ABSTRACT
Background: CFTR modulators have led to improvements in CF outcomes, including FEV1, exacerbation frequency and body mass index (BMI). Despite positive outcomes, modulators have brought new challenges – particularly elevated BMI. For many, weight gain has been due to increased fat rather than muscle mass, making exercise a high priority. Exercise has always been an integral part of CF management. However, the COVID-19 pandemic has made it harder for patients to access exercise. This presented a service need to set up a platform where patients could safely exercise at home with support from a known physiotherapist. Objectives: To assess the feasibility and acceptability of a physiotherapyled online group exercise class for CF patients. Methods: In this pilot study, high and low intensity virtual exercise classes were delivered twice weekly over four weeks. Eight participants were recruited;five completed the study. The primary outcomes were (1) feasibility, assessed by means, resources and time needed to deliver the intervention and (2) acceptability, assessed by qualitative interviews with participants. FEV1, BMI, 60STS and psychosocial outcomes were also monitored. Results: Time, resources and equipment were all adequate to deliver the intervention within the service. Positive themes from interviews included: (1) Impact on health: improved fitness, (2) Motivation to exercise: feeling encouraged, supported and accountable, and (3) Convenience: saved time, money and ease of exercising at home. Some challenges patients reported were space, technical issues with equipment and missing face-to-face interaction. Conclusion: Virtual exercise classes for patients with CF are both feasible and acceptable, with patients reporting a positive impact on their fitness levels as well as reduced travel burden. Patients also stated that classes delivered by a familiar physiotherapist motivated them to exercise and instilled confidence that the exercises were safe and effective.Background: CFTR modulators have led to improvements in CF outcomes, including FEV1, exacerbation frequency and body mass index (BMI). Despite positive outcomes, modulators have brought new challenges – particularly elevated BMI. For many, weight gain has been due to increased fat rather than muscle mass, making exercise a high priority. Exercise has always been an integral part of CF management. However, the COVID-19 pandemic has made it harder for patients to access exercise. This presented a service need to set up a platform where patients could safely exercise at home with support from a known physiotherapist. Objectives: To assess the feasibility and acceptability of a physiotherapyled online group exercise class for CF patients. Methods: In this pilot study, high and low intensity virtual exercise classes were delivered twice weekly over four weeks. Eight participants were recruited;five completed the study. The primary outcomes were (1) feasibility, assessed by means, resources and time needed to deliver the intervention and (2) acceptability, assessed by qualitative interviews with participants. FEV1, BMI, 60STS and psychosocial outcomes were also monitored. Results: Time, resources and equipment were all adequate to deliver the intervention within the service. Positive themes from interviews included: (1) Impact on health: improved fitness, (2) Motivation to exercise: feeling encouraged, supported and accountable, and (3) Convenience: saved time, money and ease of exercising at home. Some challenges patients reported were space, technical issues with equipment and missing face-to-face interaction. Conclusion: Virtual exercise classes for patients with CF are both feasible and acceptable, with patients reporting a positive impact on their fitness levels as well as reduced travel burden. Patients also stated that classes delivered by a familiar physiotherapist motivated them to exercise and instilled confidence that the exercises were safe and effective.
ABSTRACT
Introduction: Breathlessness support services for patients with chronic breathlessness improve patients' self-management and reduce their distress due to breathlessness. The provision and access to such services within the UK's National Health Service is limited. Delivering online breathlessness supportive services maybe one way of improving access to non-pharmacological self-management interventions for people living with chronic breathlessness. Aim: To explore internet accessibility and willingness of patients with chronic respiratory disease to use an internet-based breathlessness selfmanagement intervention. Methods: Patients attending 3-specialist respiratory outpatient services at a large NHS Foundation Trust over a 2-week period (prior to the COVID-19 pandemic) completed a standardised questionnaire regarding internet accessibility. The questionnaire asked;if the patient had internet access, modes of accessing the internet, frequency of internet use and if they would use an internet based breathlessness support service. Results: 46 patients (COPD: 19, Bronchiectasis: 22, Asthma: 4), 17 male, with a median (range) age 68 (41 - 86) years, MRC Dyspnoea Score of 2 (2-4) completed the questionnaire. Of these, 35 (76%) patients had access to the internet at home;28 (61%) accessed the internet daily;and 26 (57%) had two or more modes of accessing the internet. Of the 35 patients with home internet access, 33 (94%) reported that they would use an internet-based breathlessness self-management intervention, if available. Conclusion: These preliminary findings suggest that patients that have access to the internet would use an internet-based breathlessness selfmanagement intervention, if given the opportunity.