Feasibility and implementation of a personalized, web-based exercise intervention for people with cystic fibrosis for 1 year

Barlo Hillen; Perikles Simon; Sebastian Schlotter; Oliver Nitsche; Viola Bähner; Krystyna Poplawska; Daniel Pfirrmann

doi:10.1186/s13102-021-00323-y

Feasibility and implementation of a personalized, web-based exercise intervention for people with cystic fibrosis for 1 year

BMC Sports Sci Med Rehabil. 2021 Aug 19;13(1):95. doi: 10.1186/s13102-021-00323-y.

Authors

Barlo Hillen¹, Perikles Simon¹, Sebastian Schlotter², Oliver Nitsche², Viola Bähner², Krystyna Poplawska^#³, Daniel Pfirrmann^#¹

Affiliations

¹ Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University, Mainz, Germany.
² Medical Department of Pediatrics Pulmonology, Allergology and Cystic Fibrosis, University Medical Centre, Langenbeckstraße 1, 55131, Mainz, Germany.
³ Medical Department of Pediatrics Pulmonology, Allergology and Cystic Fibrosis, University Medical Centre, Langenbeckstraße 1, 55131, Mainz, Germany. Krystyna.Poplawska@unimedizin-mainz.de.

^# Contributed equally.

Abstract

Background: Regular participation in exercise is important for people with cystic fibrosis (CF). Therefore, we implemented a personalized, web-based exercise intervention over the course of one year for people with CF. The aims were to investigate the feasibility of the intervention and to evaluate changes in exercise participation, lung function, and exercise capacity.

Methods: In total, 11/17 participants [aged 12-52 years; FEV₁%pred. 72.3 (SD: 17.3)] were included in the final data analysis. Every week, the participants received an individual training recommendation at the start and uploaded their training report on our website at the end of each week. The number of training minutes and sessions performed were analyzed over 13 four-week training sections. The participation in exercise (physical activity questionnaire), lung function and exercise capacity were assessed at baseline (T0), after 12 weeks (T1) and after 52 weeks (T2).

Results: A training duration of 178 min (SD: 75.5) and 3.3 (SD: 0.89) training sessions could be achieved weekly. In the first four-week training section, the participants performed 137.31 (SD: 95.7) minutes of training, with an increase of 42% in the third training section (195.01, SD: 134.99). Minutes of training reported on the questionnaire increased by 39.7% from T0 (179.38 min, SD: 120.9) to T1 (250.63 min, SD: 124.1) but decreased at T2 (166.88, SD: 155.4). There were slight decreases in lung function (FEV₁ - 3.9%pred.; FVC - 1.9%pred.) and slight increases in exercise capacity (VO_2peak + 1.5 ml/min/kg; six-minute-walk-test-distance + 26 m). Noticeably, five participants experienced deteriorations in their FEV₁ of more than 5% but simultaneously experienced improvements in the parameters of exercise capacity of more than 5% throughout the year.

Conclusions: The web-based concept was feasible for the participants over the course of a year and supported exercise participation. The improvement in exercise capacity due to increased exercise participation over a prolonged period of time, despite a decrease in lung function, should be further investigated. Finally, if integrated into usual care, this approach could facilitate the prescription of regular personalized exercise and promote exercise participation in the daily lives of people with CF.

Keywords: Chronic diseases; Clinical exercise therapy; Exercise prescription; Long-term intervention; Personalized telemedicine.