ABSTRACT
INTRODUCTION: Exercise is vital to staying well and preventing secondary complications in people with chronic neurological impairments (CNI). Appropriate exercise is often inaccessible to this population. The purpose of the study is to investigate the effects of a seated, virtual exercise programme on heart rate, recovery, fatigue, pain, motivation, enjoyment and quality of life in people with CNI. METHODS AND ANALYSIS: Individuals with CNI will be screened for eligibility, and 60 participants will be randomised 1:1 into either a live or prerecorded group. There is no geographical limitation to where participants reside, since participation is virtual. The study will be coordinated by one site in White Plains, New York, USA. The live group will exercise with an instructor via Zoom while the prerecorded group will exercise at their chosen time using prerecorded videos, 3×/week for 12 weeks. PRIMARY OUTCOME MEASURES: change in heart rate during exercise/recovery. SECONDARY OUTCOME MEASURES: fatigue, motivation, level of pain and exertion, physical well-being, enjoyment of physical activity, motivation and quality of life. Outcomes will be assessed at baseline, midpoint, end of study and 1-month poststudy. Adverse events, medication changes and physical activity will be tracked throughout. Within-group and between-group comparisons will be performed by using analysis of covariance and regression. ETHICS AND DISSEMINATION: BRANY IRB approval: 22 September 2020, protocol #20-08-388-512. All participants will provide written informed consent. Results will be disseminated through presentations, publications and ClinicalTrials.gov. TRIAL REGISTRATION NUMBER: NCT04564495.
Subject(s)
Exercise Therapy , Quality of Life , Humans , Exercise Therapy/methods , Exercise , New York , Randomized Controlled Trials as TopicABSTRACT
Research Objectives To investigate the effect of a novel home-based tele-exercise program on personal engagement, quality of life, and physical wellness in adults with chronic neurological impairments. Design A randomized controlled trial. Setting Virtual study: participants exercise at home with guided feedback from an adaptive fitness instructor. Participants 63 adults with chronic neurological impairments (49 Multiple Sclerosis, 4 Spinal cord injury, 3 Friedreich's Ataxia, 3 Transverse myelitis, 2 Neuromyelitis Optica, 1 Myotonic Dystrophy) across U.S., Canada, and Europe participated in the entirely virtual study. Interventions All participants received the home-based seated exercise program that included power posture, boxing, and high intensity interval training for 45 minutes, 3 times per week for 3 months. The synchronous group (n=33) exercised with the fitness instructor at the scheduled time using a web-based video chat conference platform. The asynchronous group (n=30) received video recordings of the exercise sessions each week. Main Outcome Measures Physical Activity Enjoyment Scale (PACES), Reasons for Exercise Inventory (REI), Physical health (SF-36), and Perceived Wellness Scale (PWS) were measured at baseline, mid-study, end of study, and one month follow up. All assessments were completed online on REDCap. Results Within groups, the synchronous group demonstrated a statistically significant result in PACES (p< 0.01) and physical health (p=0.02). The -asynchronous group significantly improved in motivation over time (p=0.03). The remaining assessments in both groups were not significant over time. Conclusions The COVID pandemic has influenced in-person physical, social, and emotional engagement for all populations across the lifespan. Individuals with CNI who require regular exercise and physical activity may demonstrate benefits from guided virtual exercise programs that foster social interaction, personal engagement and physical well-being. Author(s) Disclosures The authors have no conflict of interest to declare.
ABSTRACT
BACKGROUND: While Walkbot-assisted locomotor training (WLT) provided ample evidence on balance and gait improvements, the therapeutic effects on cardiopulmonary and psychological elements as well as fall confidence are unknown in stroke survivors. OBJECTIVE: The present study aimed to compare the effects of Walkbot locomotor training (WLT) with conventional locomotor training (CLT) on balance and gait, cardiopulmonary and psychological functions and fall confidence in acute hemiparetic stroke. METHODS: Fourteen patients with acute hemiparetic stroke were randomized into either the WLT (60-minute physical therapy +30-minute Walkbot-assisted gait training) or CLT (60âmin physical therapy +30âmin gait training) groups, 7 days/week over 2 weeks. Clinical outcomes included the Berg balance scale (BBS), functional ambulation category (FAC), heart rate (HR) and Borg rating of perceived exertion (BRPE), Beck depression inventory-II (BDI-II), and the activities-specific balance confidence (ABC) scale. The analysis of covariance (ANCOVA) was conducted at Pâ<â0.05. RESULTS: ANCOVA showed that WLT showed superior effects, compared to CLT, on FAC, HR, BRPE, BDI-II, and ABC scale (Pâ<â0.05), but not on BBS (Pâ=â0.061). CONCLUSIONS: Our results provide novel, promising clinical evidence that WLT improved balance and gait function as well as cardiopulmonary and psychological functions, and fall confidence in acute stroke survivors who were unable to ambulate independently.