8 research outputs found
Pulmonary hypertension and homebased (PHAHB) exercise intervention: protocol for a feasibility study
Introduction Novel therapies for pulmonary hypertension
(PH) have improved survival and slowed disease
progression. However, patients still present with symptoms
of exertional dyspnoea and fatigue, which impacts their
ability to perform activities of daily living, reduces exercise
tolerance and impairs their quality of life (QoL). Exercise
training has shown to be safe and effective at enhancing
QoL and physical function in PH patients, yet it remains
an underused adjunct therapy. Most exercise training
for PH patients has been offered through hospital-based
programmes. Home-based exercise programmes provide
an alternative model that has the potential to increase
the availability and accessibility of exercise training as
an adjunct therapy in PH. The purpose of this study is to
investigate the feasibility, acceptability, utility and safety
of a novel remotely supervised home-based PH exercise
programme.
Methods Single arm intervention with a pre/post
comparisons design and a follow-up maintenance phase
will be employed. Eligible participants (n=25) will be
recruited from the Mater Misericordiae University Hospital
PH Unit. Participants will undergo a 10-week home-based
exercise programme, with induction training, support
materials, telecommunication support and health coaching
sessions followed by a 10-week maintenance phase.
The primary outcomes are feasibility, acceptability, utility
and safety of the intervention. Secondary outcomes will
include the impact of the intervention on exercise capacity,
physical activity, strength, health-related QoL and exercise
self-efficacy.
Ethics and dissemination Ethics approval has been
obtained from the Mater Misericordiae Institutional Review
Board REF:1/378/2032 and Dublin City University Research
Ethics DCUREC/2018/246. A manuscript of the results will
be submitted to a peer-reviewed journal and results will
be presented at conferences, community and consumer
forums and hospital research conferences.
Trial registration number ISRCTN83783446; Pre-result
Exploration of physical activity knowledge, preferences and support needs among pulmonary hypertension patients
Objective: Physical activity (PA) is an established adjunct therapy for pulmonary hypertension (PH) patients to mitigate PH symptoms and improve quality of life. However, PA engagement within this population remains low. This study investigated PH patientsâ knowledge of PA, recalled advice, exercise preferences and PA support needs. Methods: Semi-structured interviews were conducted with 19 adults (mean age 50 years; SD ±12 years) diagnosed with PH, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data. Results: Four key themes were identified: Lack of PA knowledge; exercise setting preference; accountability and monitoring; and clinician delivered PA information and guidance. Conclusion: This study found that PH clinicians provide suboptimal PA advice, yet patients desired clinician-delivered PA guidance. Home-based exercise was preferred with monitoring and external accountability deemed as important to facilitate sustained engagement. Practice implications: PH clinicians are well positioned to play a critical role in assisting and empowering PH patients to engage in PA. Providing training and education to PH clinicians regarding exercise prescription may be beneficial. Further research is needed to evaluate the feasibility and efficacy of home-based exercise interventions to improve quality of life and physical activity in PH
âThe illness isnât the end of the roadââPatient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme
Background: Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6â12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. Aim: To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. Methods: Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. Results: Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were âMoving from fear to confidenceâ, âDrivers of engagement,â and âChallenges to keeping it (exercise) upâ. Conclusion: Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence
Safety, Feasibility and Effectiveness of the remotely delivered Pulmonary Hypertension And Home-Based (PHAHB) Physical Activity intervention
Background Pulmonary hypertension (PH) is a heterogeneous condition, associated with a high symptom burden and a substantial loss of exercise capacity. Despite prior safety concerns regarding physical exertion, exercise training as a supportive therapy is now recommended for PH patients. Currently, most programs are hospital-based, which limits accessibility. There is a need to provide alternative approaches for physical activity engagement for PH patients. The aim of this research was to develop, implement and evaluate the safety, feasibility, and effectiveness of home-based physical activity intervention for PH.
Methods An entirely remotely delivered home-based exercise intervention underpinned by behaviour change theory and informed by end-users, was assessed using a single-arm feasibility study design. Participants (n=19; 80% female) with a mean (±sd) age of 49.9±15.9â
y with a diagnosis of PH undertook a 10-week, home-based exercise intervention with induction training, support materials, telecommunication support, health coaching, exercise training, and assessments, all remotely delivered. Training involved respiratory training along with a combination of aerobic and resistance exercises.
Results The intervention was deemed safe as no adverse events were reported. A high level of feasibility was demonstrated as the protocol was implemented as intended, sustained a high level of engagement and adherence and was well accepted by participants in terms of enjoyment and utility. There was a significant improvement in functional capacity, physical activity, exercise self-efficacy and quality of life (QoL), between baseline and post-training.
Conclusion The study demonstrates that an entirely remotely delivered home-based exercise program is safe, feasible and effective in improving functional capacity, physical activity, and QoL in PH patients
Pulmonary hypertension and home-based (PHAHB) exercise intervention: protocol for a feasibility study.
IntroductionNovel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme.MethodsSingle arm intervention with a pre/post comparisons design and a follow-up maintenance phase will be employed. Eligible participants (n=25) will be recruited from the Mater Misericordiae University Hospital PH Unit. Participants will undergo a 10-week home-based exercise programme, with induction training, support materials, telecommunication support and health coaching sessions followed by a 10-week maintenance phase. The primary outcomes are feasibility, acceptability, utility and safety of the intervention. Secondary outcomes will include the impact of the intervention on exercise capacity, physical activity, strength, health-related QoL and exercise self-efficacy.Ethics and disseminationEthics approval has been obtained from the Mater Misericordiae Institutional Review Board REF:1/378/2032 and Dublin City University Research Ethics DCUREC/2018/246. A manuscript of the results will be submitted to a peer-reviewed journal and results will be presented at conferences, community and consumer forums and hospital research conferences.Trial registration numberISRCTN83783446; Pre-results
Exploration of physical activity knowledge, preferences and support needs among pulmonary hypertension patients
Objective Physical activity (PA) is an established adjunct therapy for pulmonary hypertension (PH) patients to mitigate PH symptoms and improve quality of life. However, PA engagement within this population remains low. This study investigated PH patientsâ knowledge of PA, recalled advice, exercise preferences and PA support needs. Methods Semi-structured interviews were conducted with 19 adults (mean age 50 years; SD ±12 years) diagnosed with PH, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data. Results Four key themes were identified: Lack of PA knowledge; exercise setting preference; accountability and monitoring; and clinician delivered PA information and guidance. Conclusion This study found that PH clinicians provide suboptimal PA advice, yet patients desired clinician-delivered PA guidance. Home-based exercise was preferred with monitoring and external accountability deemed as important to facilitate sustained engagement. Practice implications PH clinicians are well positioned to play a critical role in assisting and empowering PH patients to engage in PA. Providing training and education to PH clinicians regarding exercise prescription may be beneficial. Further research is needed to evaluate the feasibility and efficacy of home-based exercise interventions to improve quality of life and physical activity in PH
Polypharmacy and drugâdrug interactions in older and younger people living with HIV: the POPPY study
The effect of participating in MedEx wellness, a community-based chronic disease exercise rehabilitation programme, on physical, clinical and psychological health: A study protocol for a cohort trial
Background: Community-based exercise rehabilitation programmes for chronic disease
are an effective alternative to traditional hospital-based programmes. MedEx Wellness is
a novel community-based exercise rehabilitation programme that integrates a range of
chronic diseases. The aim of this trial was to investigate the effect of participating in
MedEx Wellness on physical, clinical and psychological health.Methods: A prospective
cohort study was conducted. Participants were recruited at induction to the MedEx
Wellness programme following referral from healthcare professionals. Participants
underwent a baseline assessment before commencing the exercise programme and
repeat assessments at 3, 6 and 12 months. The primary outcome was cardiorespiratory
fitness (6 minute- time trial) at 12 months. Secondary outcomes included health-related
quality of life (EuroQoL-5D, Satisfaction with Life Scale, Warwick Edinburgh Mental
Wellbeing Scale, Patient Health Questionnaire8, Functional Assessment of Cancer
Therapy Questionnaire), free living activity behavior (accelerometer) and healthcare
utilization (recall questionnaire). Tertiary outcomes included blood pressure (24 h),
biomarkers (lipids, glucose and C-reactive protein), other components of physical fitness,
including strength (handgrip test, sit-to-stand test), flexibility (sit-and-reach test), body
composition (body mass index and waist-to-hip ratio), and falls risk (timed up and go test),
and claudication time (incremental treadmill walking test), cognitive function, including
attention (Attention Network Task), memory (Luck & Vogel Visual Working Memory Task)
and cognitive reserve. Exploratory outcomes included psychosocial determinants of
physical activity (self-efficacy, social support, intentions). Discussion: This trial will
evaluate whether participation in the MedEx Wellness programme has positive effects
on physical, clinical and psychological health in individuals with a range of chronic disease