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

BACKGROUND: Exercise 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. AIMS: The 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. METHODS: A 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. RESULTS: Sixty-eight participants (81.9%) completed the study, and 83 were included in the intention-to-treat analysis. The EG with higher vigorous-intensity PA (ß = 714, p = .037), walking behavior (ß = 750, p = .0007), and total amount of PA (ß = 1748, p = .001) after the intervention had significantly elevated cardiorespiratory fitness, including VO2peak (ß = 3.9, p = .042), workload (ß = 17.9, p = .034), and anaerobic threshold (ß = 2.1, p = .041), and increased one-min heart rate recovery (ß = 5.3, p = .025), compared with the CG. LINKING EVIDENCE TO ACTION: A 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.

Effectiveness of a Home-Based Telehealth Exercise Training Program for Patients With Cardiometabolic Multimorbidity: A Randomized Controlled Trial.

BACKGROUND: Exercise training has positive effects on the management of cardiometabolic conditions. Little is known about the effectiveness of home-based telehealth exercise training programs among patients with cardiometabolic multimorbidity, which is associated with functional decline and decreased health-related quality of life. OBJECTIVE: The aim of this study was to determine the effectiveness of a 12-week home-based telehealth exercise training program designed to increase physical activity and exercise capacity and improve health-related quality of life in patients with cardiometabolic multimorbidity. METHODS: A randomized controlled trial was conducted. Fifty eligible patients with 2 or more cardiometabolic conditions from outpatient clinics of a medical center in Northern Taiwan were randomized to either an experimental group (EG; received a 12-week home-based telehealth exercise training program) or a control group (CG; maintained usual lifestyles). The home-based telehealth exercise training program consisted of 36 individualized home-based exercise training sessions and a weekly reminder for maintenance of exercise and providing patient support. Amounts of physical activity, exercise capacity, and health-related quality of life were assessed at baseline and 12 weeks. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group. RESULTS: The EG had higher amounts of physical activity (ß = 1333, P = .004) and moderate-intensity physical activity (ß = 330, P = .04) than the CG after the intervention. The EG had increased exercise capacity (VO2peak, ß = 4.43, P = .04), as well as improved health-related quality of life (physical function, ß = 7.55, P = .03; and physical component summary, ß = 4.42, P = .03) compared with those in the CG. CONCLUSIONS: A 12-week home-based telehealth exercise training program is feasible and effective in increasing amounts of physical activity, elevating exercise capacity, and improving health-related quality of life in patients with cardiometabolic multimorbidity.

The immediate effects of a shoulder brace on muscle activity and scapular kinematics in subjects with shoulder impingement syndrome and rounded shoulder posture: A randomized crossover design.

BACKGROUND: Round shoulder posture (RSP) is one of the potential risks for shoulder impingement syndrome (SIS) due to alignment deviation of the scapula. Evidence on how the characteristics of a shoulder brace affecting the degree of RSP, shoulder kinematics, and associated muscle activity during movements is limited. RESEARCH QUESTION: The purposes of this study were (1) to compare the effects of a shoulder brace on clinical RSP measurements, muscle activities and scapular kinematics during arm movements in subjects with shoulder impingement syndrome (SIS) and RSP; and (2) to compare the effects of two configurations (parallel and diagonal) and two tensions (comfortable and forced tension) of the brace straps on muscle activities and scapular kinematics during arm movements in subjects with SIS and RSP. METHODS: Twenty-four participants (12 males; 12 females) with SIS and RSP were randomly assigned into 2 groups (comfortable then forced, and forced then comfortable) with 2 strap configurations in each tension condition. The pectoralis minor index (PMI), acromial distance (AD) and shoulder angle (SA) were used to assess the degree of RSP. Three-dimensional electromagnetic motion analysis and electromyography were used to record the scapular kinematics and muscle activity during arm movements. RESULTS: All clinical measurements with the brace were significantly improved (p < 0.05). Under forced tension, muscle activities were higher with the diagonal configuration than with the parallel configuration in the lower trapezius (LT) (1.2-2.3% MVIC, p < 0.05) and serratus anterior (SA) (2.3% MVIC, p = 0.015). For upward rotation and posterior tilting of the scapula, the diagonal configuration was larger than the parallel configuration (1.5°, p = 0.038; 0.4°-0.5°, p < 0.05, respectively). SIGNIFICANCE: Different characteristics of the straps of the shoulder brace could alter muscle activity and scapular kinematics at different angles during arm movement. Based on the clinical treatment preference, the application of a shoulder brace with a diagonal configuration and forced tension is suggested for SIS and RSP subjects.

How to Make Reliable, Washable, and Wearable Textronic Devices.

In this paper, the washability of wearable textronic (textile-electronic) devices has been studied. Two different approaches aiming at designing, producing, and testing robust washable and reliable smart textile systems are presented. The common point of the two approaches is the use of flexible conductive PCB in order to interface the miniaturized rigid (traditional) electronic devices to conductive threads and tracks within the textile flexible fabric and to connect them to antenna, textile electrodes, sensors, actuators, etc. The first approach consists in the use of TPU films (thermoplastic polyurethane) that are deposited by the press under controlled temperature and pressure parameters in order to protect the conductive thread and electrical contacts. The washability of conductive threads and contact resistances between flexible PCB and conductive threads are tested. The second approach is focused on the protection of the whole system-composed of a rigid electronic device, flexible PCB, and textile substrate-by a barrier made of latex. Three types of prototypes were realized and washed. Their reliabilities are studied.

Respiratory Rate Estimation by Using ECG, Impedance, and Motion Sensing in Smart Clothing.

The needs for light-weight and soft smart clothing in homecare have been rising since the past decade. Many smart textile sensors have been developed and applied to automatic physiological and user-centered environmental status recognition. In the present study, we propose wearable multi-sensor smart clothing for homecare monitoring based on an economic fabric electrode with high elasticity and low resistance. The wearable smart clothing integrated with heterogeneous sensors is capable to measure multiple human biosignals (ECG and respiration), acceleration, and gyro information. Five independent respiratory signals (electric impedance plethysmography, respiratory induced frequency variation, respiratory induced amplitude variation, respiratory induced intensity variation, and respiratory induced movement variation) are obtained. The smart clothing can provide accurate respiratory rate estimation by using three different techniques (Naïve Bayes inference, static Kalman filter, and dynamic Kalman filter). During the static sitting experiments, respiratory induced frequency variation has the best performance; whereas during the running experiments, respiratory induced amplitude variation has the best performance. The Naïve Bayes inference and dynamic Kalman filter have shown good results. The novel smart clothing is soft, elastic, and washable and it is suitable for long-term monitoring in homecare medical service and healthcare industry.