Feasibility and acceptability of establishing virtual exercise classes for cystic fibrosis (CF) patients

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.