1
|
Stölzer-Hutsch H, Schriefer D, Kugler J, Ziemssen T. Patient Perspectives on Healthcare Utilization During the COVID-19 Pandemic in People with Multiple Sclerosis-A Longitudinal Analysis. Healthcare (Basel) 2025; 13:646. [PMID: 40150496 PMCID: PMC11942241 DOI: 10.3390/healthcare13060646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 01/31/2025] [Accepted: 03/13/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND/OBJECTIVES The COVID-19 pandemic disrupted healthcare systems globally, altering the management of chronic conditions like multiple sclerosis (MS) and interrupting the regular monitoring and support that people with MS (pwMS) typically need. The aim of this study was to examine changes in the utilization of MS healthcare resources over various periods during the COVID-19 pandemic in 2020 and 2021, and to assess how these changes affected the perceptions of pwMSregarding their care. METHODS A longitudinal survey study was conducted at the MS Center at the University Hospital Dresden, Germany, involving four survey periods from April 2020 to December 2021. The study assessed the use of healthcare resources, including consultations with specialists, the use of rehabilitative therapy facilities, and unmet healthcare needs, across various phases of the pandemic, encompassing both lockdown and less restrictive periods. RESULTS At the onset of the pandemic in April 2020, during the first lockdown, 750 questionnaires were evaluated. While most pwMS reported consistent medical care compared with pre-pandemic levels, 19.2% had fewer general practitioner visits, and 10.6% fewer neurologist visits. During the follow-up survey periods, the use of medical care generally remained stable, although there were notable reductions reported by a subset of participants. CONCLUSIONS The findings suggest that medical and therapeutic care for pwMS in Germany remained largely accessible during the COVID-19 pandemic in 2020 and 2021. However, the study also reveals certain gaps in care that may be addressed by incorporating digital technologies into medical care and rehabilitation, potentially enhancing the management of healthcare during future pandemics or similar situations.
Collapse
Affiliation(s)
- Heidi Stölzer-Hutsch
- Department of Neurology, Center of Clinical Neuroscience, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstr. 74, 01307 Dresden, Germany; (H.S.-H.); (D.S.)
| | - Dirk Schriefer
- Department of Neurology, Center of Clinical Neuroscience, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstr. 74, 01307 Dresden, Germany; (H.S.-H.); (D.S.)
| | - Joachim Kugler
- Institute and Policlinic for Occupational and Social Medicine, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstr. 74, 01307 Dresden, Germany;
| | - Tjalf Ziemssen
- Department of Neurology, Center of Clinical Neuroscience, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstr. 74, 01307 Dresden, Germany; (H.S.-H.); (D.S.)
| |
Collapse
|
2
|
Garrido ND, Reis VM, Vilaça-Alves JM, Lucas GC, Godinho IL, Peixoto R, Fucarino A, Cantoia M, Iuliano E, De Giorgio A, Fabbrizio A, Suasa M, Zimatore G, Baldari C, Macaluso F. Impact of tele-exercise on quality of life, physical fitness, functional capacity and strength in different adult populations: a systematic review of clinical trials. Front Sports Act Living 2025; 7:1505826. [PMID: 39949715 PMCID: PMC11821610 DOI: 10.3389/fspor.2025.1505826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Accepted: 01/06/2025] [Indexed: 02/16/2025] Open
Abstract
Introduction This study aimed to review the impact of tele-exercise on different adult populations, comparing synchronous and asynchronous interventions and their effects on outcomes such as quality of life, physical fitness, functional capacity, strength, and pain. Methods Randomised clinical trials and quasi-experimental studies published between 2014 and 2024 were included, totalling 16 studies with 1,416 participants. The interventions varied between synchronous teleexercise (via videoconference) and asynchronous (via apps and recorded videos). The review followed the PRISMA guidelines, ensuring a systematic approach to study selection, data extraction, and bias assessment. Results The results indicate that tele-exercise, especially synchronous, has the potential to primarily improve physical fitness, functional capacity, and pain perception, being effective for the elderly and individuals with specific conditions such as multiple sclerosis and obesity. Discussion However, the methodological heterogeneity of the studies and the lack of consistent data limit the generalisation of the findings, highlighting the need for more high-quality research. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024563241, PROSPERO (CRD42024563241).
Collapse
Affiliation(s)
- Nuno Domingos Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
- Sports Science, Exercise and Health Department, University of Trás-os-Montes & Alto Douro, Vila Real, Portugal
| | - Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
- Sports Science, Exercise and Health Department, University of Trás-os-Montes & Alto Douro, Vila Real, Portugal
| | - José Manuel Vilaça-Alves
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
- Sports Science, Exercise and Health Department, University of Trás-os-Montes & Alto Douro, Vila Real, Portugal
| | - Gabriela Chaves Lucas
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Ismael Lima Godinho
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Rafael Peixoto
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Alberto Fucarino
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Manuela Cantoia
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Enzo Iuliano
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Andrea De Giorgio
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Antonio Fabbrizio
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Martina Suasa
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Giovanna Zimatore
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Filippo Macaluso
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| |
Collapse
|
3
|
Saxby SM, Shemirani F, Crippes LJ, Ehlinger MA, Brooks L, Bisht B, Titcomb TJ, Rubenstein LM, Eyck PT, Hoth KF, Gill C, Kamholz J, Snetselaar LG, Wahls TL. Effects of a Remote Multimodal Intervention Involving Diet, Walking Program, and Breathing Exercise on Quality of Life Among Newly Diagnosed People with Multiple Sclerosis: A Quasi-Experimental Non-Inferiority Pilot Study. Degener Neurol Neuromuscul Dis 2024; 14:1-14. [PMID: 38222092 PMCID: PMC10787513 DOI: 10.2147/dnnd.s441738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
Background Interventions involving diet, physical activity, and breathing exercises are shown to be beneficial in managing both fatigue and quality of life (QoL) related to MS; however, the impact of such interventions among people newly diagnosed with clinically isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS) who decline disease-modifying therapies (DMTs) is unknown. Methods A 12-month prospective quasi-experimental non-inferiority trial recruited people newly diagnosed with CIS or RRMS who voluntarily declined DMTs (health behavior group; HB, n = 29) or followed standard of care (SOC, n = 15). Participants in the HB group were remotely coached on the study diet, moderate-intensity walking, and breathing exercises. All participants completed questionnaires validated to assess MS symptoms, including perceived mental and physical QoL (MSQOL54); fatigue (Fatigue Severity Scale, FSS; and Modified Fatigue Impact Scale, MFIS); mood (Hospital Anxiety and Depression Scale, HADS); and cognitive function (Perceived Deficits Questionnaire, PDQ). Results During the 12 months, the HB group experienced improvement in scores for mental QoL (MSQOL54 - Mental, 0.24, 95% CI 0.01, 0.47; p = 0.04), fatigue (Total MFIS, -7.26, 95% CI -13.3,-1.18; p = 0.02), and perceived cognitive function (Total PDQ, PDQ-Attention, PDQ-Promemory, and PDQ-Planning, p ≤ 0.03 for all). A between-group difference was observed only for PDQ-Planning (p = 0.048). Non-inferiority analysis revealed that the 12-month changes in means for the HB group were not worse than those for the SOC group with respect to fatigue (FSS, p = 0.02), mood (HDS-Anxiety, p = 0.02; HADS-Depression, p < 0.0001), physical QoL (MSQOL54 - Physical, p = 0.02), or cognitive dysfunction (Total PDQ, p = 0.01). Conclusion The multimodal lifestyle intervention for individuals newly diagnosed with CIS or RRMS, who voluntarily decline DMTs, did not yield patient-reported outcomes worse than those observed in the SOC group regarding perceived mental quality of life, mood, fatigue, and cognitive function. Trial Registration clinicaltrials.gov identifier: NCT04009005.
Collapse
Affiliation(s)
- Solange M Saxby
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Landon J Crippes
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Mary A Ehlinger
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Lisa Brooks
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Babita Bisht
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Tyler J Titcomb
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Patrick Ten Eyck
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Karin F Hoth
- Department of Psychiatry and the Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
| | - Christine Gill
- Department of Neurology, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | - John Kamholz
- Department of Neurology, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | | | - Terry L Wahls
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| |
Collapse
|
4
|
Panisset MG, Galea MP. The effect of COVID-19 lockdowns on exercise and the role of online exercise in Australians with multiple sclerosis. Mult Scler Relat Disord 2023; 78:104901. [PMID: 37536213 DOI: 10.1016/j.msard.2023.104901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/26/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Regular exercise is beneficial for people with Multiple Sclerosis (MS), regardless of disability level. The previously reported differential effect of COVID-19-related lockdowns on exercise levels in this population remains unexplained. We examined effects of lockdowns on exercise in Australians with MS according to disability levels, lockdown severity and health technology use. METHODS A cross-sectional survey of people with MS in Australia (22 April-23 September 2021) collected demographic and clinical information as well as exercise patterns before and during lockdowns. Mann-Whitney was used to compare ordinal data and Likelihood Ratio to compare dichotomous data. RESULTS 151 people completed the survey. 72.2% had mild disability and 25.2% moderate disability. Extended lockdowns were associated with significantly decreased sedentary behaviour (31.5% to 25.9%) but also with decreased exercise frequency in frequent exercisers (≥3 times/week; 53.7% to 22.2%). The latter occurred significantly more in those with mild disability (-22.7%) than with moderate disability (-3.5%). More people with mild disability walked for exercise pre-pandemic (LR 8.6, p=.004) and during lockdowns (LR 6.6, p=.010). Walking during lockdowns was positively associated with working from home. People with moderate disability were more likely to engage in home exercise both pre-pandemic (LR 5.5, p=.019) and during lockdown (LR 5.2, p=.023). Engagement in home exercise rose for both groups during lockdowns and was facilitated by on-line exercise classes. CONCLUSION Lockdowns differentially affected exercise patterns according to disability level. The proportion of people achieving exercise recommendations decreased more in those with mild but not moderate disability. Incidental physical activity was disproportionately impacted in people with moderate disability.
Collapse
Affiliation(s)
- M G Panisset
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC 3050, Australia.
| | - M P Galea
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC 3050, Australia; Australian Rehabilitation Research Centre, Parkville, Australia
| |
Collapse
|
5
|
Dos Santos FC, Candotti CT, Rodrigues LP. Reliability of the Five Times Sit to Stand Test performed remotely by multiple sclerosis patients. Mult Scler Relat Disord 2023; 73:104654. [PMID: 37060677 DOI: 10.1016/j.msard.2023.104654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Multiple Sclerosis, known main cause of non-traumatic neurological disability in adults, leads to changes in muscle strength, especially in the lower limbs. Assessing muscle strength in these patients is thus essential and can be achieved by the Five Times Sit to Stand Test (FTSST), commonly performed in person. Due to the COVID-19 pandemic and social distancing measured adopted, Brazilian physiotherapists turned to remote monitoring and assessment, supported by Resolution n° 516/2020, which required proving the reliability of tests. Given this scenario, this study sought to evaluate the intra- and inter-rater reliability of the Five Times Sit to Stand Test performed remotely and synchronously by multiple sclerosis patients. METHODS A sample of 33 individuals with relapsing-remitting Multiple Sclerosis (18 women and 15 men, mean age 43.7 ± 13.4 years) were remotely and synchronously by video call. Inter-rater reliability was evaluated by analyzing FTSST execution time, in seconds, timed by two different raters on the same video call. In turn, intra-rater reliability was assessed by analyzing the execution time recorded in two different video calls made by the same rater, within a 24-28-h interval. Descriptive and inferential data analysis were performed using SPSS 20.0 software. Means and standard deviation were calculated for descriptive statistic. Intraclass correlation coefficient (ICC), with a 0.05 significance level, standard error of measurement (SEM) and minimal detectable change (MDC) were calculated for inferential analysis. RESULTS Data analysis showed excellent ICC values and low SEM and MDC values regarding inter-rater reliability (ICC: 0.993 (0.986-0.996); p-value: <0.001; SEM: 0.6 s; MDC: 1.6 s) and intra-rater reliability (ICC: 0.962 (0.925-0.981); p-value: <0.001; SEM: 1.4 s; MDC: 3.8 s). CONCLUSION Based on these values, FTSST performed remotely and synchronously by relapsing-remitting Multiple Sclerosis patients is reliable and can be used both by different raters, for assessment, or by the same rater, in pre- and post-test situations.
Collapse
Affiliation(s)
- Felipe Colmeneiro Dos Santos
- Undergraduate of the Physiotherapy Course, Escola de Educação Fìsica, terapia e Dança, Universidade Federal do Rio Grande do Sul, Rua Felizardo, 750. Bairro Jardim Botânco. Porto Alegre, RS CEP 90690-200, Brasil
| | - Cláudia Tarragô Candotti
- Professor of the Physiotherapy Course, Escola de Educação Fìsica, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul. Rua Felizardo, 750. Bairro Jardim Botânco. Porto Alegre, RS CEP 90690-200, Brasil
| | - Luciano Palmeiro Rodrigues
- Professor of the Physiotherapy Course, Escola de Educação Fìsica, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul. Rua Felizardo, 750. Bairro Jardim Botânco. Porto Alegre, RS CEP 90690-200, Brasil.
| |
Collapse
|
6
|
Qomi M, Rakhshan M, Ebrahimi Monfared M, Khademian Z. The effect of distance nurse-led fatigue management on fatigue, sleep quality, and self-efficacy in patients with multiple sclerosis: a quasi-experimental study. BMC Neurol 2023; 23:71. [PMID: 36788480 PMCID: PMC9926409 DOI: 10.1186/s12883-023-03115-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Fatigue is one of the most common problems in patients with multiple sclerosis (MS) and has adverse effects on their sleep status and self-efficacy. This study aimed to determine the effect of distance nurse-led fatigue management on fatigue, sleep quality, and self-efficacy in patients with MS. METHODS This quasi-experimental study was performed on 60 patients with MS in Arak, Iran. Subjects were randomly assigned into intervention and control groups. The intervention group received eight sessions of nurse-led fatigue management training through the Skyroom platform. The control group received only the usual programs. Data were collected before and two months after the intervention using the Fatigue Severity Scale, the Pittsburgh Sleep Quality Index, and the Multiple Sclerosis Self-Efficacy Scale. The significance level in this study was determined 0.05. RESULTS After the intervention, the mean score of fatigue severity in the intervention group was significantly lower than the control group (2.52 ± 0.40 vs 5.65 ± 0.52) (P < 0.001). Also, after the intervention, the mean score of self-efficacy in the intervention group was significantly higher than the control group (49.37 ± 3.25 vs 24.43 ± 2.52) (P < 0.001). Furthermore, after the intervention the mean score of sleep quality was lower in intervention group (11.92 ± 2.01) than the control group (15.46 ± 1.40) (P < 0.001). CONCLUSION Distance nurse-led fatigue management improved fatigue, sleep quality, and self-efficacy in patients with MS. We recommend the use of these courses as an important step toward improving fatigue, sleep quality, and self-efficacy among these patients.
Collapse
Affiliation(s)
- Mahla Qomi
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zahra Khademian
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
van de Venis L, van de Warrenburg B, Weerdesteyn V, Geurts ACH, Nonnekes J. Gait-Adaptability Training in People With Hereditary Spastic Paraplegia: A Randomized Clinical Trial. Neurorehabil Neural Repair 2023; 37:27-36. [PMID: 36695288 PMCID: PMC9896539 DOI: 10.1177/15459683221147839] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND OBJECTIVES In people with hereditary spastic paraplegia (HSP), reduced gait adaptability is common and disabling. Gait impairments result from lower extremity spasticity, muscle weakness, and impaired proprioception. The aim of this study was to assess the efficacy of a 5-week gait-adaptability training in people with pure HSP. METHOD We conducted a randomized clinical trial with a cross-over design for the control group, and a 15-week follow-up period after training. Thirty-six people with pure HSP were randomized to 5 weeks of (i) gait-adaptability training (10 hours of C-Mill training-a treadmill equipped with augmented reality) or (ii) a waiting-list control period followed by 5 weeks gait-adaptability training. Both groups continued to receive usual care. The primary outcome was the obstacle subtask of the Emory Functional Ambulation Profile. Secondary outcome measures consisted of clinical balance and gait assessments, fall rates, and spatiotemporal gait parameters assessed via 3D motion analysis. RESULTS The gait-adaptability training group (n = 18) did not significantly decrease the time required to perform the obstacle subtask compared to the waiting-list control group (n = 18) after adjusting for baseline differences (mean: -0.33 seconds, 95% CI: -1.3, 0.6). Similar, non-significant results were found for most secondary outcomes. After merging both groups (n = 36), the required time to perform the obstacle subtask significantly decreased by 1.3 seconds (95% CI: -2.1, -0.4) directly following 5 weeks of gait-adaptability training, and this effect was retained at the 15-week follow-up. CONCLUSIONS We found insufficient evidence to conclude that 5 weeks of gait-adaptability training leads to greater improvement of gait adaptability in people with pure HSP.
Collapse
Affiliation(s)
- Lotte van de Venis
- Department of Rehabilitation, Center of
Expertise for Rare and Genetic Movement Disorders, Donders Institute for Brain,
Cognition and Behavior, Radboud University Medical Center, Nijmegen, The
Netherlands,Lotte van de Venis, Radboud University
Medical Center, PO Box 9101, Reinier Postlaan 4, 6500 HB Nijmegen, The
Netherlands.
| | - Bart van de Warrenburg
- Department of Neurology, Center of
Expertise for Rare and Genetic Movement Disorders, Donders Institute for Brain,
Cognition and Behavior, Radboud University Medical Center, Nijmegen, The
Netherlands
| | - Vivian Weerdesteyn
- Department of Rehabilitation, Center of
Expertise for Rare and Genetic Movement Disorders, Donders Institute for Brain,
Cognition and Behavior, Radboud University Medical Center, Nijmegen, The
Netherlands,Research, Sint Maartenskliniek,
Nijmegen, The Netherlands
| | - Alexander C. H. Geurts
- Department of Rehabilitation, Center of
Expertise for Rare and Genetic Movement Disorders, Donders Institute for Brain,
Cognition and Behavior, Radboud University Medical Center, Nijmegen, The
Netherlands,Department of Rehabilitation, Sint
Maartenskliniek, Nijmegen, The Netherlands
| | - Jorik Nonnekes
- Department of Rehabilitation, Center of
Expertise for Rare and Genetic Movement Disorders, Donders Institute for Brain,
Cognition and Behavior, Radboud University Medical Center, Nijmegen, The
Netherlands,Department of Rehabilitation, Sint
Maartenskliniek, Nijmegen, The Netherlands
| |
Collapse
|
8
|
Daveri M, Fusco A, Cortis C, Mascherini G. Effectiveness of Different Modalities of Remote Online Training in Young Healthy Males. Sports (Basel) 2022; 10:sports10110170. [PMID: 36355821 PMCID: PMC9697893 DOI: 10.3390/sports10110170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Since 2020 there has been an increase in demand for home workouts. Therefore, different ways of delivering distance training have been proposed to promote “stay active at home.” This study aimed to compare the effectiveness of three different training programs consisting of a total of 15 workouts (three sessions per week): supervised livestreaming (LS), unsupervised following a video recording (VR), and unsupervised following a written program (WP). Changes in anthropometric and cardiovascular variables, muscle fitness, and physical activity levels were evaluated. To provide a meaningful analysis for significant comparisons between small groups, mean differences (∆), 95% confidence interval (95% C.I.), and Cohen’s effect sizes (E.S.) were also calculated. The three training modalities increased physical activity levels, with an adherence rate of LS = 93.3%, VR = 86%, and WP = 74%. Although there was no reduction in body weight, waist circumference decreased by 1.3 cm (95% C.I. = −2.1, −0.5; E.S. = 0.170; p < 0.004). Furthermore, where LS, VR, and WP resulted in improvements in muscle fitness, only LS showed changes in cardiovascular variables, such as resting heart rate (∆ = −7.3 bpm; 95% C.I. = −11.9, −2.7; E.S. = 1.296; p < 0.001) and Ruffier’s index (∆ = −2.1bpm; 95% C.I. = −3.5, −0.8; E.S. 1.099; p < 0.001). Remote online training proved its effectiveness over a short period of time. However, supervised training proved to be the most effective, highlighting the importance of an experienced trainer.
Collapse
Affiliation(s)
- Michael Daveri
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, 03043 Cassino, Italy
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, 03043 Cassino, Italy
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Correspondence:
| |
Collapse
|