Comparison of effects of telerehabilitation-based individual and group exercise on functional capacity in patients with cystic fibrosis

Aim: The primary aim of the present study was to compare the effects of telerehabilitation-based individual and group exercise, against routine treatment on exercise capacity in people with cystic fibrosis (PwCF). The secondary aim was to compare effects of these programs on lung function, muscle strength, anaerobic power, balance, quality of life, and change in clinical status in PwCF. Methods: Eligible 45 patients aged 8 to 18 years included in the study, and randomly allocated into three groups; a telerehabilitation-based individual or group exercise, and a control arm. Telerehabilitation-based exercise arms underwent supervised exercise programs 3 days/week via an online platform, and the control arm continued their routine care during an 8 week period. Exercise capacity of PwCF was assessed with six-minute walking test and incremental shuttle walking test. Spirometry meauserements were recorded, muscle and handgrip strength were evaluated. Anaerobic power via vertical jump test, balance via Timed Up and Go Test, and quality of life via Pediatric Quality of Life Inventory were assessed as well. Adherence rate to exercise programs was calculated. Change in clinical status for all groups, and motivation and enjoyment in the intervention groups were assessed. Results: Fourty-one patients completed the study. There were statistically significant similar improvements between group and individual exercise arms, and more than control arm in six-minute walking distance, incremental shuttle walking test distance, shoulder flexors, elbow flexors, lower extremity peripheral muscle strength, balance, anaerobic performance, quality of life in the total patient form, physical functionality, emotional functionality, school sub-parameters as well (p<0.05). A significant difference was found between the groups in FEV1, FEV1/FVC, PEF changes (p<0.05). The change in grip strength and quality of life for parents was similar between groups (p>0.05). Participation in the sessions was approximately 90% in both exercise groups (p>0.05). Conclusion: Telerehabilitation-based exercise programs minimize barriers to undertaking exercise in CF. The current research demonstrates similar effects between group and individual telerehabilitation sessions, physiotherapists can integrate group tele-exercises into CF centres. This approach not only save time, but also enhances patients adherence to exercise programs, producing many overall benefits.