North American Cystic Fibrosis Conference

North American Cystic Fibrosis Conference

Source:

Mermis J, et al. Poster 260. Presented at: North American Cystic Fibrosis Conference; Nov. 2-5, 2021 (virtual meeting).

Disclosures: Mermis reports no relevant financial disclosures.
November 19, 2021
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Telehealth-based aerobic exercise training program feasible for adults with cystic fibrosis

Source:

Mermis J, et al. Poster 260. Presented at: North American Cystic Fibrosis Conference; Nov. 2-5, 2021 (virtual meeting).

Disclosures: Mermis reports no relevant financial disclosures.
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A telehealth-based aerobic exercise training program was feasible for adults with cystic fibrosis, researchers reported at the North American Cystic Fibrosis Conference.

Researchers conducted a randomized, controlled, 12-week pilot trial to evaluate the feasibility and uptake of personalized home exercise via a telehealth platform. The study was halted at the start of the COVID-19 pandemic.

Source: Adobe Stock.

Joel Mermis, MD, critical care medicine specialist at the University of Kansas Medical Center, Kansas City, presented results from eight patients with cystic fibrosis who completed the study. All were on highly effective modulator therapy for at least 1 month prior to enrollment. Participants were randomly assigned to usual care alone (n = 6) or usual care plus weekly aerobic exercise prescription via an exercise coach during a telehealth visit (n = 2).

Those randomly assigned to telehealth-based aerobic exercise had a goal of 60 minutes of exercise in week 1, with a gradual increase to 180 minutes per week by week 9. Patients wore a fitness tracker during their telehealth exercise coaching to collect data, including heart rate, percent predicted FEV1, HbA1c, sweat chloride, quality of life measured by the Cystic Fibrosis Questionnaire-Revised and submaximal VO2 via cardiopulmonary exercise testing. Exercise participants were coached to spend one-third of their exercise time at a vigorous aerobic exercise level.

“The goal with the exercise prescription was not to instruct people on what type of exercise to do, [but] rather give the participant the freedom to choose the exercise of their choice, guiding them on intensity and duration of exercise based upon their fitness level,” Mermis said.

At enrollment, the researchers assessed barriers to exercise, with the goal of helping the coaches better understand how to motivate patients during the telehealth coaching sessions, Mermis said. Lack of discipline and lack of time were the primary barriers to exercise among this population.

One patient with advanced lung disease discontinued the study early due to transplantation.

The researchers hypothesized that patients randomly assigned to the telehealth exercise group would complete greater than 70% of their weekly prescribed exercise time. Mermis said the primary endpoint was met, as the telehealth exercise group completed 87% of their weekly prescribed exercise time, as measured by data from the activity monitors.

Cardiorespiratory variables, including exercise time (2.10 min:sec vs. –0.22 min:sec), work measured in watts (24 vs. 0) and submaximal VO2 (91 mL/kg/min vs. 45 mL/kg/min) improved in the exercise group compared with the usual care group.

In addition, mean changes in sweat chloride, percent predicted FEV1, HbA1c and Cystic Fibrosis Questionnaire-Revised scores all trended in favor of the exercise group compared with the usual care group.

“The inferences from the small sample size are limited. However, the home-based telehealth coaching was favorable and did demonstrate improvement in important parameters linked to morbidity and mortality in [cystic fibrosis],” Mermis said.

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