Rethinking physical exercise training in the modern era of cystic fibrosis: A step towards optimising short-term efficacy and long-term engagement

Gruet, Mathieu; Saynor, Zoe L.; Urquhart, Don S.; Radtke, Thomas

doi:10.1016/j.jcf.2021.08.004

Cited by 24 publications

(36 citation statements)

References 162 publications

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“…The tools developed in this project to foster an increase in vigorous PA would then be introduced successively to maintain or even further increase the activity level. In view of the multiple benefits of PA established in various populations, healthcare providers are advised to motivate people with CF to be physically active, without pressure, but appropriate supervision including individual goal setting aiming to build positive long-term activity behavior ( 47 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of a Partially Supervised Conditioning Program in Cystic Fibrosis: An International Multicenter, Randomized Controlled Trial (ACTIVATE-CF)

Hebestreit

Kriemler

Schindler

et al. 2022

Am J Respir Crit Care Med

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Rationale The long-term effects of vigorous physical activity (PA) on lung function in cystic fibrosis are unclear. Objectives To evaluate effects of a 12-month partially supervised PA intervention using motivational feedback. Methods In a parallel-arm multicenter randomized controlled trial (ACTIVATE-CF), relatively inactive patients aged at least 12 years were randomly assigned (1:1 ratio) to an intervention group or control group. The intervention group consented to add 3 hours of vigorous PA per week, whereas the control group was asked not to change their PA behavior. Primary endpoint was change in percent predicted FEV 1 (ΔFEV 1 ) at 6 months. Secondary endpoints included PA, exercise capacity, exercise motives, time to first exacerbation and exacerbation rates, quality of life, anxiety, depression, stress, and blood glucose control. Data were analyzed using mixed linear models. Measurements and Main Results A total of 117 patients (40% of target sample size) were randomized to an intervention (n = 60) or control group (n = 57). After 6 months, ΔFEV 1 was significantly higher in the control group compared with the intervention group (2.70% predicted [95% confidence interval, 0.13–5.26]; P = 0.04). The intervention group reported increased vigorous PA compared with the control group at each study visit, had higher exercise capacity at 6 and 12 months, and higher PA at 12 months. No effects were seen in other secondary outcomes. Conclusions ACTIVATE-CF increased vigorous PA and exercise capacity, with effects carried over for the subsequent 6 months, but resulted in better FEV 1 in the control group.

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Section: Discussionmentioning

confidence: 99%

Effects of a Partially Supervised Conditioning Program in Cystic Fibrosis: An International Multicenter, Randomized Controlled Trial (ACTIVATE-CF)

Hebestreit

Kriemler

Schindler

et al. 2022

Am J Respir Crit Care Med

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“…Despite this, we had low uptake of the intervention and poor compliance with study procedures. Future studies may need to consider intervention designs that more explicitly target physiological, psychological and practical factors associated with achieving long-term behaviour change with respect to physical activity 38. This might include study designs that allow participants their choice of intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Future studies may need to consider intervention designs that more explicitly target physiological, psychological and practical factors associated with achieving long-term behaviour change with respect to physical activity. [38] This might include study designs that allow participants their choice of intervention. Choice-based interventions have been shown improve participant retention, adherence, satisfaction and behaviour change.…”

Section: Future Research Considerationsmentioning

confidence: 99%

Web-based physical activity promotion in young people with CF: a randomised controlled trial

Cox

Eldridge

Rawlings

et al. 2022

Thorax

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BackgroundPhysical activity levels are known to decline following hospitalisation for people with cystic fibrosis (pwCF). However, optimal physical activity promotion strategies are unclear. This study investigated the effect of a web-based application (ActivOnline) in promoting physical activity in young pwCF.MethodsMulticentre randomised controlled trial with assessor blinding and qualitative evaluation. People with CF (12–35 years) admitted to hospital for a respiratory cause were eligible and randomised to the 12-week ActivOnline intervention (AO) or usual care (UC). The primary outcome was change in device-based time spent in moderate-to-vigorous physical activity (MVPA) from baseline to post-intervention. Follow-up was at 6 months from hospital discharge when qualitative evaluation was undertaken.Results107 participants were randomised to AO (n=52) or UC (n=55). Sixty-three participants (59%) contributed to the intention-to-treat analysis. Mean (SD) age was 21 (6) years (n=46, <18 years). At baseline, physical activity levels were high in both groups (AO 102 (52) vs UC 127 (73) min/day). There was no statistically significant difference in MVPA between groups at either timepoint (post-intervention mean difference (95% CI) −14 mins (−45 to 16)). Uptake of the intervention was low with only 40% (n=21) of participants accessing the web application.ConclusionA web-based application, including individualised goal setting, real-time feedback and motivation for behavioural change, was no better than usual care at promoting physical activity in young pwCF following hospital discharge. High levels of baseline physical activity levels in both groups, and limited engagement with the intervention, suggest alternative strategies may be necessary to identify and support young pwCF who would benefit from enhanced physical activity.Trial registration numberACTRN12617001009303, 13 July 13 2017.

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“…Aerobic exercise training has a positive effect on exercise capacity, as well as on cardiovascular endurance and mucus clearance [ 7 , 35 , 36 ]. On the contrary, resistance training increases muscle strength and local muscle endurance [ 37 ]. The combination of both training modalities adapted to the patient’s age, and health status is recommended as the most profitable option [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Especially in young people with CF, the burden of lung disease can affect their physical activity levels, which is an essential part of their socialization and group integration [ 15 ]. Due to lung disease, such individuals cannot participate in daily activity, and their emotional health and quality of life are negatively affected [ 37 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Physical Activity and Quality of Life among Patients with Cystic Fibrosis

et al. 2022

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Background: Physical activity (PA) improves exercise capacity, slows the decline in lung function, and enhances Quality of Life (QoL) in patients with cystic fibrosis (pwCF). Objectives: The study aimed to evaluate PA and QoL among children with CF compared to healthy controls; the secondary aim was to assess the correlation between PA, QoL, and lung function (FEV1). Methods: Forty-five children and adolescents with CF and 45 age-matched controls completed two self-administered validated questionnaires: The Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the DISABKIDS for QoL. Moreover, pwCF performed spirometry and multiple breath washout tests (MBW). In addition, weight, height, and BMI were recorded. The Godin Leisure-Time Exercise Questionnaire was used to evaluate physical activity; QOL was assessed using the DISABKIDS Questionnaire. The correlation of PA with QOL was assessed as well. Results: Mean age of the CF population was 13.22 (±4.6) years, mean BMI 19.58 (±4.1) kg/m2, mean FEV1% 91.15 ± 20.46%, and mean LCI 10.68 ± 4.08. 68% of the CF group were active, 27% were medium active, 5% were sedentary, while 83% of the control group were active and 17% were medium active. PwCF with higher PA scores showed significantly higher emotional health (r2: 0.414, p: 0.006) and total QOL score (r2: 0.372; p: 0.014). The PA score showed no significant correlation with FEV1% or LCI. Conclusions: The children with CF showed satisfactory PA levels, which positively correlated to their QoL. More research is needed on the effect of increased levels of habitual physical activity to establish the decline in pulmonary function among pwCF.

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Rethinking physical exercise training in the modern era of cystic fibrosis: A step towards optimising short-term efficacy and long-term engagement

Cited by 24 publications

References 162 publications

Effects of a Partially Supervised Conditioning Program in Cystic Fibrosis: An International Multicenter, Randomized Controlled Trial (ACTIVATE-CF)

Effects of a Partially Supervised Conditioning Program in Cystic Fibrosis: An International Multicenter, Randomized Controlled Trial (ACTIVATE-CF)

Web-based physical activity promotion in young people with CF: a randomised controlled trial

Physical Activity and Quality of Life among Patients with Cystic Fibrosis

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