Gym vs. home-based exercise for chronic diseases
Physical inactivity causes a significant public health burden, with direct healthcare costs of over $377 million per year. Chronic diseases like heart disease, stroke, depression and diabetes contribute the greatest burden. Fortunately, an individualised, exercise-based rehabilitation program provided by a physiotherapists significantly improves clinical health, exercise tolerance, psychological status and quality of life. Unfortunately, physical activity levels decrease after the supervised exercise program ends.
In a randomised trial involving over 100 people with a range of chronic diseases, a 6-week exercise rehabilitation program was followed by one of 2 year-long approaches to try to maintain exercise adherence: 1) encouragement to complete three 1-hour exercise sessions at a community gym ($5 per visit) that was open in business hours and had an exercise physiologist available to supervise exercise for 2 hours per day; or 2) encouragement to complete 3 1-hour exercise sessions at home, with 5 fortnightly phone calls for guidance and health coaching. Both maintenance exercise regimens included strengthening, aerobic and stretching exercise components.
Adherence to ongoing exercise was similar in both group, at about 35%. The groups had similar results on the study's primary outcome: quality of life. The gym group had slightly fewer symptoms of depression, but all other outcomes were the same in both groups at the end of the 12-month follow-up period. Physiotherapists can assist adults with a chronic disease who have recently completed a supervised exercise program to achieve similar outcomes and maintain similar exercise adherence a year later with either a gym-based maintenance exercise program or a home-based maintenance exercise program with telephone support. This opens avenues to help for people with chronic disease who live remotely.
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> From: Jansons et al., J Physiother 63 (2017) 154-160. All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.