Feasibility and effectiveness of telehealth exercise in Systemic Lupus Erythematosus

This study was a single group pilot intervention of exercise. All participants underwent an 8-week, two days per week, 45-minute, one-on-one telehealth-supervised exercise program. Exercise was performed at moderate intensity, with a rating of perceived exertion (RPE) between 3-4 out of 10, in accordance with the American College of Sports Medicine (ACSM) intensity guidelines. All participants were allocated at least 48 h of relative rest (i.e.: no structured exercise) between the two sessions, however, participants were not advised to discontinue their regular exercise during this time. All telehealth exercise sessions were conducted in real-time using Zoom (video conferencing software) by two Accredited Exercise Physiologists AEPs (i.e., a research assistant (SG) delivered one session per week, and the principal investigator of the project (SF) delivered the second session of the week, throughout the duration of the program). All participants received the same exercise program. The 45-minute moderate intensity exercise session comprised of a 10-minute seated mobility flow warm up which included ten chair-based mobility yoga exercises targeting all joints of the body, a 25–30-minute whole-body functional strength circuit, and 5-minutes of static stretches and breathing to cool down. The functional strength circuit was designed in accordance with the ACSM resistance training guidelines for muscular strength, with exercise volume comprising of 2-4 sets and 8-12 repetitions, and rest periods of 15-30 seconds between each exercise, 1 minute rest between each set, and inclusion of 6-8 exercises focusing on major muscle groups. The program was structured as a circuit, with 6-8 exercises comprising 1 set. All exercises were functional movements that are replicable to activity of daily living such as push, pull, squat, lunge, locomotion, and rotation, using either their own body weight, exercise apparatus such as resistance bands or external weights. Given that the exercise sessions were completed in the participants’ home with minimal equipment, a TheraBand and resistance loop band was sent to all participants involved in the study for consistency of equipment available and exercise programming. RPE was used as the primary tool to substantiate an increase in volume or intensity over the 8-week period. For example, the exercises commenced with 2 sets and progressed to 3 sets, and exercise repetitions commenced at 8 reps and progressed to 12 reps. However, to maintain the desired moderate RPE intensity of 3-4/10 for all participants through-out the intervention, the intensity of an exercise slightly varied between participants.