Proof of Concept of a 6-Month Person-Oriented Exercise Intervention ‘MultiPill-Exercise’ among Patients at Risk of or with Multiple Chronic Diseases: Results of a One-Group Pilot Trial

Simone Schweda, Barbara Munz, Christof Burgstahler, Andreas Michael Niess, Inka Roesel, Gorden Sudeck and Inga Krauss
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Simone Schweda: Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany
Barbara Munz: Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany
Christof Burgstahler: Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany
Andreas Michael Niess: Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany
Inka Roesel: Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany
Gorden Sudeck: Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany
Inga Krauss: Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany

IJERPH, 2022, vol. 19, issue 15, 1-24

Abstract: Physical exercise has been shown to be effective in the treatment of non-communicable chronic diseases. However, patients with multiple chronic diseases (multimorbidity) have received little attention in health policy. This pilot trial served as a proof of concept of a 6-months person-oriented exercise intervention for people at risk of or with diagnosed cardiovascular diseases, diabetes mellitus type 2, overweight and/or hip/knee osteoarthritis, regarding effects on health outcomes as well as adherence and safety. The intervention (‘MultiPill-Exercise’) was designed to promote physical exercise participation, considering an individual perspective by addressing personal and environmental factors. Outcomes were assessed at baseline (t0) and after three- (t3) and six-months (t6). The primary outcome was self-reported physical exercise participation in minutes/week comparing t3 and t6 vs. t0. Secondary outcomes included cardio-respiratory fitness (maximum oxygen uptake VO 2 peak during incremental cycling ergometry), isometric peak torque of knee extensors and flexors, health-related quality of life (Veterans Rand 12 with its subscales of perceived general health (GH), mental health (MCS), and physical health (PCS)) and blood levels. Adherence to exercise (% of attended sessions during the first 12-weeks of the intervention) and adverse events were monitored as well. Data were analyzed using a non-parametric procedure for longitudinal data, estimating rank means (M Rank ) and relative treatment effects (RTE) as well as linear-mixed effect models for parametric data. The primary endpoint of physical exercise participation was significantly higher at t3 and t6 compared to baseline (t3 vs. t0: M Rank = 77.1, p < 0.001, RTE: 0.66; t6 vs. t0: M Rank = 70.6, p < 0.001, RTE = 0.60). Improvements at both follow-up time points compared to t0 were also found for relative VO 2 peak (t3 vs. t0 = 2.6 mL/kg/min, p < 0.001; t6 vs. t0 = 2.0 mL/kg/min, p = 0.001), strength of knee extensors (t3 vs. t0 = 11.7 Nm, p = 0.007; t6 vs. t0= 18.1 Nm, p < 0.001) and GH (t3 vs. t0 = 16.2, p = 0.003; t6 vs. t0 = 13.4, p = 0.008). No changes were found for MCS, PCS and for blood levels. Overall exercise adherence was 77%. No serious adverse events were recorded. Results of this pilot trial represent a first proof of concept for the intervention ‘MultiPill-Exercise’ that will now be implemented and evaluated in a real-world health care setting.

Keywords: multimorbidity; comorbidity; health behavior change techniques; chronic non-communicable diseases; cardiovascular diseases; diabetes mellitus; osteoarthritis; overweight; physical activity; exercise (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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