Cancer is a chronic disease requiring long-term treatment. Exercise interventions are increasingly being recognized as an important part of treatment and supportive cancer care for patients and survivors. Previous reviews have evaluated the benefits of exercise interventions in populations of patients under supervision at a center, but none have explored the possibilities of a home-based (HB) approach in exercise during cancer rehabilitation and the period immediately following the end of cancer treatment. The aim of this descriptive systematic review was to identify the literature focusing on the health effects of HB exercise interventions in cancer survivors and to evaluate the methodological quality of the examined studies. Relevant studies were identified by a systematic search of PubMed and the Web of Science until January 2021. Nine randomized controlled trials were included. Most studies were on aerobic and resistance exercises, and the frequency, duration, intensity, and modality varied across the different interventions. Improvements in cardiorespiratory fitness (CRF), physical activity (PA) levels, fatigue, health-related quality of life (HRQOL), and body composition have been reported. However, all the studies were limited in methodology and the reporting of results. Nevertheless, the evidence in this new area, despite the methodological limitations of the studies, suggests that HB exercise interventions are feasible, and may provide physiological and psychological benefits for cancer survivors during the rehabilitation period. A methodologically rigorous design for future research is essential for making progress in this field of study.
Cardiovascular rehabilitation (CR) is an effective secondary preventive model of care. However, the use of CR is insufficient, and the reasons for this are not well-characterized in East-Central Europe. This prospective observational study psychometrically validated the recently translated Cardiac Rehabilitation Barriers Scale for the Czech language (CRBS-CZE) and identified the main CR barriers. Consecutive cardiac in/out-patients were approached from January 2020 for 18 months, of whom 186 (89.9%) consented. In addition to sociodemographic characteristics, participants completed the 21-item CRBS-CZE (response options 1–5, with higher scores representing greater barriers), and their CR utilization was tracked. Forty-five (24.2%) participants enrolled in CR, of whom 42 completed the CRBS a second time thereafter. Factor analysis revealed four factors, consistent with other CRBS translations. Internal reliability was acceptable for all but one factor (Cronbach’s alpha range = 0.44–0.77). Mean total barrier scores were significantly higher in non-enrollers (p < 0.001), decreased from first and second administration in these enrollers (p < 0.001), and were lower in CR completers (p < 0.001), supporting criterion validity. There were also significant differences in barrier scores by education, geography, tobacco use, among other variables, further supporting validity. The biggest barriers to enrolment were distance, work responsibilities, lack of time, transportation problems, and comorbidities; and the greatest barriers to adherence were distance and travel. Several items were considered irrelevant at first and second administration. Other barriers included wearing a mask during the COVID-19 pandemic. The study demonstrated sufficient validity and reliability of CRBS-CZE, which supports its use in future research.
Telehealth cardiac rehabilitation (CR) is a feasible and effective alternative to conventional outpatient CR. Present evidence is limited on the comparison of exercise intensity adherence in telehealth and outpatient CR. The purpose of the study was to evaluate and compare training intensity adherence through 12-week phase II CR in telehealth and outpatient CR. A sample of 56 patients with coronary artery disease (CAD) with a mean age of 56.7 ± 7.1 entering comprehensive secondary prevention phase II was randomized into telehealth CR (n = 28) and control outpatient CR (n = 28) groups. The primary outcome was a comparison of training intensity adherence in both CR models and heart rate (HR) response from individual CR sessions, expressed by the HR reserve percentage. As a result, the parameter HR reserve percentage as the total average of the training intensity during the telehealth intervention and the outpatient CR did not differ statistically (p = 0.63). There was no death case, and all severe adverse cases required medical admission throughout an exercise training session in study subjects in both groups. This research evidence demonstrated that the telehealth CR model is similar in training intensities to the conventional outpatient CR in CAD patients with low to moderate cardiovascular risk.
This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.
1 October 2023 in International Journal of Chronic Obstructive Pulmonary Disease
Objective: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Telehealth rehabilitation may offer new opportunities in patient therapy. This systematic review aimed to evaluate the effects of internet-mediated telerehabilitation and compare them with the outcomes of conventional pulmonary rehabilitation in COPD patients. Methods: Electronic databases PubMed, Prospero, Scopus, and Cochrane were searched for randomized controlled trials from January 2005 to December 2021. Two investigators reviewed studies for relevance and extracted study population, methods, and results data. Results: Ten studies were eligible for systematic review from the initial selection (n = 1492). There was considerable heterogeneity in telerehabilitation approaches. Functional exercise capacity and quality of life were assessed in all studies. None of the results were inferior to conventional care. High adherence and high levels of safety were observed. Conclusion: Telerehabilitation in COPD patients is a safe therapy approach that increases and maintains functional exercise capacity and quality of life, making it an equivalent option to conventional outpatient rehabilitation. However, there is currently a lack of a unified approach to the composition of therapy and the use of technology, which needs to be addressed in the future.
Home-based exercises have been on the rise recently. This pilot study aimed to assess the adherence and effect of a home-based rehabilitation programme using telemonitoring in patients with chronic non-specific low back pain (CNLBP). Twenty-seven patients with CNLBP were enrolled in the study, each of whom underwent a neurological assessment, including patient-oriented measures and a functional assessment—a battery of tests that comprehensively evaluated trunk muscle function. The rehabilitation programme lasted 18 weeks and included daily home-based exercises. A mobile application or an exercise diary was used to monitor compliance. Adherence to the programme was excellent for both the diary and mobile application groups, with 82.3% in the diary group exercising at least once a day and 72.9% twice a day, and 94.8% in the mobile application group exercising at least once a day and 86.6% twice a day. Both patient-oriented and functional outcomes improved significantly; however, the relative changes of the parameters in these two groups did not correlate, which supports the idea that trunk muscle function does not directly relate to patient complaints and that CNLBP is a multifactorial issue. This model of rehabilitation programme should be used in clinical practice, as its adherence and effectiveness seem noticeable.