2. Characteristics of exercise interventions.
Study ID | Deliverer of intervention | Explanation and materials | Type of exercise | Schedule therapist | Schedule home | Duration of activity | Initial exercise level | Increment steps | Participant self‐monitoring | Criteria for (non)‐increment |
Fulcher 1997 | Exercise physiologist | Verbal explanation of deconditioning and reconditioning | Walking (encouraged to take other modes such as cycling and swimming) | Weekly (1 h), talking only |
5 d/week | 5‐15 min increasing to 30 min/d | 5‐15 min at 40% of peak O2 consumption (target HR of resting + 50% of HRR) |
Duration increased 1‐2 min/week up to 30 min then intensity increased | Ambulatory HR monitors | If increased fatigue, continue at the same level for an extra week |
Jason 2007 | Registered nurses supervised by exercise physiologist | "Behavioral goals explained, energy system education, redefining exercise" | "individualized, constructive and pleasurable activities" | Every 2 weeks (45 min), 13 sessions |
3/week | Tailored | Flexibility tests Strength test (hand grip) |
"Gradually increasing anaerobic activity levels" | Self‐monitoring daily exercise diary | New targets only after habituation, or if goals achieved for 2 weeks |
Moss‐Morris 2005 | Health psychology MSc student, researcher | Focused on the "downward spiral of activity reduction, deconditioning" | Walking (but could also do other preferred exercise, e.g. jogging, swimming) | Weekly for 12 weeks, talking only | 4‐5 d/wk | Set collaboratively approx 5‐15 min | HR at 40% of VO2max | Duration 3‐5 min/week Intensity increased after 6 weeks 5 bpm/week |
Ambulatory HR monitors | If increased fatigue, continue at the same level for an extra week |
Powell 2001 | Senior clinical therapist | Explanations for GET, circadian dysrhythmia, deconditioning, sleep "educational information pack" |
Aerobic exercise; own choice but mostly exercise bike |
9 face‐to‐face (1.5 h each) |
Tailored | Tailored to functional abilities | Tailored to functional abilities: “a level which you are capable of doing on a BAD DAY” | Varying daily increase (e.g. "5 second increase each day for the rest of the second week" to 30 min twice/d |
Duration of exercise | Discouraged, but restart at lower level and rapidly re‐increase |
Wallman 2004 | Single physical therapist | Small laminated Borg Scale and HR monitor | Walking/jogging, swimming or cycling | Phone contact every 2 weeks | Every second day | From 5‐15 min, increasing to 30 min | Initial exercise duration was between 5 and 15 min, and intensity was based on the mean HR value achieved midpoint during submaximal exercise tests | Duration increased by 2‐5 min/2 wk | HR monitoring, Borg Exertion Scale |
Keep Borg within 11‐14. Adjust every 2 weeks. Average peak HR when exercising comfortably at a typical day represents participant’s target HR (± 3 bpm) for future sessions |
Wearden 1998 | Physiotherapist, fitness focus |
Minimal explanation; no written materials | Preferred activity (walking/jogging, some did cycling, swimming) |
At week 0, 1, 2, 4, 8, 12*, 20, 26*, talking only (*evaluation visits) |
3 d/week | 20 min | 75% of VO2max from bike test | Intensity increased | Borg Exertion Scale chart, before and after HR | Increase if: 10 bpm drop post‐exercise and 2‐point drop in Borg Scale score |
Wearden 2010 | Nurses with 16 half‐days of training and supervision | Explanation of physiological symptoms and training in first session | Wide choice: walking, stairs, bicycle, dance, jog | 10 sessions over 18 weeks | Several times/d | First 90 min, then alternating 60 and 30 min | Determined collaboratively with the participant | "Increased very gradually," examples show 50% increase/d | Diary of progress on exercise programme, with note of daily activities | On "bad days" try to do same as day before |
White 2011 | Exercise therapist/physiotherapist (8‐10 d training + ongoing supervision) |
142‐page manual: benefits of exercise and "how to" of GET; some got pedometers |
Wide choice: walking, cycling, swimming, Tai Chi Aim to build into daily activities |
Weekly x 4, then fortnightly; total of 15 sessions |
5‐6 d/week | Negotiated, goal to get to 30 min/session | Test of fitness (step test and 6MWT), perceived physical exertion, actigraph data |
"20% increases" per fortnight; increase duration to 30 min, then increase intensity | Exercise diary + Borg scale + “Use non‐symptoms to monitor” and HR monitor (for intensity increases) |
Do not increase if global increase in symptoms |
bpm: beats per minute; GET: graded exercise therapy; HR: heart rate; HRR: heart rate reserve; VO2: oxygen consumption; 6MWT: six‐minute walking test © 9 March 2012, Paul Glasziou, Bond University, Australia |