Feasibility of a blended therapy approach in the treatment of patients with inflammatory myopathies

Abstract

Background Inflammatory myopathies (IMs) are a group of rare conditions characterized by proximal and often symmetrical muscle weakness and reduced muscle endurance. The recommended medical treatment is based on corticosteroids in combination with immunosuppressants. This anti-inflammatory therapy serves to inhibit and prevent inflammation but does not influence impaired muscle strength. Exercise, particularly progressive resistance training, plays therefore an important role in IMs management. Blended therapy, a combination of face-to-face treatment and telerehabilitation, may be a powerful therapy option in improving exercise program adherence in these patients. Methods The feasibility of a 12-week interactive tablet-based home exercise program combined with face-to-face therapy sessions – a ‘blended therapy’ approach - was evaluated using a quasi-experimental one-group pre-post comparison design. Primary outcomes were recruitment, attrition and adherence rates, plus measures of acceptance (Technology Acceptance Model Questionnaire (TAM)) and satisfaction (satisfaction questionnaire). Secondary outcomes comprised potential effects of the intervention on muscle strength and function, activity limitation, disability and health-related quality of life. Results Thirteen of the included 14 participants completed the study without any related adverse events. Mean adherence to exercise program was 84% (range: 25–100%) and participants indicated high acceptance of the intervention with mean TAM scores between 6.1 and 6.5 points. Overall satisfaction with the therapy sessions, the home program, and the technology was good. Approximately half the participants wished for longer training periods and more training sessions per week. There were inconsistent effects on muscle strength, muscle function, activity limitation, disability, and health-related quality of life. Conclusion Blended therapy combining the use of an interactive tablet-based resistance training program with face-to-face therapy sessions is feasible and safe and participants` acceptance with this approach was high. Furthermore, results were obtained that might be useful in selecting appropriate assessments and sample sizes in future trials. Trial registration NCT03713151.

Older adults' needs and requirements for a comprehensive exergame-based telerehabilitation system: A focus group study

“…Thereby, the focus should be on changing attitudes and self-efficacy beliefs which have proven to have a greater effect on older people's use of ICTs than actual knowledge ( 40 , 47 ). This points to the necessity of a blended therapy approach where conventional face-to-face care is combined with telerehabilitation (TR) ( 48 , 49 ). Future iterations within the development process should shed a light on this.…”

Presymptomatic myositis in patients with antisynthetase syndrome associated with interstitial lung disease: A prospective small case series clinical study

“…Therefore, the use of resistance exercise is encouraged. 8 Recognizing the onset of presymptomatic myogenic changes and engaging in appropriate exercises may help to maintain muscle strength and improve the quality of life.…”