Aerobic exercise in adult neuromuscular rehabilitation: A survey of healthcare professionals

Abstract

LAY ABSTRACTAn important goal of rehabilitation programmes in slowly progressive neuromuscular diseases is to promote physical fitness through aerobic exercise programmes. This survey of Dutch rehabilitation specialists and physical therapists, specialized in neuromuscular diseases, aimed to evaluate how often and what way aerobic exercise is applied in clinical practice. The results showed that all respondents prescribed aerobic exercise and in a wide variety of neuromuscular diseases. How ever, all respondents also experienced one or more barriers to aerobic exercise and, most importantly, more than three-quarters reported a need for support. The preferred method of support is through the development of guidelines, with a focus on the screening procedures (to assess the need for aerobic training) and design of training programmes. In conclusion, more evidence-based knowledge is needed, in order to develop guidelines to support healthcare professionals in prescribing aerobic exercise in neuromuscular rehabilitation.Objective: To evaluate the current application of aerobic exercise in adult neuromuscular rehabilitation. Design: Cross-sectional survey. Participants: Dutch rehabilitation specialists and physical therapists in specialized centres for slowly progressive neuromuscular diseases and in primary care. Methods: Participants received a self-designed, web-based, questionnaire, including 27 close-ended questions covering 4 categories: respondent profile, application of aerobic exercise, barriers to prescribing aerobic exercise, and need for support to improve the application of aerobic exercise. Results: All respondents (n = 52) prescribed aerobic exercise and in a wide variety of neuromuscular diseases, mostly applying sessions of more than 20 min, 2 days per week, over a period of 9-16 weeks, using different exercise modes and methods to target intensity. The majority (81%) agreed that aerobic exercise should be incorporated into neuromuscular rehabilitation. However, all respondents perceived barriers to the application of aerobic exercise in one or more domains, and 77% of the respondents indicated needing support to improve application of this type of training, mostly with respect to screening procedures (54%) and dosing of exercise programmes (48%). Conclusion: Aerobic exercise is widely applied, yet our results raise awareness of the necessity of more evidence based knowledge, in order to develop and implement guidelines in adult neuromuscular rehabilitation.

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