35.0 U/mL; p = 0.10). A small decrease in the fat percentage (−1.3%; p = 0.03) was observed in addition to increases in fat-free mass (1.5 kg; p = 0.01) and the fat-free mass index (0.4; p = 0.01). Small, yet statistically significant increases were observed in V̇O2peak (0.1 L/min p = 0.01), V̇CO2peak (0.1 L/min; p = 0.01), and ventilation (5.3 L/min; p = 0.04). Telehealth-based RET is feasible in adolescents with CF and impaired glucose tolerance and elicits small yet favorable changes in insulin secretion, body composition, and exercise capacity.

Comparison of Bioelectrical Impedance Analysis with DXA in Adolescents with Cystic Fibrosis before and after a Resistance Training Intervention

“…The current pilot study and outcome measures were secondary, derived from a larger study investigating the feasibility and effects of home-based resistance exercise training in adolescents with CF and impaired glucose tolerance [ 36 ]. Adolescents aged 10 to 18 years with CF and pancreatic insufficiency were invited to participate in this prospective study.…”

Exercise and Airway Clearance Techniques in Cystic Fibrosis

“…25 Since the coronavirus disease 2019 pandemic, there has been a rapid increase in telehealth availability and this may serve as a useful adjunct to improve adherence and clinical outcomes for pwCF. 32 33 Similarly, the use of internet-based programs to increase participation of pwCF with exercise and physical activity has been trialed, albeit with varied success. 34 35 It is likely that there is a no “one-size fits all” approach to improving adherence to exercise and physical activity recommendations for pwCF and that an individualized, multifaceted approach is required.…”

Preferences and perspectives regarding telehealth exercise interventions for adults with cystic fibrosis: A qualitative study

“…Telehealth refers to the delivery of remote health care via communication technologies such as telephone calls, video calls, or text messaging. 10 In an era of advancing healthcare technology and access to telehealth, providing a supervised telehealth exercise program to this population could be a way to deliver exercise interventions to this population. This would minimize risks of cross-infection, and increase access to this important intervention for those who are geographically remote.…”

“…Recent single-arm trials with small sample sizes in adolescents and young adults with CF concluded that completing a supervised exercise program via video conferencing was feasible and acceptable to participants. 10,14 However, participation rates and compliance to the exercise interventions were variable and the studies did not report the involvement of end users in the design process. A randomized controlled trial comparing web-based physical activity promotion versus usual care in 107 adolescents and young adults with CF following hospital discharge demonstrated low uptake of the intervention and no between-group differences in changes in physical activity.…”

“…Telehealth exercise interventions have proven to be effective and safe for other chronic lung conditions 9 however there is limited evidence for adults with CF. Telehealth refers to the delivery of remote health care via communication technologies such as telephone calls, video calls, or text messaging 10 . In an era of advancing healthcare technology and access to telehealth, providing a supervised telehealth exercise program to this population could be a way to deliver exercise interventions to this population.…”