The effectiveness of exercise interventions to increase physical activity in Cystic Fibrosis: A systematic review

Impact of BRACTS exercises on muscular strength in eumenorrheic women

The sex steroid hormones significantly impact women's physiology. Therefore, recently developed integrated exercises consisting of Bending, Roll-ups, Arm swings with loads, Crunches, Tandem walks, and Squats (BRACTS) were formulated. It was the exercise approach that required minimal equipment and was cost-effective and practical for implementation across a broad spectrum of women. So, this study aims to evaluate the effects of BRACTS exercises on strength during different phases of the menstrual cycle in eumenorrheic women. This is a two-armed parallel design, single-blinded, randomized controlled trial following Consolidated Standards of Reporting Trials (CONSORT) guidelines, and the study protocol is based on Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. Participants were randomly allocated with a 1:1 ratio into Group A (control group) and Group B (treatment group). Group A was given an educational program related to menstrual hygiene and active lifestyle maintenance with 20 min walk 3 times a week for 16 weeks, while group B was given an educational program related to menstrual hygiene along with BRACTS exercises of 50 min for 3 times per week for 16 weeks. Assessments were done at baseline, midline, and end of the therapy using SPSS version 25. The experimental group demonstrated a notable improvement in muscular strength in follicular, mid-cycle, and luteal phases, with Cohen's d values for left and right hand grip strength to be maximum in follicular phase while for left and right quadriceps, left and gastro-soleus showed maximum Cohen's d value in mid-cycle phase of menstrual cycle. The mixed model ANOVA indicates statistically significant differences (p < 0.05) between the two groups, with influence from menstrual cycle phases. So, the BRACTS exercise protocol significantly improves muscular strength across different phases of the menstrual cycle in eumenorrheic women, demonstrating its efficacy as a cost-effective and practical approach. The trial was registered on clinicaltrials.gov for registration with ID: NCT05460741 on 05/31/2022 and was last released on 04/29/2024.Trial registration number: NCT05460741.

Telerehabilitation in Children and Adolescents with Cystic Fibrosis: A Scoping Review

Cystic fibrosis requires regular monitoring and intervention by healthcare teams; despite that, adherence to therapeutic measures is less than desired. The evolution of technology has allowed much of the care provided in person to be replaced by a telehealth delivery model, but studies on telerehabilitation are scarce and dispersed. This scoping review aimed to identify which domains of rehabilitation intervention are mediated by information and communication technologies and how they are developed in the provision of care to children and adolescents with cystic fibrosis. The data collection was conducted in February and June 2023, following the three steps recommended by the JBI for this type of review: (1) the search was conducted in MEDLINE, CINAHL, Scopus, JBI, and Web of Science; (2) the bibliographic references obtained from the included articles were analysed; and (3) the grey literature was checked. The eligibility criteria were children and adolescents and rehabilitation interventions mediated by information and communication technologies. The five studies included in this review were subjected to analysis, and a narrative synthesis of the results was carried out. The interventions identified included physical exercise programs (60%), management of the therapeutic regimen (40%), and symptom control (40%). The information and communication technologies were web-based platforms, video games, and telephones. The use of telerehabilitation included face-to-face meetings to ensure participants performed the exercises correctly, monitor their response to exercise, and teach them how to avoid risky situations during home workouts. In all studies, exercise sessions were supervised by the participants' parents or caregivers.

[Respiratory physiotherapy in private practice: Interest and prescription modalities]

INTRODUCTION

Respiratory diseases represent a major public health issue and impact both quality of life and life expectancy of the patients.

STATE OF ART

Several interventions used in respiratory physiotherapy have been shown to reduce dyspnoea, improve quality of life and reduce hospitalisation in many respiratory diseases. However, respiratory physiotherapy remains poorly known to the medical community and may be under-prescribed.

PERSPECTIVES

In order to improve the interdisciplinarity around the patient with respiratory impairment, we describe the interests and prescription modalities of liberal respiratory physiotherapy. In the context of respiratory physiotherapy acts, the precision of drafting prescription directly conditions the means implemented by the physiotherapist regarding care provided to the patient.

CONCLUSION

The increased knowledge of prescribers, both concerning the prescription methods and the precise content of the rehabilitation sessions is one of the keys to their success.

Exercise and Airway Clearance Techniques in Cystic Fibrosis

Exercise and airway clearance techniques (ACTs) have been a cornerstone of treatment for people with cystic fibrosis (pwCF) for many decades. Exercise may confer both respiratory and nonrespiratory benefits for pwCF, with greater exercise capacity associated with improved survival. A wide variety of exercise interventions for pwCF have been investigated. ACTs may assist in reducing respiratory symptoms for pwCF and are currently recommended to be performed daily, with the types of ACTs used varying globally. While recommended components of care, both exercise and ACTs are time-intensive and maintaining adherence to the recommendations over the longer term can be challenging. It has been proposed that with advances in the therapeutic options for pwCF, a rationalization of the therapeutic regimen may be possible. We summarize the current evidence for the use of exercise and ACTs by pwCF, discuss the implications of the introduction of cystic fibrosis transmembrane conductance regulator modulators on both exercise and ACTs, and highlight areas for further research.

Effects of Exercise Training on Peripheral Muscle Strength in Children and Adolescents with Cystic Fibrosis: A Meta-Analysis

Background: Exercise training is a cornerstone of care for people with cystic fibrosis (pwCF); it improves exercise capacity and health-related physical fitness, but no meta-analysis has investigated its effects on muscle function in young pwCF. The objective of this meta-analysis was to assess the effects of exercise on peripheral muscle strength in young pwCF. Methods: An electronic search was conducted in four databases (Pubmed, Science Direct, CENTRAL, and PEDRO) from their inception to July 2022. Grey literature databases (OpenGrey, the European Respiratory Society, the American Thoracic Society, and the European Cystic Fibrosis Society) were also consulted. Randomized controlled trials comparing any type of exercise with standard care in young pwCF (5 to 19 years old) were included. Two authors independently selected the relevant studies, extracted the data, assessed the risk of bias (using the Rob2 tool), and rated the quality of the evidence. Results: Ten studies met the inclusion criteria, involving 359 pwCF. Exercise training improved both lower and upper limb muscle strength (SMD 1.67 (95%CI 0.80 to 2.53), I2 = 76%, p < 0.001 and SMD 1.30 (95%CI 0.66 to 1.93), I2 = 62%, p < 0.001, respectively). Improvements were also reported in muscle mass and maximal oxygen consumption. Results regarding physical activity levels were inconclusive. The overall risk of bias for the primary outcome was high. Conclusions: Exercise training may have a positive effect on peripheral muscle strength in young pwCF. The evidence quality is very low and the level of certainty is poor. There is a need for high-quality randomized controlled studies to confirm these results.