Journal of clinical exercise physiology最新文献

{"title":"MEANINGFUL MULTIDISCIPLINARY REHABILITATION FOR HEART AND LUNG CONDITIONS: A COLLABORATION BETWEEN ORGANISATIONS AND SECTORS TOWARDS SELF-MANAGEMENT","authors":"Mrs Katrina Ghidella","doi":"10.31189/2165-7629-13-s2.502","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.502","url":null,"abstract":"It is well documented that mainstream services are not always well attended by Aboriginal and Torres Strait Islander people due to a range of issues including transport and culturally safe practice. Establishing these services within the community-controlled sector is one way to increase access and culturally responsive care.\u0000 This initiative involved a new model of service delivery, whereby a partnership between Hospital Health Services and community-controlled Aboriginal and Torres Strait Islander primary healthcare organisations enabled the establishment of new Cardiac and Pulmonary Rehabilitation Programs within the Institute for Urban Indigenous Health (IUIH) Network for First Nations people. This Network is comprised of the five Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ATSICCHO’s) who operate as a regional collective with IUIH providing leading strategic direction and coordination.\u0000 Through a multidisciplinary team, specialised cardiac and pulmonary rehabilitation is provided to First Nations people as a culturally capable alternative to hospital cardiac and pulmonary rehabilitation, particularly for those not currently accessing treatment.\u0000 The specialised rehabilitation programs are supported by the IUIH System of Care that supports clients to access a wide array of holistic health services and programs designed to meet community needs and strengthen pathways for clients to self-manage their health needs in a self-led manner.\u0000 The Rehabilitation Programs are a multidisciplinary exercise and education program delivered by a range of health professionals including Accredited Exercise Physiologist’s, Physiotherapists, Nurses and Aboriginal and Torres Strait Islander Allied Health Assistants. Clients also have access to a range of other Allied Health Professionals, including Dieticians Occupational Therapists, Pharmacists, Social Health, Podiatrists, Optometrists, Speech Therapists and Audiologists.\u0000 Referrals are received from ATSICCHOS, Queensland Health and Primary Health General Practitioners and Specialists. The client journeys through a multidisciplinary assessment to then determine their goals and health needs. This presentation will provide insights into the First Nations-led partnership, challenges and solutions to working across the whole health sector and outcomes for clients.","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141046726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INDIVIDUAL STRENGTH CHANGES FOLLOWING A VERY BRIEF INTERVENTION ON NATIONAL STRENGTH TRAINING GUIDELINES IN ADULTS AGED 50 - 75 YEARS","authors":"Dr. Ashley Gluchowski","doi":"10.31189/2165-7629-13-s2.351","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.351","url":null,"abstract":"\u0000 \u0000 There is little evidence that the public or healthcare practitioners are aware of and implementing the strength training component of the United Kingdom’s (UK) Chief Medical Officers’ physical activity guidelines in practice. Our study aimed to objectively measure strength following a very brief intervention with the strength component to determine if this practice could increase muscle strength.\u0000 \u0000 \u0000 \u0000 This was a mixed method, one-arm, pre-post six-month study. Thirty adults aged 50-75 years had hand grip (upper) isometric strength and ankle plantarflexion (lower) isometric strength measured. The average of two trials on the dominant limb were recorded. Participants were provided a physical copy of the guidelines and were asked to follow the strength recommendations. The very brief intervention (five minutes) included information on why and how to follow the strength guidelines, example exercises, along with a proven behaviour change technique (providing a journal to record training sessions). Strength was tested after six-months.\u0000 \u0000 \u0000 \u0000 The group average indicated that there was no change in upper or lower body strength from baseline. However, when data were viewed individually, upper body strength was gained in 21 of 30 participants and lost in 9 (range: -4.5 to +6 kg). 42% of participants gained more than 2 kg in hand strength after six-months. Lower body strength was gained in 15 participants and lost in 15 (range: -12.4 to +8.65 kg). 43% of participants lost more than 2 kg. Qualitatively participants took the opportunity to ‘procure some new weights’ as they found their weights at home ‘too easy.’ Participants had a new-found realisation that ‘strength training is vital to muscle strength.’ Some mentioned that ‘strength training is now part of my life.’ On the other hand, other participants wanted more, noting that ‘there should be more publicity, information about [strength training] to the general public’ and found it unnecessarily ‘hard to find [follow up information] online.’\u0000 \u0000 \u0000 \u0000 In the movement to make ‘every contact count,’ a very brief intervention has been shown to raise awareness and change strength training behaviour. Healthcare practitioners should focus on lower body exercise examples alongside progression techniques to avoid rapid loss in lower body strength. Public health stakeholders need to work together to provide easily accessible strength training resources.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141050826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE SMALLEST WORTHWHILE EFFECT OF EXERCISE THERAPY FOR PEOPLE WITH CHRONIC LOW BACK PAIN: A DISCRETE CHOICE EXPERIMENT STUDY","authors":"Mr Harrison Hansford, Matthew D Jones, Aidan G. Cashin, R. Ostelo, Alessandro Chiarotto, Sam A. Williams, Saurab Sharma, Jack J. Devonshire, Michael C. Ferraro, M. Wewege, James H McAuley, John M Rose","doi":"10.31189/2165-7629-13-s2.378","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.378","url":null,"abstract":"\u0000 \u0000 Understanding the magnitude of treatment effect patients need to see to consider a treatment worthwhile is of clear clinical and research importance. Current measures of clinical importance, such as the minimum clinical important difference, are limited as they are not determined by patients, and do not reflect specific costs, risks or inconveniences of individual treatments, i.e. you could have the same MCID for surgery as for exercise. We aimed to identify the smallest worthwhile effect (SWE), a new measure of clinical importance, of exercise therapy for people with non-specific chronic low back pain (CLBP) using discrete choice experiment.\u0000 \u0000 \u0000 \u0000 The SWE was estimated as the lowest reduction in pain that participants would consider exercising worthwhile, compared to not exercising i.e., effects due to natural history and other components (e.g., regression to the mean). We recruited English-speaking adults in Australia with non-specific CLBP to our online survey via email from a registry of previous participants and advertisements on social media. We used discrete choice experiment to estimate the SWE of exercise compared to no exercise for pain intensity. We analysed the discrete choice experiment using a mixed logit model, and mitigated hypothetical bias through certainty calibration, with sensitivity analyses performed with different certainty calibration thresholds.\u0000 \u0000 \u0000 \u0000 213 participants completed the survey. Mean age (±SD) was 50.7±16.5, median (IQR) pain duration 10 years (5-20), and mean pain intensity (±SD) was 5.8±2.3 on a 0-10 numerical rating scale. For people with CLBP the SWE of exercise was a between-group reduction in pain of 20%, compared to no exercise. This means, for a baseline pain of 5, the SWE would be a 1/10 between-group reduction in pain.\u0000 \u0000 \u0000 \u0000 This patient-informed threshold of clinical importance should guide the interpretation of findings from randomised trials and meta-analyses of exercise therapy compared to no exercise.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXERCISE IN ADULTS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER: A SYSTEMATIC REVIEW","authors":"Christopher Hanbury-Brown, P. Am, Dr Michael Inskip, Dr Michelle Ogrodnik, Dr Jennifer Heisz, Dr Yorgi Mavros","doi":"10.31189/2165-7629-13-s2.387","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.387","url":null,"abstract":"\u0000 \u0000 Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in adults. Stimulant medications are first-line treatments, they have many side effects and do not address common comorbidities such as cardiometabolic disease, depression, and anxiety. Exercise, by contrast, not only improves ADHD symptoms in youth but effectively treats such comorbidities, making it a potentially valuable treatment option. However, exercise efficacy in adults with ADHD has not been systematically reviewed. Therefore, we aimed to summarise the results of acute exercise and training interventions on health-related outcomes for adults with ADHD, including ADHD symptoms, cognitive function, and psychological well-being.\u0000 \u0000 \u0000 \u0000 Using PRISMA guidelines, fifteen databases were searched (including grey literature) on 27/08/2020, yielding 22,088 unique publications. Database alerts were created to capture additional studies (n= 2). Screening, data extraction, Risk of Bias and GRADE assessment was conducted by CEHB.\u0000 \u0000 \u0000 \u0000 Seven acute (6 cycling, 1 self-selected, 1 yoga) and 6 training studies (Yoga, Pilates, Kickboxing, Tai Chi, General Coordination, Group Circuit Class, Cycling) were included. Among acute studies, those reporting small-to-moderate improvements in cognitive function were characterised by longer duration exercise (>30 minutes), withholding ADHD medication before exercise, and using cohorts with clinician-confirmed ADHD diagnosis. Among the training studies, only one reported an improvement in cognition following Pilates when compared to an inactive control. It was longer (6 months vs. <8 weeks), prescribed progressive intensity and volume, and had high adherence compared to the non-significant trials. The certainty of evidence was low or very low for all outcomes.\u0000 \u0000 \u0000 \u0000 Overall, acute exercise may have a small positive effect on cognition in adults with ADHD; however, certainty of the evidence is low. Further research is needed to investigate the impact of different modalities, durations, and intensities of acute exercise and chronic exercise on adult ADHD.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141041721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE EFFECTS OF ACUTE AND CHRONIC HYPOXIC PLYOMETRIC EXERCISE ON POST ACTIVATION POTENTIATION","authors":"Dr Betul Coskun, Prof Michael J. Hamlin","doi":"10.31189/2165-7629-13-s2.524","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.524","url":null,"abstract":"\u0000 \u0000 In the literature, only acute effects of exercise, mostly combined with plyometrics or blood flow restriction (BFR), have been examined on post-activation-potentiation (PAP). Although systemic and local hypoxia have some similar effects, we found only one study (Ramos-Campo et al., 2020) reporting a PAP effect with systemic hypoxia. There is no study investigating chronic effects, and there is also no study examining acute and chronic effects of exercise together, not only in hypoxia but also in normoxia. The aim of this study is to examine the acute and chronic effects of plyometric exercise in hypoxia on PAP, and to test differences between high and low hypoxia.\u0000 \u0000 \u0000 \u0000 Nineteen team-sports athletes undertook 8-week drop-jump (DJ) training in Low-Hypoxia (LH, n=8), Normoxia (N, n=6), and High-Hypoxia (HH, n=5) using a hypoxicator set using a biofeedback system to sustain a SpO2 of 90%, 97-100%, and 80%, respectively. PAP assessments were applied under both normoxia and hypoxia on different days. Two DJ trials from 40-cm height were obtained as baseline measurements, and then 7.5 min passive rest was given under each group’s hypoxia level. Following 1x5 DJs for pre-test, and 1x8 DJs for post-test as PAP protocol, DJ tests were applied at 2nd and 4th min.\u0000 \u0000 \u0000 \u0000 RM-ANOVA, to assess acute effect, showed a significant conditionxtest interaction (F=3.40, p=0.044), and only under normoxia condition DJ-height was significantly higher at 2nd (31.7cm) and 4th min (31.6cm) than baseline (30.1cm)(p<0.05). For chronic effect, mixed-ANOVA represented a significant groupxtest interaction (F=2.70, p=0.048). Only HH significantly increased DJ-height from baseline (30.0cm) to 2nd (31.9cm) and 4th min (32.9cm) (p<0.05).\u0000 \u0000 \u0000 \u0000 We conclude that while acute hypoxia drop jump exercise may damage net balance between potentiation and fatigue which occurred after conditioning activity, high hypoxia drop jump training may affect this balance in favour of potentiation without any condition difference.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141044379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PHYSICAL ACTIVITY RECOMMENDATIONS FOR PEOPLE WITH CHRONIC KIDNEY DISEASE: ARE RESEARCH PARTICIPANTS REPRESENTATIVE OF REAL-WORLD PATIENTS?","authors":"Mr Thai Binh Tran, Ms Noor Ul Eman Tahir, Mr Alexander Bates, Ms Jennifer Nguyễn, Doctor Hicham Ibrahim Cheikh Hassan, A/Prof Jeanette Thom, Dr Shaundeep Sen, Assoc Prof Kelly Lambert, Ria Arnold","doi":"10.31189/2165-7629-13-s2.424","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.424","url":null,"abstract":"Physical activity is important to maintain good health for people with chronic kidney disease (CKD). However, people with CKD often have a complex health status which necessitates advice tailored to their safety profile. As such, this study aimed to review clinical practice recommendations on physical activity for people with CKD and evaluate how representative research participants are compared to a real-world cohort.\u0000 A systematic search was completed to identify physical activity recommendations for people with CKD Stage 3-5. Primary studies that informed these recommendations were identified and data extracted. Meta-analysis of proportion was undertaken for sex, age, and comorbidities and compared to n=679 people with CKD from the Centre for Health Research Illawarra-Shoalhaven Population database.\u0000 There were 17 physical activity recommendations for people with CKD. Thirteen provided physical activity guidelines for general adult populations. Three provided specific guidance on exercise prescription. Thirty-four primary studies informed these recommendations, including 22 intervention (65%); 6 aetiology (18%); 4 prognosis (12%); and 2 screening studies (6%). Twelve interventional studies were randomised controlled trials (55%). Primary intervention studies comprised 1,792 participants. Compared to the real-world cohort, research participants were significantly younger (mean age 59.7 vs 78.2); had higher proportions of male (60% vs 51%), hypertension (89% vs 80%) and peripheral vascular disease (12% vs 6%); but lower proportions of coronary artery disease (16% vs 20%) and diabetes (35% vs 38%).\u0000 Physical activity recommendations for people with CKD lacked specific, tailored advice to address the complex health status and safety profile of people with CKD. Primary intervention studies that inform these recommendations included participants that were younger and had different comorbid profile when compared to a real-world cohort. Future intervention trials with pragmatic design are needed to improve the evidence base and specificity of recommendations.","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141050266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCOPING THE AVAILABILITY AND APPROPRIATENESS OF EXERCISE SERVICES FOR PEOPLE WITH CANCER IN REGIONAL WESTERN AUSTRALIA","authors":"Mr Christopher Andrew, Dr Annie De Leo, Dr Carolyn McIntyre, Dr Joshua Lewis, Dr Amy Dennett, Dr Yvonne Zissiadis, Dr Mar Kennedy","doi":"10.31189/2165-7629-13-s2.434","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.434","url":null,"abstract":"\u0000 \u0000 National guidance directs oncology healthcare professionals to refer patients to exercise in standard care, yet referrals happen rarely in practice resulting in a critical research-to-practice gap. One major barrier preventing referrals—especially in rural and regional areas—is the lack of appropriate exercise programming available to people with cancer. Therefore, the aims of this study are to 1) determine the availability of exercise oncology programs in a regional area of Western Australia; and 2) explore the appropriateness of these resources to meet the needs of people living with cancer in this region so that a comprehensive referral resource can be created for the region.\u0000 \u0000 \u0000 \u0000 A comprehensive online search identified all exercise services available in the region for people with cancer. Services were categorised using the Cancer Rehabilitation to Recreation (CaReR) framework to describe the level of care each provided. The geographical makeup and demographics of the cancer population in the region were matched to the services to identify service-gaps.\u0000 \u0000 \u0000 \u0000 Approximately 194 000 people live in the Soutwest, with ∼1300 residents diagnosed with cancer each year. Sixty-six exercise oncology services were identified as appropriate for serving this entire population. 62% of all programs were located in the two largest shires across the region. 66% of services were categorised as CaReR Phase 1, providing targeted, supervised care for high-needs patients; 79% as Phase 2, providing targeted, supervised care for medium needs patients; and 28 percent as Phase 3, independent, community-based care for low needs patients.\u0000 \u0000 \u0000 \u0000 The Southwest region is significantly under-resourced to meet the national directive to embed exercise referrals into care for people with cancer. Lack of available exercise services for this population, and few programs catering for a diverse range of patient needs underpin this. Implementation-focused research is required to address this critical research-to-practice gap.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PAINFUL VS NON-PAINFUL EXERCISE ON CREPITUS IN PEOPLE WITH KNEE OSTEOARTHRITIS: A MIXED-METHODS ANALYSIS","authors":"Mr Alexandre Kovats, Mr Adrian Ram, Matthew D Jones, A/Prof John Booth, Dr Mitchell T. Gibbs, A/Prof Jeanette Thom","doi":"10.31189/2165-7629-13-s2.477","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.477","url":null,"abstract":"\u0000 \u0000 Crepitus (or physiological noise) is a key criterion in the diagnosis of knee osteoarthritis (OA). Exercise is foundational to guideline-based care for knee OA, however the effect exercise on knee crepitus is unknown. This study aimed to explore the perceptions of people with knee OA following a 6-week accredited exercise physiologist (AEP) led intervention involving painful vs non-painful exercise, especially in relation to their knee crepitus.\u0000 \u0000 \u0000 \u0000 Participants were randomly assigned to either a painful (higher intensity) or non-painful (lower intensity) exercise program supervised by an AEP twice a week for six weeks with concurrent education. Volunteers partook in a post-intervention semi-structured interview with questions surrounding their experience and perceived outcomes of the program. Thematic qualitative analysis was conducted and compared to the Knee Injury and Osteoarthritis Outcome Score (KOOS) crepitus question (0 - 4 scale).\u0000 \u0000 \u0000 \u0000 Eleven participants volunteered. Qualitatively, approximately half of the participants self-reported a decrease in their knee crepitus following the program “I haven’t had the creaky knees so much”, with the rest stating their crepitus did not change. No participants perceived their crepitus increased (n=9 no change, n=2 decreased) or said that their crepitus was worse, “the noise and grinding doesn’t become evident (now) until the weights become higher”. Quantitatively, KOOS crepitus scores also did not change following the intervention [mean (SD) (2.4(1.0) to 2.1(1.3), p=0.19)]. There were no differences between exercise groups in self-perceived crepitus results, and most said that the exercise program was beneficial “Right after this whole program, I find that I can move much easier.”\u0000 \u0000 \u0000 \u0000 Exercise at higher intensities (into painful range) does not change crepitus or may improve it for some. People with OA perceive that exercise at both higher and lower intensity is beneficial and enjoyable.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FOSTERING RECOVERY: A CASE STUDY ON THE JOURNEY FROM UNCERTAINTY TO DIAGNOSIS IN POST-COVID POTS","authors":"Olivia Powrie","doi":"10.31189/2165-7629-13-s2.375","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.375","url":null,"abstract":"\u0000 \u0000 Imagine, one day you are an active 20-year-old, then after a COVID-19 infection, your life is now limited by debilitating symptoms: fainting, palpitations, and exercise intolerance. Your whole world has changed, and you have no diagnosis and no treatment options. This was reality for a patient referred to cardiac rehabilitation in early 2023 as a unique case, not meeting usual service criteria.\u0000 \u0000 \u0000 \u0000 In the absence of a formal diagnosis, there was no clear pathway for treatment and no rehabilitation guidelines to follow. After a comprehensive assessment, marking the start of the road to recovery, a conservative and gradual approach to re-introducing exercise was developed, whereby progressions were only made when no symptoms were experienced during nor following the sessions. Across the next nine months, further symptoms were identified, prompting further research, which shaped a plausible diagnosis: Postural Orthostatic Tachycardia Syndrome (POTS). Whilst initially dismissed as a possibility by the patient’s cardiologist, after further questioning, gaining objective data and referral to specialist physicians, this plausible diagnosis was confirmed.\u0000 \u0000 \u0000 \u0000 Through months of rehabilitation, lifestyle modifications and commencing medication, this patient has improved symptom control and increased activity tolerance. Importantly, this has allowed return to studying, return to part time work and return to tolerating daily activities.\u0000 \u0000 \u0000 \u0000 As exercise physiologists, we often spend more time with patients than medical practitioners, and resultingly identify characteristics which may otherwise be missed in busy clinics. This case study acts as a reminder of the importance of trusting your instinct and not being afraid to advocate for patients - doing so may just re-direct them down the road to recovery. With the increasing prevalence of dysautonomia, particularly POTS, as consequences of COVID-19 infections, there is an ever-increasing need for awareness, in addition to clinician upskilling to ensure best support and management of these patients.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141050377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CONSUMER EXPERIENCE OF AN AUSTRALIAN MULTIDISCIPLINARY LONG COVID CLINIC THAT INCORPORATES PERSONALISED EXERCISE PRESCRIPTION: A QUALITATIVE ANALYSIS","authors":"Ms Tanya Buettikofer, Ms Allison Maher, Ms Veronica Rainbird, Ms Michelle Bennett, Associate Professor Nicole Freene, Professor Imogen Mitchell, Dr Hsin-Chia Carol Huang, Dr Phil Gaughwin, Mary Johnson, Jenny Paratz, Bernie Bissett","doi":"10.31189/2165-7629-13-s2.501","DOIUrl":"https://doi.org/10.31189/2165-7629-13-s2.501","url":null,"abstract":"\u0000 \u0000 Little is known about the Australian experience of Long COVID recovery, particularly with respect to exercise prescription. The aim of this study was to understand the consumer experience and acceptability of a novel Australian Long COVID Recovery Clinic that incorporates personalised exercise prescription, including respiratory and peripheral strengthening and carefully monitored cardiovascular training.\u0000 \u0000 \u0000 \u0000 Qualitative study; semi-structured interviews with a convenience sample of participants who have completed a multidisciplinary, individually-tailored and supervised programme at our Long COVID Recovery Clinic. Interviews were conducted by a researcher external to the clinic delivery. Major themes were identified by inductive thematic analysis.\u0000 \u0000 \u0000 \u0000 15 participants were interviewed. 14/15 (93%) participants described the clinic model as acceptable or highly acceptable. Five core themes were identified, including (1) encouraging staff and light-filled facilities are key to support recovery; (2) individually tailored, supervised exercise and pacing helped to improve confidence in building exercise capacity; (3) peer support and group therapy augments recovery; (4) recovery from Long COVID is incomplete, and other services augment the Long COVID Recovery Clinic model; and (5) importance of GP involvement in connection with clinic participation. Suggestions for improvement included extending the duration of the clinic programme beyond 2 months, reducing wait times by increasing staffing levels and adjusting the clinic schedule to broaden access options.\u0000 \u0000 \u0000 \u0000 The majority of participants found the Long COVID Recovery Clinic, which incorporates both supervised exercise and pacing, acceptable and would recommend it to others. From the consumer perspective, the Long COVID Recovery Clinic aids recovery alongside GP management through a combination of peer support and an individually tailored program.\u0000","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}