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. 2023 Jan 18;9(1):12.
doi: 10.1186/s40814-023-01242-0.

Personalised exercise therapy and self-management support for people with multimorbidity: feasibility of the MOBILIZE intervention

Søren T Skou  1   2 , Rasmus H Brødsgaard  3   4 , Mette Nyberg  4 , Mette Dideriksen  3   4 , Uffe Bodtger  5   6 , Alessio Bricca #  3   4 , Madalina Jäger #  3   4
Affiliations

Personalised exercise therapy and self-management support for people with multimorbidity: feasibility of the MOBILIZE intervention

Søren T Skou et al. Pilot Feasibility Stud. .

Abstract

Background: Exercise therapy is safe and effective in people with single conditions, but the feasibility in people with two or more conditions is unclear. Therefore, the aim was to evaluate the feasibility of exercise therapy and self-management in people with multimorbidity prior to a randomised, controlled trial (RCT).

Methods: This was a mixed-methods feasibility study performed in two general hospitals and one psychiatric hospital. 20 adult patients (8 females; mean age (SD) 67 (6.9)) with at least two long-term conditions and a score of ≥ 3 on Disease Burden Impact Scale for at least one condition (at least moderate limitations of daily activities) and of ≥ 2 for at least one other condition. Patients with unstable health conditions, at risk of serious adverse events (SAE) or with terminal conditions were excluded. Participants received 12 weeks of exercise (18 60-min group-based and 6 home-based sessions) and self-management support (6 90-min group-based sessions) supervised by physiotherapists. Pre-defined progression to RCT criteria were the primary outcomes and included recruitment rate (acceptable 20 participants in 3 months), retention through follow-up (75% retention), compliance (75% complete > 9 of exercise and > 3 self-management sessions), outcome burden (80% do not find outcomes too burdensome), improvement in quality of life (EQ-5D-5L) and function (6-min walk test; ≥ 50% experience clinically relevant improvements) and intervention-related SAEs (No SAEs). Furthermore, a purposeful sample including eleven participants and two facilitators were interviewed about their experiences of participating/facilitating. Qualitative data was analysed using thematic analysis.

Results: Recruitment rate (20 in 49 days), retention (85%), outcome burden (95%), and SAEs (0 related to intervention) were acceptable, while compliance (70%) and improvements (35% in quality of life, 46% in function) were not (amendment needed before proceeding to RCT). The intervention was found acceptable by both participants and physiotherapists with some barriers among participants relating to managing multiple chronic conditions while caring for others or maintaining a job. Physiotherapists expressed a need for additional training.

Conclusions: Exercise therapy and self-management are feasible in people with multimorbidity. The subsequent RCT, amending the intervention according to progression criteria and feedback, will determine whether the intervention is superior to usual care alone.

Trial registration: ClinicalTrials.gov registration: NCT04645732 Open Science Framework https://osf.io/qk6yg/.

Keywords: Exercise; Feasibility; Multimorbidity; Physical Function; Quality of Life; Rehabilitation; Self-management.

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Conflict of interest statement

AB and MJ are postdocs in the MOBILIZE project funded by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 801790). STS is associate editor of the Journal of Orthopaedic & Sports Physical Therapy and has received personal fees from Munksgaard and TrustMe-Ed, all of which are outside the submitted work. He is co-founder of Good Life with Osteoarthritis in Denmark (GLA:D®), a not-for profit initiative hosted at University of Southern Denmark aiming at implementing clinical guidelines for patients with osteoarthritis in clinical practice. There is no other relationships or activities that could appear to have influenced the submitted work. The funders were not involved in any aspect of the study.

Figures

Fig. 1
Fig. 1
Study flow
See this image and copyright information in PMC

References

    1. Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: a systematic review and meta-analysis of observational studies. J Comorb. 2019;9:2235042x19870934. doi: 10.1177/2235042X19870934. - DOI - PMC - PubMed
    1. The Lancet Making more of multimorbidity: an emerging priority. Lancet. 2018;391(10131):1637. doi: 10.1016/S0140-6736(18)30941-3. - DOI - PubMed
    1. Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, Boyd CM, Pati S, Mtenga S, Smith SM. Multimorbidity. Nat Rev Dis Primers. 2022;8(1):48. doi: 10.1038/s41572-022-00376-4. - DOI - PMC - PubMed
    1. Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA. Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. Br J Gen Pract. 2011;61(582):e12–e21. doi: 10.3399/bjgp11X548929. - DOI - PMC - PubMed
    1. Menotti A, Mulder I, Nissinen A, Giampaoli S, Feskens EJ, Kromhout D. Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: the FINE study (Finland, Italy, Netherlands, Elderly) J Clin Epidemiol. 2001;54(7):680–686. doi: 10.1016/S0895-4356(00)00368-1. - DOI - PubMed

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