Physical Medicine

mHealth-supported exercise reverses frailty after autologous transplant

In multiple myeloma survivors within 180 days post-autologous transplant, a 16-week mHealth-supported program reduced Fried frailty scores more than usual care (P<.001). The intervention used 8 weeks supervised tele-exercise (3×/week, 50 minutes) then 8 weeks home exercise with high adherence (85% supervised, 78% unsupervised). Chair-stand time improved with sustained benefit; other SPPB components and grip strength trended favorably but were not uniformly significant. No serious adverse events were reported, supporting feasibility and safety in this early posttransplant prefrail/frail population. 1

Avatar-guided home exercise feasible in older sepsis survivors

In a pilot RCT of older sepsis survivors (EX n=10, CO n=11), a 12-week avatar-guided home program showed high retention (95%) and moderate adherence (76%). The exercise group trended toward improved lower-extremity strength (30SSTS +1.14 reps, d=0.39) and balance (4SBT +5.07 s, d=1.07) versus controls. Thirty-four adverse events occurred but serious events were judged unrelated to the intervention, supporting short-term safety. Findings are preliminary and require adequately powered trials to confirm clinical efficacy. 2

Home-based exercise improves aerobic capacity in children

Systematic review and meta-analysis of 81 studies (2923 children) found home-based exercise increased aerobic capacity versus controls (SMD 0.53; p<0.0001). No consistent benefits were observed for functional capacity or quality of life compared with controls, and muscle-strength data were insufficient for meta-analysis. Adherence was generally high (>80% in many studies) and adverse events were uncommon, but reporting quality and risk of bias limit certainty. 3