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Guide to prescribing exercise

Md Shajahan MY

Family Physician, 1994;6:20-26.

Matched MeSH terms: Exercise
Fulltext The effect of exercise on balance in patients with stroke, Parkinson, and multiple sclerosis: a systematic review and meta-analysis of clinical trials

Salari N, Hayati A, Kazeminia M, Rahmani A, Mohammadi M, Fatahian R, et al.

Neurol Sci, 2022 Jan;43(1):167-185.
PMID: 34709478 DOI: 10.1007/s10072-021-05689-y

BACKGROUND: Stroke, Parkinson, and multiple sclerosis are a range of diseases affecting the nervous system and show balance impairments due to damage of the balance control system. Many early articles have been published on the effect of exercise on balance in patients suffering from neuromuscular diseases. However, a comprehensive study showing a clear result of these three diseases was not found. Hence, the purpose of the present meta-analysis and systematic review is to determine the effect of exercise on balance in people with stroke, Parkinson, and multiple sclerosis.
METHODS: According to the PRISMA 2009 multi-step instructions, keywords related to the purpose of the research were browsed in the MeSH browser databases; IranDoc, MagIran, IranMedex, SID, ScienceDirect, Web of Science (WoS), ProQuest, Medline (PubMed), Scopus, and Google Scholar were searched to extract articles published in Persian and English language. The search process for retrieving the articles in the sources mentioned from January 01, 2000, to December 30, 2020, was done. The heterogeneity index of the studies was determined using the I2 test. Given the heterogeneity, the random-effects model was used to combine the articles and the results.
RESULTS: Initially, 7067 articles were found, but after removing duplicate and irrelevant articles, 96 clinical trials with a sample size of the intervention group of 1760 people were included in the study. As a result of the articles' composition, the mean balance score index after exercise in the intervention group showed a significant increase of 0.67 ± 0.12 of the unit (P˂0.01). The highest rate of increase in the balance score after the intervention was reported in patients with myelomeningocele with 1.66 ± 0.3 unit (P˂0.01).
CONCLUSION: Considering the positive effect of using exercise on increasing the balance in patients with stroke, Parkinson, and multiple sclerosis, it is recommended that health care providers implement a regular exercise program to improve the condition of these patients.

Matched MeSH terms: Exercise Therapy; Exercise
Optimizing the setting of medical interactive rehabilitation assistant platform to improve the performance of the patients: A case study

Gharaei N, Ismail W, Grosan C, Hendradi R

Artif Intell Med, 2021 10;120:102151.
PMID: 34629147 DOI: 10.1016/j.artmed.2021.102151

Tele-rehabilitation is an alternative to the conventional rehabilitation service that helps patients in remote areas to access a service that is practical in terms of logistics and cost, in a controlled environment. It includes the usage of mobile phones or other wireless devices that are applied to rehabilitation exercises. Such applications or software include exercises in the form of virtual games, treatment monitoring based on the rehabilitation progress and data analysis. However, nowadays, physiotherapists use a default profiling setting for patients carrying out rehabilitation, due to lack of information. Medical Interactive Rehabilitation Assistant (MIRA) is a computer-based (virtual reality) rehabilitation platform. The profile setting includes: a level of difficulty, percentage of tolerance and maximum range. To the best of our knowledge, there is a lack of optimization in the parameter values setting of MIRA exergames that could enhance patients' performance. Generally, non-optimal profile setting leads to reduced effectiveness. Therefore, this study aims to develop a method that optimizes the profile setting of each patient according to the estimated (desired) optimal results. The proposed method is developed using unsupervised and supervised machine learning techniques. We use Self-Organizing Map (SOM) to cluster patient records into several distinct clusters. K-fold cross validation is applied to construct the prediction models. Classification And Regression Tree (CART) is utilized to predict the patient's optimal input setting for playing the MIRA games. The combination of these techniques seems to improve the efficiency of the standard (default) way in predicting the optimal settings for exergames. To evaluate the proposed method, we conduct an experiment with data collected from a rehabilitation center. We use three metrics to quantify the quality of the results: R-squared (R2), Mean Absolute Error (MAE) and Root Mean Square Error (RMSE). The results of experimental analysis demonstrate that the proposed method is effective in predicting the adequate parameter setting in MIRA platform. The method has potential to be implemented as an intelligent system for MIRA prediction in healthcare. Moreover, the method could be extended to similar platforms for which data is available to train our method on.

Matched MeSH terms: Exercise Therapy*; Exercise*
A Systematic Review of Exercise Therapy for Bowel Preparation: Evidence to Guide Practice

Zhang YY, Vimala R, Chui PL, Hilmi IN

Gastroenterol Nurs, 2023 06 20;46(5):393-403.
PMID: 37347807 DOI: 10.1097/SGA.0000000000000759

This systematic review aims to evaluate (1) the effectiveness of exercise therapy in bowel preparation for colonoscopy, and (2) the characteristics of exercise programs for bowel preparation. Systematic searches were done in PubMed, EMBASE, the Cochrane Library, Web of Science, and CINAHL from inception to November 2022. Randomized controlled trials and quasi-experimental studies assessing the efficacy of exercise during bowel preparation were included in this review. Two reviewers independently assessed the methodological quality using a modified Downs and Black checklist. A narrative synthesis was conducted. A total of five studies (1,109 participants) were included in this review. In all eligible studies, the characteristics of the exercise programs varied and included mainly two types of exercise (walking and yoga), various amount of exercise (3,000-10,000 steps or 0.5-1.9 hours), and two exercise timing (during and 1 hour after taking the laxative). Available evidence indicated that exercise therapy is effective in improving the quality of bowel preparation. However, there was insufficient high-quality evidence to conclude the effects on procedure-related indicators, adverse events, and willingness to repeat preparation. Exercise should be recommended as an important part of routine bowel preparation for patients undergoing colonoscopy to improve the quality of bowel preparation. More rigorous studies focusing on the effects on procedure-related indicators, adverse events, and willingness to repeat preparation are needed. To ensure the effectiveness and safety of the intervention, it is critical to establish a standard, well-structured exercise program for bowel preparation.

Matched MeSH terms: Exercise Therapy*; Exercise*
Fulltext Physical Activity Promotion in Malaysia: Challenges and Opportunities

Khoo S, Poh BK, Suhaimi SA, Chong KH, Ramirez Varela A

Front Public Health, 2020;8:536239.
PMID: 33194945 DOI: 10.3389/fpubh.2020.536239

About three quarters of the Malaysian adult population are physically active. There has been growth in physical activity and health research since 2010, with most studies being observational in design and few included objective measures of physical activity. The Malaysian Ministry of Health has published physical activity guidelines, strategies and action plans aimed at promoting physical activity. Physical activity promotion activities have included national campaigns and programmes which target different populations. Further work that incorporates the WHO Global Action Plans on Physical Activity (GAPPA), as well as a more systemic approach is needed, to promote physical activity and a healthy lifestyle. High-level multi-stakeholder collaboration is required for continuing expansion and strengthening of research capacity, and for bridging the physical activity policy gaps in Malaysia.

Matched MeSH terms: Exercise*
Physiological characteristics and performance of a world-record breaking tower runner

Loh TC, Tee CCL, Pok C, Girard O, Brickley G, James C

J Sports Sci, 2023 Mar;41(5):451-455.
PMID: 37286473 DOI: 10.1080/02640414.2023.2221957

This study reports the physiological and performance profiles of a world-class tower runner during a 6-week period surrounding a successful Guinness World Record (WR) attempt, and discusses the efficacy of a tower running specific field test. The world-ranked number 2 tower runner completed four exercise tests [laboratory treadmill assessment (3 weeks before the WR attempt), familiarisation to a specific incremental tower running field test (1 week before), tower running field test (1 week after), and tower running time trial (TT) (3 weeks after)] and the WR attempt within 6-week period. Peak oxygen consumption (VO2peak) during the laboratory test, field test, and TT were 73.3, 75.5 and 78.3 mL·kg-1·min-1, respectively. The VO2 corresponding to the second ventilatory threshold was 67.3 mL·kg-1·min-1 (89.1% of VO2peak), identified at stage 4 (tempo; 100 b·min-1), during the field test. The duration of the TT was 10 min 50 s, with an average VO2 of 71.7 mL·kg-1·min-1 (91.6% of VO2peak), HR of 171 b·min-1 (92% of peak HR), vertical speed of 0.47 m·s-1, and cadence was 117 steps·min-1. A world-class tower runner possesses a well-developed aerobic capacity. A specific, field-based test revealed greater VO2peak than a laboratory test, indicating a need for sport-specific testing procedures.

Matched MeSH terms: Exercise Test/methods
Fulltext Role of exercise in patients with symptomatic knee osteoarthritis

Koh KL

Malays Fam Physician, 2008;3(3):155.
PMID: 25606141
Matched MeSH terms: Exercise
Fulltext Effects of high-intensity interval exercise on cardiac troponin elevation when comparing with moderate-intensity continuous exercise: a systematic review and meta-analysis

Li S, Shaharudin S, Cirer-Sastre R, Li F, Abdul Manaf F, Mohd Shukri MF

PeerJ, 2023;11:e14508.
PMID: 36647447 DOI: 10.7717/peerj.14508

BACKGROUND: This systematic review and meta-analysis aimed to compare the effects of high-intensity interval exercise (HIIE) with different recovery modes versus moderate-intensity continuous exercise (MICE) on cardiac troponin (cTn) elevation.
METHODOLOGY: A literature search was conducted in four databases: Scopus, PubMed, EBSCO and Web of Science from January 2010 to June 2022. The articles were screened, evaluated for quality before data were extracted. The review protocol was registered at PROSPERO (CRD42021245649). Standardized mean differences (SMD) of peak cTn were analyzed with a 95% confidence interval (95% CI) using Revman 5.4 software.
RESULTS: Six studies satisfied the inclusion criteria with a total of 92 and 79 participants for HIIE and MICE, respectively. Overall, there was no significant difference between HIIE and MICE in the elevation of cardiac troponin T (SMD: 0.41 [95% CI [-0.21, 1.03]], p = 0.20, I 2 = 77%, p for heterogeneity <0.01). In subgroup analysis, HIIE with passive recovery elicits greater release of cardiac troponin T than MICE (SMD: 0.85 [95% CI [0.44, 1.27]], p

Matched MeSH terms: Exercise Test; Exercise*
Fulltext Exercise-induced asthma: fresh insights and an overview

Khajotia R

Malays Fam Physician, 2008;3(1):21-4.
PMID: 25606107

Exercise-induced asthma (EIA) is a common condition affecting 12-15% of the population. Ninety percent of asthmatic individuals and 35-45% of patients with allergic rhinitis are afflicted by EIA, while 3-10% of the general population is also believed to suffer from this condition. EIA is a condition which is more prevalent in strenuous outdoor, cold weather and winter sports. The pathophysiology of EIA continues to intrigue medical physiologists. However, the water-loss hypothesis and the post-exertional airway-rewarming hypothesis are as yet the best accepted theories. EIA is best diagnosed by a good medical history and a free-run challenge test. A post-exertion decrease by 15% in FEV1 and PEFR is diagnostic of EIA. Sensitivity of exercise testing ranges from 55% to 80% while specificity is as high as 93%. EIA is a disorder that can be successfully treated by combining both non-pharmacological and pharmacological treatment options. Prompt diagnosis and treatment of this condition is vital if we hope to provide our patients with better overall health, better social life and a better self-image.

Matched MeSH terms: Asthma, Exercise-Induced*; Exercise
Fulltext Effects of moderate-intensity aerobic exercise combined with acupuncture on attention function of mentally-retarded adolescents: a randomised controlled trial

Shuoqi LI, Rong G, Chunjing L, Jiali Z, Keke LI, Shiming LI, et al.

J Tradit Chin Med, 2023 Feb;43(1):154-159.
PMID: 36640007 DOI: 10.19852/j.cnki.jtcm.20220425.003

OBJECTIVE: To detect the impact of moderate-intensity aerobic exercise combined with acupuncture on the attention function of mentally-retarded adolescents from the three dimensions of attention concentration, attention transfer and attention span.
METHODS: A total of 48 adolescents with mild to moderate mental disabilities were recruited. The participants were randomly divided into four groups: control group (C), Traditional Chinese Medicine acupuncture group (M), moderate-intensity aerobic exercise group (E) and exercise and acupuncture combined intervention group (J). Before and after the experimental intervention, the participant's height, weight and attention ability were measured.
RESULTS: The improved range of attention total duration of the J group after the intervention was significantly higher than that of the E and M groups (0.05), whereas that of the latter groups was significantly higher compared to that of the C group ( 0.05). The J group showed significantly higher ( 0.05) attention span values after the intervention compared to the E, M and C groups. The C group did not show a significant difference in attention transfer at 12 weeks compared to before intervention (0.05), whereas the E, M and J groups increased significantly ( 0.05) after intervention than the C group.
CONCLUSIONS: Moderate-intensity aerobic exercise combined with acupuncture can more effectively improve the attention concentration and attention span of mentally-retarded adolescents than aerobic exercise or acupuncture alone.

Matched MeSH terms: Exercise Therapy; Exercise*
Ramadan intermittent fasting and its association with health-related indices and exercise test performance in athletes and physically active individuals: an overview of systematic reviews

Trabelsi K, Ammar A, Boukhris O, Boujelbane MA, Clark C, Romdhani M, et al.

Br J Sports Med, 2024 Feb 07;58(3):136-143.
PMID: 37923379 DOI: 10.1136/bjsports-2023-106826

OBJECTIVE: To systematically review, summarise and appraise findings of published systematic reviews, with/without meta-analyses, examining associations between Ramadan fasting observance (RO), health-related indices and exercise test performances in athletes and physically active individuals.
DESIGN: Overview of systematic reviews with assessment of reviews' methodological quality.
DATA SOURCES: PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, SPORTDiscus, ProQuest, PsycINFO and SciELO.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews with/without meta-analyses examining associations of RO with health-related indices and exercise performances in athletes and physically active individuals.
RESULTS: Fourteen systematic reviews (seven with meta-analyses) of observational studies, with low-to-critically-low methodological quality, were included. Two reviews found associations between RO and decreased sleep duration in athletes and physically active individuals. One review suggested athletes may experience more pronounced reductions in sleep duration than physically active individuals. One review found associations between RO and impaired sleep quality in athletes and physically active individuals. RO was associated with decreased energy, carbohydrate and water intake in adult-aged athletes, but not adolescents. One review suggests RO was associated with athletes' increased feelings of fatigue and decreased vigour. No association was found between RO and athletes' lean mass or haematological indices. RO was unfavourably associated with changes in athletes' performance during high-intensity exercise testing.
CONCLUSION: Continuance of training during RO could be associated with athletes' mood state disturbances, decreased sleep duration and performance decline during high-intensity exercise testing, while preserving lean mass. However, careful interpretation is necessary due to the low-to-critically-low methodological quality of the included reviews.

Matched MeSH terms: Exercise Test*; Exercise
Fulltext Effects of a behavioral program on exercise adherence and exercise self-efficacy in community-dwelling older persons

Azizan A, Justine M, Kuan CS

Curr Gerontol Geriatr Res, 2013;2013:282315.
PMID: 24489539 DOI: 10.1155/2013/282315

Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.

Matched MeSH terms: Exercise*
Effect of physical exercise on some hematological parameters in female athletes in Bangladesh

Alam T, Rahman SM, Alam T, Habib N, Umar BU, Banna QR, et al.

JNMA J Nepal Med Assoc, 2014 Jul-Sep;52(195):892-6.
PMID: 26982662

Long term physical training has been considered to adversely affect the performance of athletes especially the females. It may be due to the iron depletion caused by hemolysis or hemodilution results from plasma volume expansion. This study aims to assess the effect of heavy exercise on hemoglobin concentration and some other hematological parameters in female athletes.

Matched MeSH terms: Exercise*
Fulltext Web-Based Dietary and Physical Activity Intervention Programs for Patients With Hypertension: Scoping Review

Baderol Allam FN, Ab Hamid MR, Buhari SS, Md Noor H

J Med Internet Res, 2021 03 15;23(3):e22465.
PMID: 33720036 DOI: 10.2196/22465

BACKGROUND: Hypertension is the root cause of many chronic diseases. Lifestyle changes (ie, dietary alterations and physical activity) are seen to be an important step in the prevention and treatment of hypertension. Educating people through web-based interventional programs could offer an effective solution and help these patients with hypertension in the existing health care scenario.
OBJECTIVE: In this study, the researchers conducted a scoping literature review of the web-based dietary changes and physical activity-related intervention programs designed for the patients with hypertension and identified the methodologies, effectiveness, protocols, and theories, which could affect and improve existing clinical activities.
METHODS: This review followed the scoping review methodology to identify and process the peer-reviewed studies published between 2010 and 2020. The literature searches were conducted on the following electronic databases: PubMed, Web of Science, MEDLINE (Medical Literature Analysis and Retrieval System Online), ScienceDirect, Scopus, and Google Scholar. By using relevant search terms, studies were included if they offered information related to the web-based intervention tools, specifically dietary and physical activity intervention for patients with hypertension. Studies written or translated in English language and published within the date range (January 2010 to March 2020) were included.
RESULTS: Overall, 1441 articles were initially identified. The reviewers included 35 articles after removing duplicates and screening titles. Only 21 articles were assessed for full review, and 15 were kept for analysis. The researchers selected 15 web-based intervention articles published on the topic of hypertension from 7 countries. A few of these 15 web-based tools (4, 27%) included more than 3 functions and provided a lot of important information (such as appointments, health records, or viewable care). Several tools were standalone tools (11, 73%), while most of the tools supported communication intervention-related lifestyle or behavioral changes (13, 87%) and medication adherence (6, 40%). It was found that physicians (9, 60%), allied health professionals (5, 33%), and nurses (5, 33%) were the health care providers who generally used these tools for communicating with their patients. More than half of the above tools (10, 67%) were assessed by different researchers in randomized controlled trials, while 5 tools (33%) were investigated in nonrandomized studies.
CONCLUSIONS: We identified many web-based intervention programs for patients with hypertension from the literature databases. The findings indicate that numerous benefits can be derived after using a web-based dietary and physical activity intervention program for hypertension focusing on lifestyle changes. However, developers need to consider the preferences of the patients with regard to the information or the design features while developing or modifying web-based educational websites. These tools could be used for designing a patient-tailored website intervention program that is based on diet and physical activities for patients with hypertension.

Matched MeSH terms: Exercise*
Fulltext Disaster Medicine-Is it time we embrace it?

Amjad, N.M.

International Medical Journal Malaysia, 2011;10(1):1-2.
MyJurnal

Education and training in disaster medicine is an ongoing process to all categories of personnel involved.
In addition to the collaborative inter-professional table top exercises, regularly conducted field exercise drills offers the best form of training. Currently in most countries there is no standardized curriculum
for the training of disaster management from the medical perspective. It is imperative that the concept of disaster medicine and its principles should be a component in the undergraduate and postgraduate
curriculum of Medical and Allied health related programmes.

Matched MeSH terms: Exercise Therapy; Exercise
An epidemiological exercise on malaria in the district of Perak North

Griffith DH, Choo LS

Med J Malaya, 1956 Dec;11(2):139-52.
PMID: 13417938
Matched MeSH terms: Exercise*
Fulltext Muscle Fatigue in the Three Heads of Triceps Brachii During Intensity and Speed Variations of Triceps Push-Down Exercise

Hussain J, Sundaraj K, Subramaniam ID, Lam CK

Front Physiol, 2020;11:112.
PMID: 32153422 DOI: 10.3389/fphys.2020.00112

The objective of this study was to investigate the effects of changes in exercise intensity and speed on the three heads of the triceps brachii (TB) during triceps push-down exercise until task failure. Twenty-five subjects performed triceps push-down exercise at three different intensities (30, 45, and 60% 1RM) and speeds (slow, medium, and fast) until failure, and surface electromyography (sEMG) signals were recorded from the lateral, long and medial heads of the TB. The endurance time (ET), number of repetitions (NR) and rate of fatigue (ROF) were analyzed. Subsequently, the root-mean-square (RMS), mean power frequency (MPF) and median frequency (MDF) under no-fatigue (NF) and fatigue (Fa) conditions were statistically compared. The findings reveal that ROF increases with increase in the intensity and speed, and the opposite were obtained for the ET. The ROF in the three heads were comparable for all intensities and speeds. The ROF showed a significant difference (P < 0.05) among the three intensities and speeds for all heads. The three heads showed significantly different (P < 0.05) MPF and MDF values for all the performed exercises under both conditions, whereas the RMS values were significantly different only under Fa conditions. The current observations suggest that exercise intensity and speed affect the ROF while changes in intensity do not affect the MPF and MDF under Fa conditions. The behavior of the spectral parameters indicate that the three heads do not work in unison under any of the conditions. Changes in the speed of triceps push-down exercise affects the lateral and long heads, but changes in the exercise intensity affected the attributes of all heads to a greater extent.

Matched MeSH terms: Exercise Therapy; Exercise
Fulltext The relationship between extrinsic motivation and physical activity level among students

Kamal AA, Zulkifli AF

Movement Health & Exercise, 2019;8(1):145-156.
MyJurnal

Nowadays, people have realized that physical activity plays a critical role in determining the health and wellness of an individual. This is proven by the extensive research on this area, which indicates that people have started to emphasize this matter. In addition, it is also well known that motivation is one of the main factors that determine whether people will participate in performing physical activity or not. Both extrinsic and intrinsic motivators play a major role in determining levels of physical activity. Therefore, this study is made to investigate the relationship between extrinsic motivation and physical activity level. The researcher randomly selected 195 students from SMK Alam Megah 2, Seksyen 28, Shah Alam, Selangor as respondents for this study. The method of this study includes a questionnaire adapted from International Physical Activity Questionnaire (IPAQ) and Exercise Motivation Inventory (EMI), which was edited to fulfil the requirements of this study. The results from this study show that there is a positive and significant relationship between extrinsic motivation and physical activity.

Matched MeSH terms: Exercise*
Attenuation of stress-induced cardiovascular reactivity following high-intensity interval exercise in untrained males

Farah NM, Amran AD, Che Muhamed AM

J Sports Sci, 2021 Dec;39(24):2755-2762.
PMID: 34323655 DOI: 10.1080/02640414.2021.1957294

Exaggerated cardiovascular (CV) reactivity to stress is associated with negative cardiovascular outcomes. This study aimed to investigate the effects of acute high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on CV reactivity in response to a stress challenge in untrained males. Thirteen, normotensive males (age: 22.8 ± 2 years, BMI: 21.9 ± 3.6 kg/m2) underwent three conditions in counterbalanced order: HIIE (bodyweight exercises; 80-90% HRR), MIE (treadmill-jog; 55-60% HRR) and seated rest (CON) separated by 7-10 days. Thirty minutes after performing HIIE, MIE or CON, subjects underwent a 2-min cold pressor task (CPT). Blood pressure (BP) and heart rate (HR) were measured before, during, and after CPT. CV reactivity, i.e., the change in BP and HR responses were compared across conditions. Systolic BP reactivity were attenuated following HIIE (-60%, p = 0.015) and MIE (-42%, p = 0.033) compared to CON, but no differences were observed between HIIE and MIE. HR reactivity was not different across all conditions. We conclude that performing HIIE or MIE 30 minutes prior to acute stress exposure lowers BP reactivity compared to rest in untrained males. These findings highlight the potential benefits of HIIE in lowering stress-induced elevations in blood pressure.

Matched MeSH terms: Exercise*
Fulltext Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis

Uzzaman MN, Agarwal D, Chan SC, Patrick Engkasan J, Habib GMM, Hanafi NS, et al.

Eur Respir Rev, 2022 Sep 30;31(165).
PMID: 36130789 DOI: 10.1183/16000617.0076-2022

INTRODUCTION: Despite proven effectiveness for people with chronic respiratory diseases, practical barriers to attending centre-based pulmonary rehabilitation (centre-PR) limit accessibility. We aimed to review the clinical effectiveness, components and completion rates of home-based pulmonary rehabilitation (home-PR) compared to centre-PR or usual care.
METHODS AND ANALYSIS: Using Cochrane methodology, we searched (January 1990 to August 2021) six electronic databases using a PICOS (population, intervention, comparison, outcome, study type) search strategy, assessed Cochrane risk of bias, performed meta-analysis and narrative synthesis to answer our objectives and used the Grading of Recommendations, Assessment, Development and Evaluations framework to rate certainty of evidence.
RESULTS: We identified 16 studies (1800 COPD patients; 11 countries). The effects of home-PR on exercise capacity and/or health-related quality of life (HRQoL) were compared to either centre-PR (n=7) or usual care (n=8); one study used both comparators. Compared to usual care, home-PR significantly improved exercise capacity (standardised mean difference (SMD) 0.88, 95% CI 0.32-1.44; p=0.002) and HRQoL (SMD -0.62, 95% CI -0.88--0.36; p<0.001). Compared to centre-PR, home-PR showed no significant difference in exercise capacity (SMD -0.10, 95% CI -0.25-0.05; p=0.21) or HRQoL (SMD 0.01, 95% CI -0.15-0.17; p=0.87).
CONCLUSION: Home-PR is as effective as centre-PR in improving functional exercise capacity and quality of life compared to usual care, and is an option to enable access to pulmonary rehabilitation.

Matched MeSH terms: Exercise; Exercise Tolerance

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