Gym-based exercise and home-based exercise with telephone support have similar outcomes when used as maintenance programs in adults with chronic health conditions: a randomised trial

Question: What is the effectiveness of gym-based exercise versus home-based exercise with telephone follow-up amongst adults with chronic conditions who have completed a short-term exercise program supervised by a health professional? Design: A randomised, controlled trial with concealed allocation, intention-to-treat analysis, and blinded outcome assessment at baseline and 3, 6, 9 and 12 months. Participants: The participants were recruited following a 6-week exercise program at a community health service. Intervention: One group of participants received a gym-based exercise program for 12 months (gym group). The other group received a home-based exercise program for 12 months with telephone follow-up for the first 10 weeks (home group). Outcome measures: Outcome measures included European Quality of Life Instrument (EQ-5D), the Friendship Scale, the Hospital and Anxiety and Depression Scale, Phone-FITT, 6-minute walk test, body mass index and 15-second sit-to-stand test. Results: There was no significant difference between study groups in the primary outcome (EQ-5D visual analogue scale, 0 to 100) across the 12-month intervention period, with an estimate (adjusted regression coefficient) of the difference in effects of 0 (95% CI - 5 to 4). The gym group demonstrated slightly fewer symptoms of depression over the 12-month period compared to the home group (mean difference 0.8 points on a 21-point scale, 95% CI 0.1 to 1.6). Conclusion: Similar long-term clinical outcomes and long-term exercise adherence are achieved with the two approaches examined in this study. Participation in gym-based group exercise may improve mental health outcomes slightly more, although the mechanisms for this are unclear because there was no change in the selected measure of social isolation or other measures of health and wellbeing. This finding mayalso be a Type 1 error. Further research to reproduce these results and that investigates the economic efficiency of these models of care is indicated. Crown Copyright (C) 2017 Published by Elsevier B.V. on behalf of Australian Physiotherapy Association.