Tele-Exercise as a Promising Tool to Promote Exercise in Children With Cystic Fibrosis

Abstract

Introduction: Cross-infection risk from contact exposure limits exercise opportunities in children with cystic fibrosis (CF). The purpose of this study is to evaluate the feasibility of a new live-streamed platform which delivered supervised and interactive group exercise sessions to CF children via digital devices while avoiding contact exposure.Methods: Ten CF children participated in a 6-week tele-exercise program. The program consisted of three 30-min sessions per week for a total of 18 sessions and included aerobic, resistance, and flexibility exercises. Sessions were streamed via a HIPAA compliant VSee telemedicine platform. Instructors and participants were able to interact in real-time online. Heart rate (HR) monitors were used to evaluate exercise intensity with a goal of moderate-vigorous physical activity ≥10 min, 70% of the sessions. System usability scale (SUS) and qualitative questionnaires were used to gauge participants' satisfaction and feedback.Results: On average participants attended 85% of the sessions. For the overall sessions participants exercise 21.1 ± 6.9 min at moderate-vigorous physical activity. Nine out of 10 participants used the exercise platform without parental guidance. Qualitative questionnaire and System Usability Scale (SUS) indicated that all participants enjoyed the tele-exercise program and highly rated the exercise platform 90.8 out of 100 (passing > 68).Conclusions: Tele-exercise platform is a promising new approach to promote exercise in children with CF. The online platform allows supervised virtual group exercise experience with optimal participation and no risk for cross-infection. This approach might prove to be useful in enhancing the use of exercise as therapy in children with CF.

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

“…They suggested conducting a randomized controlled trial to examine the effect on participation in physical activity. In 2018, Chen et al [ 30 ] addressed the issue of the risk of cross-infection in the population of CF patients. Therefore, they examined the use of a live-streaming platform that offered supervised and interactive group exercises.…”

“…Recently, elaborate and promising study protocols for web-based RCTs have been published. Hebestreit et al [ 30 ] published a study protocol for “Activate-CF” involving a “partially supervised conditioning program” based on the use of pedometers, with an international, multicenter randomized controlled trial design. Lang et al [ 31 ] presented a study protocol for a 12-months multimodal telehealth-based outpatient physiotherapy service and compare the usual outpatient physiotherapy service with the telehealth intervention CyFiT, eHAB®.…”

Mobile Health and Telehealth Interventions to Increase Physical Activity in Adolescents with Obesity: a Promising Approach to Engaging a Hard-to-Reach Population

“…Tele-exercise programs have been used successfully in children with cystic fibrosis [57], as well as in elderly adults, in which participation in a video conferencing-based supervised resistance exercise program resulted in increased muscle mass and lean soft tissue [58]. In youth-targeted interventions, telemedicine-based exercise coaching could also facilitate caregiver involvement, which has been associated with greater success in mHealth interventions [13].…”

Virtual Strategies for the Broad Delivery of High Intensity Exercise in Persons With Spinal Cord Injury: Ongoing Studies and Considerations for Implementation

“…Therefore, if desired and possible, multidirectional connection via video conferencing allows for instructor(s) and participant(s) to engage during the exercise session. This live streaming of VEX gives exercise professionals the potential to actively monitor participants during the session, allowing for remote delivery of exercise to specialty populations (Chen et al, 2018). The availability of virtual platforms has increased recently, especially since the online transition in response to the COVID-19 pandemic.…”

“…Utilizing virtual platforms to deliver on-demand exercise instructions, in the form of graphics and/or pre-recorded videos, has been successfully implemented in adults with a mobility limitation including those with SCI as part of the "Scale Up Project Evaluating Responsiveness to Home Exercise and Lifestyle Tele-Health" (SUPER-HEALTH; NCT03024320) study (Wilroy et al, 2017(Wilroy et al, , 2020Lai et al, 2019;Rimmer et al, 2019). Further utilization of video conferencing technologies can be used to deliver an even more interactive service to exercise participants, similarly to the implementation of VEX for other populations (Hong et al, 2017;Chen et al, 2018). Currently, there are three ongoing registered trials involving real-time participant monitoring during home-based VEX individualized for persons with SCI.…”