Personalised Exercise-Rehabilitation for People With Multiple Long-Term Conditions (PERFORM): A Randomised Feasibility Study
Bibliographic record
Abstract
Abstract RATIONALE: Exercise-based rehabilitation interventions are beneficial for a variety of long-term conditions (LTC). Currently, services are centred around single conditions (e.g., pulmonary or cardiac) and may not meet the complex needs of those with multiple LTC (MLTC). The aim was to determine the feasibility of a newly developed personalised exercise-rehabilitation programme for people with MLTC (PERFORM). METHODS: A parallel two-group randomised mixed-methods feasibility study was conducted across 3 sites in the UK. Adults with MLTC (2 or more, with at least one from a prespecified list [1]) were randomly assigned in a 2:1 ratio to either the PERFORM intervention plus usual care (intervention) or usual care alone (control). The novel and bespoke PERFORM intervention consisted of an 8-week supervised group-based rehabilitation (aerobic and resistance exercises) and self-care support programme. Primary feasibility outcomes were based on prespecified progression criteria to a randomised controlled trial (RCT) i.e., trial recruitment (percentage recruitment target [60] met within the 4.5-month window), retention (percentage of randomised participants with complete EuroQol 5-Dimensions [EQ-5D] data), and intervention adherence (percentage of participants allocated to PERFORM intervention attending ≥60% sessions). The proposed primary outcome for the future RCT (EQ-5D Utility Index) and other secondary outcomes were assessed at baseline and 3-month follow-up. RESULTS: Recruitment rate reached 100% of target (60/60; 40 in PERFORM, 20 in control) within the 4.5-month recruitment window: 57% female; mean (SD) age, 62 (13) years; BMI, 30.8 (8.0). The median number of conditions, reported by participants, was 4, with the most prevalent being diabetes (41.7%), hypertension (38.3%), asthma (36.7%), and a painful condition (35.0%). Overall, 46/60 participants (76.7%) attended the 3-month follow-up assessment and had complete EQ-5D data. 29/40 (72.5%) participants attended ≥60% sessions (≥9/14 sessions). Patient reported secondary outcomes at 3-month follow up showed a trend toward greater improvement in the PERFORM intervention compared to control group (Table 1). CONCLUSION: Our study shows that the PERFORM intervention was feasible and acceptable, and supports continuance to a fully powered multicentre RCT of the PERFORM intervention compared to usual care to formally assess clinical- and cost-effectiveness. 1. Dibben, G. O., Gardiner, L., Ml, H., Wells, Y. V., Evans, R. A., Ahmed, Z.,.. & Taylor, R. S. (2024). Evidence for Exercise-Based Interventions across 45 Different Long-Term Conditions: An Overview of Systematic Reviews. eClinicalMedicine.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.013 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".