Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. Increasing the medium-term clinical benefits of hospital-based cardiac rehabilitation by physical activity telemonitoring in coronary artery disease patients Impact of feedback on physical activity levels of individuals with chronic obstructive pulmonary disease during pulmonary rehabilitation Effects of two behavioral cardiac rehabilitation interventions on physical activity: A randomized controlled trial. Results of the Sedentary Intervention Trial in Cardiac Rehabilitation (SIT-CR Study): A pilot randomized controlled trial. Walk2Bactive: A randomised controlled trial of a physical activity-focused behavioural intervention beyond pulmonary rehabilitation in chronic obstructive pulmonary disease. A pedometer-based physical activity intervention for patients entering a maintenance cardiac rehabilitation program: a pilot study. In-class Active Video Game Supplementation and Adherence to Cardiac Rehabilitation The likelihood of improving physical activity after pulmonary rehabilitation is increased in patients with COPD who have better exercise tolerance Randomised controlled trial of a pedometer-based telephone intervention to increase physical activity among cardiac patients not attending cardiac rehabilitation. Effects of low-intensity exercise and home-based pulmonary rehabilitation with pedometer feedback on physical activity in elderly patients with chronic obstructive pulmonary disease. Effects of a Pedometer‐Based Intervention on Physical Activity Levels After Cardiac Rehabilitation: A RANDOMIZED CONTROLLED TRIAL The effect of mere measurement from a cardiovascular examination program on physical activity and sedentary time in an adult population Effects of a Phase IV Home-Based Cardiac Rehabilitation Program on Cardiorespiratory Fitness and Physical Activity. Cost-effectiveness of a Population-based Lifestyle Intervention to Promote Healthy Weight and Physical Activity in Non-attenders of Cardiac Rehabilitation. Clinician-Facilitated Physical Activity Intervention Versus Pulmonary Rehabilitation for Improving Physical Activity in COPD: A Feasibility Study Physical activity combined with resistance training reduces symptoms of frailty in older adults: A randomized controlled trial.
OBJECTIVE To assess the efficacy of a strategy , based on telephone support oriented by accelerometer measurements , on the adherence to physical activity ( PA ) recommendations in cardiac patients not achieving PA recommendations . DESIGN Prospect i ve and r and omized study . SETTING A cardiac rehabilitation program ( CRP ) at a clinic . PARTICIPANTS Stable , noncompliant cardiac ( coronary artery disease , heart failure , post-cardiovascular surgery ) patients ( weekly moderate-intensity PA < 150 min ) were r and omly assigned to an intervention group ( n=19 ) or a control group ( n=10 ) . INTERVENTIONS The intervention group wore an accelerometer for 8 weeks . Every 15 days , feedback and support were provided by telephone . The control group wore the accelerometer during the 8th week of the intervention only . MAIN OUTCOME MEASURES Active energy expenditure ( EE ) ( in kilocalories ) and the time spent doing light , moderate , or intense PA ( minutes per week ) . RESULTS In the intervention group , the time spent at moderate-intensity PA increased from 95.6±80.7 to 137.2±87.5 min/wk between the 1st and 8th week ( P=.002 ) , with 36.8 % of the sample achieving the target amount of moderate-intensity PA . During the 8th week , the EE averaged 543.7±144.1 kcal and 266.7±107.4 kcal in the intervention group and control group , respectively ( P=.004 ) . CONCLUSIONS Telephone support based on accelerometer recordings appeared to be an effective strategy to improve adherence to PA in noncompliant patients . This intervention could be implemented after a CRP as an inexpensive , modern , and easy-to-use strategy Background The purpose of this study was to evaluate the effect of a physical activity telemonitoring program on daily physical activity level , oxygen uptake capacity ( VO2peak ) , and cardiovascular risk profile in coronary artery disease ( CAD ) patients who completed phase II cardiac rehabilitation ( CR ) . Methods Eighty CAD patients who completed phase II CR were r and omly assigned to an additional telemonitoring intervention or st and ard CR . The patients in the intervention group ( n = 40 ) wore a motion sensor continuously for 18 weeks . Each week these patients received a step count goal , with the aim to gradually increase the patients ’ physical activity level . In the control group ( n = 40 ) , the patients wore an unreadable motion sensor for seven days for measurement purpose s only ( at start of follow-up , and after six and 18 weeks ) . At start of follow-up and after 18 weeks blood lipid profile , glycemic control , waist circumference and body mass index was assessed . VO2peak was assessed at start of follow-up , and after six and 18 weeks . Re-hospitalisation rate was followed during this timeframe . Results In the intervention group , VO2peak increased significantly during follow-up ( P = 0.001 ) , in the control group it did not ( P = 0.273 ) . A significant correlation was found between daily aerobic step count and improvement in VO2peak ( P = 0.030 , r = 0.47 ) . Kaplan-Meier curve analysis showed a trend towards fewer re-hospitalisations for patients in the telemonitoring group ( P = 0.09 ) . Conclusions The study showed that , to maintain exercise tolerance and lower re-hospitalisation rate after hospital-based CR in CAD patients , a physical activity telemonitoring program might be an effective intervention This study aim ed at investigating whether providing feedback on physical activity ( PA ) levels to patients with chronic obstructive pulmonary disease ( COPD ) is feasible and enhances daily PA during pulmonary rehabilitation ( PR ) . Patients with COPD participated in a 12-week PR program  . Daily PA was measured using activity monitors on weeks 1 , 7 , and 12 , and feedback was given in the following weeks on the number of steps , time spent in sedentary , light , and moderate-to-vigorous intensity activities , and time spent st and ing , sitting , and lying . Compliance with PA monitoring was collected . Two focus groups were conducted to obtain patients ’ perspectives on the use of activity monitors and on the feedback given . Differences in PA data were also assessed . Sixteen patients ( 65.63 ± 10.57 years ; forced expiratory volume in one second ( FEV1 ) 70.31 ± 22.74 % predicted ) completed the study . From those , only eleven participants used the activity monitors during all monitoring days . Participants identified several problems regarding the use of activity monitors and monitoring duration . Daily steps ( p = 0.026 ) and st and ing time ( p = 0.030 ) were improved from week 1 to week 7 ; however , the former declined from week 7 to week 12 . Findings suggest that using feedback to improve PA during PR is feasible and results in improved daily steps and st and ing time on week 7 . The subsequent decline suggests that additional strategies may be needed to stimulate/maintain PA improvements . Further research with more robust design s is needed to investigate the impact of feedback on patients ’ daily PA BACKGROUND St and ard cardiac rehabilitation ( CR ) is insufficient to help patients achieve an active lifestyle . The effects of two advanced and extended behavioral CR interventions on physical activity ( PA ) and sedentary behavior ( SB ) were assessed . METHODS In total , 731 patients with ACS were r and omized to 1 ) 3months of st and ard CR ( CR-only ) ; 2 ) 3months of st and ard CR with three pedometer-based , face-to-face PA group counseling sessions followed by 9months of aftercare with three general lifestyle , face-to-face group counseling sessions ( CR+F ) ;  or 3 )  3months of st and ard CR , followed by 9months of aftercare with five to six general lifestyle , telephonic counseling sessions ( CR+T ) . An accelerometer recorded PA and SB  at r and omization , 3months , 12months , and 18months . RESULTS The CR+F group did not improve their moderate-to-vigorous intensity PA ( MVPA ) or SB time compared to CR-only ( between-group difference=0.24 % MVPA , P=0.349 ; and 0.39 % SB , P=0.529 ) . However , step count ( between-group difference=513 steps/day , P=0.021 ) and time in prolonged MVPA ( OR=2.14 , P=0.054 ) improved at 3months as compared to CR-only . The improvement in prolonged MVPA was maintained at 18months ( OR=1.91 , P=0.033 ) . The CR+T group did not improve PA or SB compared to CR-only . CONCLUSIONS Adding three pedometer-based , face-to-face group PA counseling sessions to st and ard CR increased daily step count and time in prolonged MVPA . The latter persisted at 18months . A telephonic after-care program did not improve PA or SB . Although after-care should be optimized to improve long-term adherence , face-to-face group counseling with objective PA feedback should be added to st and ard CR BACKGROUND Sedentary time ( ST ) is negatively associated with cardiometabolic health and fitness . Traditional cardiac rehabilitation ( CR ) programming may not significantly reduce ST . The objectives of the study were to assess the feasibility and practicality of activPAL devices for measuring ST in CR , and whether prompting cues to interrupt sedentary behaviour can decrease ST and improve clinical outcomes . METHODS An 8-week , two-arm pilot r and omized controlled trial allocated coronary artery disease patients to either a control ( usual care CR ) or intervention ( CR + sedentary prompts from an activPAL3-VT ) group . Primary outcomes included : recruitment ; acceptability ; completion ; and , adherence rates . Secondary outcomes included changes in : ST ; physical activity ( PA ) ; cardiometabolic health ; psychosocial health ; and , fitness . RESULTS Forty participants ( 16 females ; 19 intervention ; 62 ± 10 years ) were r and omized . Outcome data were available for 95 % of participants . All but one participant completed the full intervention . Most ( 73 % ) intervention participants felt the prompts had somewhat changed their sedentary behaviour . At baseline , participants spent 47 % of their day sedentary . No significant group differences in changes for any of the ST , PA or fitness outcomes were observed . The mean group difference for post-intervention ST ( controlling for baseline ) was 30.3 min/day ( 95 % CI : -51.7 , 112.2 ) in favour of the intervention . The intervention group reported significantly better physical health and had a lower ratio of total cholesterol-to-high density lipoprotein when compared to controls . CONCLUSIONS It is feasible to use activPAL devices to measure ST in a CR setting . Further studies are needed to assess the effectiveness of multi-component sedentary behaviour interventions The aim of this study was to investigate the impact of a physical activity (PA)-focused behavioural intervention during and after  pulmonary rehabilitation ( PR ) on PA levels ( primary aim ) , health-related outcomes and self-efficacy ( secondary aims ) of patients with COPD . Thirty-two patients were r and omly assigned to an experimental group ( EG ) or control group ( CG ) . The EG received a PA-focused behavioural intervention during PR ( 3 months ) and follow-up support ( 3 months ) . The CG received PR ( 3 months ) . Daily PA was collected : number of steps ; time spent in moderate-to-vigorous PA ( MVPA ) , total PA and sedentary activities ( SA ) . Secondary outcomes comprised exercise capacity , muscle strength , health-related quality of life ( HRQOL ) and self-efficacy . Measures were collected at baseline , 3 and 6 months . Compared with the CG , the EG improved the number of steps ( p = 0.006 ) and time spent in MVPA ( p = 0.007 ) , total PA ( p = 0.014 ) and SA ( p = 0.018 ) at 3 months . Differences were maintained after follow-up support ( 0.025 ≤ p ≤ 0.040 ) , except for SA ( p = 0.781 ) . Exercise capacity , muscle strength and HRQOL were increased at 3 and 6 months ( p ≤ 0.002 ) with no between-group differences ( 0.148 ≤ p ≤ 0.987 ) . No changes were observed in self-efficacy ( p = 0.899 ) . A PA-focused behavioural intervention during and after PR may improve patients ' PA levels . Further research is warranted to assess the sustainability of the findings PURPOSE To compare the effects of an individualized pedometer-driven physical activity ( PA ) intervention with the usual time-based PA recommendations given to patients entering a maintenance cardiac rehabilitation ( CR ) program . METHODS A total of 18 subjects entering a maintenance CR program were recruited and completed the study . Subjects were r and omized into pedometer feedback [ PF : n=10 ( 2 women ) , 53.3±8.1 yrs ] and usual care [ UC : n=8 ( 2 women ) , 59.4±9.9 yrs ] groups . New Lifestyles NL-1000 pedometers were used to  monitor ambulatory PA . Subjects in both groups participated in the same maintenance CR program for a total of 8 weeks and all were encouraged to obtain a minimum of 30 - 40 min/d of moderate-vigorous-intensity physical activity ( MVPA ) , on days they did not attend CR . Subjects in the PF group were given individualized daily stepcount goals ( increase 10 % of baseline steps/d each week ) for weeks 2 - 8 . Ambulatory PA  was measured with pedometers , recording both total number of steps/d and min/d of MVPA . Measures were obtained during the first week of the maintenance CR program and during the 8th week . Data were also compared between days subjects attended and on days they did not attend . RESULTS By the 8th week of CR , PF subjects increased daily stepcounts by 42 % ( 2,297±1,606 steps/d , P=0.001 ) , with a 36 % increase on CR days ( 2,654±2,089 steps/d , P=0.003 ) and a 45 % increase on days they did not attend CR ( 1,872±2,026 steps/d , P=0.017 ) . There were no changes observed in the UC group . CONCLUSIONS Providing pedometers with individualized stepcount goals to patients entering a CR program was superior to the usual time-based PA recommendations for increasing PA Purpose : The application of active video games ( AVGs ) during cardiac rehabilitation ( CR ) sessions could potentially facilitate patient adherence . The feasibility , safety , and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated . Methods : A pilot , evaluator-blinded , intention-to-treat , r and omized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise . Both groups experienced equal exercise loads for 6 weeks . Patients were assessed at baseline , end of the program , and after an 8-week followup . Adherence and safety-related outcomes were the primary endpoints . Secondary outcomes included change in exercise capacity , daily physical activity ( PA ) , energy expenditure ( EE ) , and psychometric profiling . Results : Patients ( males 81 % ; 60 ± 10 years ) presented with typical cardiovascular risk factors and similar baseline characteristics . Participants did not perceive an increased risk of injury and were more interactive . At the end of the program , there was a lower tendency for dropping out ( 6 % vs 19 % , P > .05 ) , a significant improvement in PA ( 322 vs 247 arbitrary acceleration units/min , P = .047 ) and related EE per body weight ( 13 vs 11 kcal/kg/d , P = .04 ) among AVG participants compared with controls . No significant differences between groups for adverse medical events , exercise capacity , affect toward exercise , anxiety , depression , or quality -of-life changes were reported . Conclusions : The additional use of AVGs during CR sessions is feasible , safe , and significantly improved daily PA and EE . A dropout reduction trend among its users , which needs to be confirmed in a larger trial , raises awareness to AVG supplementation as a promising strategy to increase CR adherence Purpose Pulmonary rehabilitation ( PR ) enhances exercise tolerance in patients with COPD ; however , improvements in physical activity ( PA ) are not guaranteed . This study explored the relationship between baseline exercise tolerance and changes in PA after PR . Material s and methods Patient data from prospect i ve clinical trials in the PR setting s of Athens and Leuven ( 2008–2016 ) were analyzed . Vali date d PA monitors were worn for 1 week before and after a 12-week program . The proportion of patients who improved PA levels ≥1,000 steps/day ( “ PA responders ” ) after PR was compared between those with initial 6-minute walk distance [ 6MWDi ] < 350 m and ≥350 m. Baseline predictors of PA change were evaluated via univariate and multivariate logistic regression analyses . Results Two hundred thirty-six patients with COPD ( median [ IQR ] FEV1 44 [ 33–59 ] % predicted , age 65±8 years , 6MWDi 416 [ 332–486 ] m ) were included .  The proportion of “ PA responders ” after PR was significantly greater in those with higher vs lower 6MWDi ( 37.9 % vs 16.4 % , respectively ; P<0.001 ) . 6MWDi group classification was the strongest baseline independent predictor of PA improvement ( univariate OR 3.10 , 95 % CI 1.51–6.36 ) . Conclusion The likelihood of improving PA after PR is increased with greater 6MWDi . Baseline exercise tolerance appears as an important stratification metric for future research in this field OBJECTIVE To determine the effectiveness of a pedometer-based telephone intervention on the physical activity levels of cardiac patients who did not attend a CRP . METHODS A r and omised controlled trial was conducted with 215 patients referred to a CRP but who could not or chose not to attend . The 6-week intervention included self-monitoring of physical activity using a pedometer and step calendar ; and behavioural counselling and goal setting sessions . Data were collected at baseline , 6 weeks and 6 months . RESULTS Study groups did not differ significantly at baseline . After 6 weeks , improvements in total physical activity time ( p=0.027 ) , total physical activity sessions ( p=0.003 ) , walking time ( p=0.013 ) and walking sessions ( p=0.002 ) in the intervention group were significantly greater than the control group after adjusting for baseline differences , and remained significant at 6 months . CONCLUSION The findings that the pedometer-based telephone intervention was successful in increasing physical activity levels in cardiac patients who did not attend a CRP could result in major health benefits for this group of people . PRACTICAL IMPLICATION S The pedometer-based telephone intervention could be offered as an effective and accessible option for patients not attending a CRP to increase and maintain their physical activity levels after hospitalisation PURPOSE We evaluated the effects of low-intensity and home-based pulmonary rehabilitation ( PR ) on physical activity ( PA ) and the feedback provided by a pedometer in stable elderly patients with chronic obstructive pulmonary disease ( COPD ) . METHODS We assessed PA using a newly developed triaxial accelerometer ( A-MES ™ , Kumamoto , Japan ) , which measures the time spent walking , st and ing , sitting and lying down .  Twenty-seven elderly patients with COPD ( age 74 ± 8 yrs ; % FEV1 56.6 ± 18.7 % ) participated . They were r and omly selected to undergo PR ( pulmonary rehabilitation only ) or PR + P ( PR plus the feedback from using a pedometer ) . Their PA and pulmonary function , exercise capacity ( 6-min walking distance ; 6MWD ) , quadriceps femoris muscle force ( QF ) were evaluated before the PR began ( baseline ) and at 1 year later . We compared the patients ' changes in PA and other factors between the baseline values and those obtained 1 year later and analyzed the relationships between the changes in PA and other factors in the both groups . RESULTS The increase in the time spent walking in the PR + P group ( 51.3 ± 63.7 min/day ) was significantly greater than that of PR group ( 12.3 ± 25.5 min/day ) after the PR . The improvement rate of daily walking time after PR was significantly correlated with that of the 6MWD and QF in all subjects . CONCLUSIONS These data suggest that low-intensity and home-based PR with the feedback from using pedometer was effective in improving PA , and the improvements of physiological factors were correlated with increased walking time in stable elderly patients with COPD PURPOSE In Australia , patient adherence to physical activity after a cardiac rehabilitation program ( CRP ) is poor . This study evaluated the efficacy of a pedometer-based intervention to increase physical activity after CRP . METHODS Patients ( n = 110 ) who had attended a CRP were r and omized into an intervention or a control group . The 6-week intervention included self-monitored physical activity using a pedometer and step calendar and 2 behavioral counseling and goal - setting sessions .  Self-reported physical activity and psychosocial status were collected at baseline , 6 weeks , and 6 months . Participant exercise capacity was measured using a gas exchange analysis system . RESULTS Study groups were not significantly different at baseline , except for occupation . At 6 weeks and 6 months , improvements in total physical activity sessions ( P = .002 and P = .016 , respectively ) , walking minutes ( P = .013 , 6 weeks only ) , and walking sessions ( P < .001 and P = .035 ) in the intervention group were significantly greater than those in the control group after adjusting for baseline differences . At 6 months , total physical activity minutes in the intervention group also increased significantly more than those in the control group ( P = .044 ) . These self-reported behavioral changes were corroborated by improvements in cardiorespiratory fitness at 6 months in the intervention group ( P = .01 ) . There were also significant improvements in psychosocial health at 6 weeks and 6 months in the intervention group . CONCLUSION The pedometer-based intervention was successful in increasing physical activity in cardiac patients after a CRP . This intervention could be given to patients to promote adherence to physical activity guidelines after a CRP , particularly in centers where maintenance programs are not available Background Measuring physical activity ( PA ) and sedentary time ( ST ) by self-report or device as well as assessing related health factors may alter those behaviors . Thus , in intervention trials assessment s may bias intervention effects . The aim of our study was to examine whether leisure-time PA , transport-related PA , and overall ST measured via self-report vary after assessment s and whether a brief tailored letter intervention has an additional effect . Methods Among a sample of subjects with no history of myocardial infa rct ion , stroke , or vascular intervention , a number of 175 individuals participated in a study comprising multiple repeated assessment s. Of those , 153 were analyzed ( mean age 54.5 years , st and ard deviation = 6.2 ; 64 % women ) . At baseline , participants attended a cardiovascular examination ( st and ardized measurement of blood pressure and waist circumference , blood sample taking ) and wore an accelerometer for seven days . At baseline and after 1 , 6 , and 12 months , participants completed the International Physical Activity Question naire . A r and om sub sample received a tailored counseling letter intervention at month 1 , 3 , and 4 . Changes in PA and ST from baseline to 12-month follow-up were analyzed using r and om-effects modelling . Results From baseline to 1-month assessment , leisure-time PA did not change ( Incidence rate ratio = 1.13 , p = .432 ) , transport-related PA increased ( Incidence rate ratio = 1.45 , p = .023 ) , and overall ST tended to decrease ( b = − 1.96 , p = .060 ) . Further , overall ST decreased from month 6 to month 12 ( b = − 0.52 , p = .037 ) . Time trends of the intervention group did not differ significantly from those of the assessment -only group . Conclusions Results suggest an effect of measurements on PA and ST . Data of r and om-effects modelling results revealed an increase of transport-related PA after baseline to 1-month assessment . Decreases in overall ST may result from repeated assessment s. A brief tailored letter intervention seemed to have no additional effect . Thus , measurement effects should be considered when planning intervention studies and interpreting intervention effects . Trial registration Clinical Trials.gov NCT02990039 . Registered 7 December 2016 . Retrospectively registered BACKGROUND Cardiovascular diseases are the leading cause of death globally and sedentary lifestyle is one of the main risk factors . Home-based cardiac rehabilitation ( CR ) programs appear to be effective to improve exercise tolerance . The aim of the study , therefore , was to evaluate the effects of a phase IV ( maintenance ) home-based CR program on cardiorespiratory fitness and daily physical activity of patients recovering from an acute myocardial infa rct ion . METHODS This pilot study , with a sub-group r and omised controlled trial , included 32 individuals recovering from a myocardial infa rct ion , r and omly divided into the experimental group ( EG , n=16 ) and the control group ( CG , n=16 ) . The EG performed an exercise program , three times per week , at home during eight weeks . The two groups received health education sessions . Baseline and final assessment s included cardiorespiratory fitness , resting and peak heart rate , blood pressure and rate pressure , heart rate recovery and daily physical activity . ( Clinical Trials.gov : NCT01887080 ) . RESULTS At baseline no significant differences were observed between groups . After eight weeks of exercise , the EG significantly increased peak oxygen uptake ( p=0.02 ) , test duration ( p=0.019 ) , peak rate pressure ( p=0.003 ) , peak heart rate ( p=0.003 ) and heart rate recovery ( 0.025 ) when compared to the CG . No changes were observed on daily physical activity in both groups . CONCLUSION This specific phase IV home-based exercise program seems to improve cardiorespiratory fitness , haemodynamics at peak exercise and heart rate recovery , an indicator of cardiac autonomic function BACKGROUND To evaluate the long-term cost-effectiveness of two home-based cardiac rehabilitation ( CR ) interventions ( Healthy Weight ( HW ) and Physical Activity ( PA ) ) for patients with cardiovascular disease ( CVD ) , who had been referred to cardiac rehabilitation ( CR ) but had not attended . The interventions consisted of pedometer-based telephone coaching sessions on weight , nutrition and physical activity ( HW group ) or physical activity only ( PA group ) and were compared to a control group who received information brochures about physical activity . METHODS A cost-effectiveness analysis was conducted using data from two r and omised controlled trials . One trial compared HW to PA ( PANACHE study ) , and the second compared PA to usual care . A Markov model was developed which used one risk factor , body mass index ( BMI ) to determine the CVD risk level and mortality . Patient-level data from the trials were used to determine the transitions to CVD states and healthcare related costs . The model was run for separate cohorts of males and females . Univariate and probabilistic sensitivity analysis were conducted to test the robustness of the results . RESULTS Given a willingness-to-pay threshold of $ 50,000/QALY , in the long run , both the HW and PA interventions are cost-effective compared with usual care . While the HW intervention is more effective , it also costs more than both the PA intervention and the control group due to higher intervention costs . However , the HW intervention is still cost-effective relative to the PA intervention for both men and women . Sensitivity analysis suggests that the results are robust . CONCLUSION The results of this paper provide evidence of the long-term cost-effectiveness of home-based CR interventions for patients who are referred to CR but do not attend . Both the HW and PA interventions can be recommended as cost-effective home-based CR programs , especially for people lacking access to hospital services or who are unable to participate in traditional CR programs Abstract Pulmonary rehabilitation ( PR ) may not suit all individuals with chronic obstructive pulmonary disease ( COPD ) and may not result in increased physical activity . Higher levels of physical activity are associated with reduced mortality and morbidity . The aim of this study was to assess the feasibility of conducting a trial to investigate the effectiveness of a clinician-facilitated physical activity intervention ( PAI ) versus PR in improving physical activity in patients with COPD referred to PR . In this r and omised controlled mixed methods feasibility study , all patients referred to PR who were eligible and willing were assessed at baseline and then r and omised to the PAI or to PR . The assessment s were repeated post-intervention and at 3-month follow-up . The main outcome was step count measured by Actigraph . Semi-structured interviews were conducted post-intervention . The N = 50 patients ; mean ( SD ) age , 64.1(8.6 ) years , 24 M were recruited and r and omised ; N = 23 ( PAI ) and n = 26 ( PR ) : one patient was excluded from the analysis as that person did not meet the GOLD diagnostic criteria . Key feasibility criteria were met ; recruitment was 11 % , dropouts in PAI were 26 % ( n = 6 ) and 50 % ( n = 13/26 ) PR . Participants in both groups experienced a range of health benefits from their respective programmes . The PAI appears to be effective in increasing step counts in people with COPD : mean change ( st and ard deviation ) [ confidence interval ] for the PAI group was 972.0(3230.3)[–1080.3 to 3024.4 ] , n = 12 and 4.3(662.7)[-440.9 to 449.5 ] , n = 11 for the PR group . The PAI met all domains of fidelity . This study provides key information to inform a future-r and omised controlled trial in physical activity INTRODUCTION Increased physical activity ( PA ) is a crucial factor in the prevention of physical deterioration , and resistance training ( RT ) is also a common and effective intervention for older adults . However , the effects of PA as an adjunct to RT on frailty status remains unclear ; therefore , we clarified the effect of a PA intervention with feedback , as an adjunct to resistance strength training , on the physical and mental outcomes of frail older adults . MATERIAL S AND METHODS We employed a r and omized controlled trial . Community-dwelling frail older adults in Japan were recruited to participate . Forty-one participants ( mean age 81.5 ) were r and omly assigned to engage in a resistance training with PA ( RPA group ) or RT group for six months . Frailty status and frailty scores , which were measured according to the Cardiovascular Health Study criteria -muscle strength , mobility , instrumental activities of daily living , and health-related quality of life-were assessed . RESULTS Participants in the RPA group exhibited a significant increase in light-intensity PA , the number of steps taken daily ( p < 0.05 ) , and lower-limb muscle strength ( p < 0.05 ) and a significant decrease in frailty scores . However , pre- and postintervention frailty status , instrumental activities of daily living , and health-related quality of life did not differ significantly . CONCLUSIONS Implementation of a PA intervention as an adjunct to RT is feasible , as it reduced frailty scores and increased lower-limb muscle strength and mobility in older adults with frailty symptoms
There was no significant between group difference in six-minute walk test distance .
Conclusions Our meta- analysis showed WPAM with exercise prescription or advice are superior to no device in improving CRF in the maintenance phase of CR and no cardiac adverse events were reported with WPAM use .
Our qualitative analysis showed evidence in favour of WPAM with exercise prescription or advice for both CRF and step count .
WPAM with exercise prescription or advice did not change sedentary time .
Background Physical activity ( PA ) is a component of cardiac rehabilitation ( CR ) .
However , life-long engagement in PA is required to maintain benefits gained .
Wearable PA monitoring devices ( WPAM ) are thought to increase PA .
There appear to be no review s which investigate the effect of WPAM in cardiac population s. We firstly aim ed to systematic ally review r and omised controlled trials within the cardiac population that investigated the effect WPAM had through the maintenance phase of CR .
We specifically examined the effect on cardiorespiratory fitness ( CRF ) , amount and intensity of daily PA , and sedentary time .