520
E. L. Voorn et al.
Table I. Respondent profile
Characteristics n (%)
Female sex
Profession 33 (64)
n (%)
a
Setting
Rehabilitation centre 25 (48)
13 (25) Physical therapy practice 25 (48)
At home 23 (44)
Bachelor’s 25 (48) Gym 13 (25)
Master’s 18 (35) University hospital 11 (21)
Physical therapist
Table II. Training setting and aerobic exercise training dose (in terms of
frequency, intensity, time and type (FITT) factors)
Rehabilitation specialist
Highest degree
PhD
Practice setting
Specialized centre
Primary care setting
Years in clinical practice
39 (75)
9 (17)
Individual training 25 (48)
Mix of individual and group training 24 (46)
6–10 years 17 (33)
22 (42)
15 (29)
6–10 years 13 (25)
> 16 years
Practice time in neuromuscular rehabilitation
1 day/week
51–75% 12 (23)
7 (14)
In terms of the FITT factors (Table II), most of the
healthcare professionals prescribed 2 exercise ses-
sions per week (frequency) of more than 20 min over
a period of 9–16 weeks (time), using a wide variety of
exercise modes (type) and methods to target intensity
(intensity). Ratings of perceived exertion were most
often used to target intensity (83%), followed by
standardized walk tests (60%), and a percentage of
the maximal heart rate based on submaximal exercise
tests (46%).
The majority of respondents (81%) agreed with
the statement “AE should be incorporated into tre-
atment programmes of adults with neuromuscular
diseases”. Underuse (i.e. insufficient training dose)
and overuse of AE in adult neuromuscular rehabilita-
5 (10)
2 days/week 36 (69)
3 days/week 11 (21)
Standardized walk tests (e.g. 6-min walk test) 31 (60)
% of predicted maximal heart rate based on submaximal exercise 24 (46)
test
17 (33)
33 (64)
3 (6)
Intensity of exercise (i.e. methods used to determine target intensity) a
43 (83)
Rating of perceived exertion (e.g. Borg scale)
7 (14)
0–50%
76–100%
Group training
Frequency of exercise
5 (10)
< 6 years
11–15 years
7 (14)
12 (23) 8 (15)
> 16 years
Years in neuromuscular rehabilitation
Format a
40 (77) < 6 years
11–15 years
General hospital
% of predicted maximal heart rate based on a formula (e.g. 220
minus age) 14 (27)
Threshold values (e.g. anaerobic threshold) 11 (21)
% of maximal heart rate based on maximal exercise test
Talk test
Time per exercise session
<10 min
8 (15)
7 (14)
3 (6)
11–15 min 5 (10)
16–20 min 10 (19)
21–30 min 25 (48)
> 30 min
Type of exercise a
9 (17)
Ergometer exercise (e.g. cycle ergometer, treadmill, arm
ergometer) 51 (98)
Overground exercise (e.g. cycling, walking/running) 44 (85)
Swimming 26 (50)
Cross trainer 25 (48)
Circuit training 21 (40)
Motion control video games
5 (10)
Duration of the entire exercise programme
4–8 weeks
3 (6)
9–12 weeks 18 (35)
13–16 weeks 17 (33)
> 16 weeks 10 (19)
Varying
4 (8)
a
Multiple response variable.
tion were reported by, respectively, 58% and 17% of
the respondents.
Barriers to application of aerobic exercise
Fig. 1. Application of aerobic exercise in adult neuromuscular
rehabilitation. Light bars indicate the number of respondents reporting
to treat the neuromuscular diseases in clincal practice; dark bars indicate
the number of respondents reporting to prescribe aerobic exercise in
that neuromuscular diseases group. This concerned a multiple response
variable.
www.medicaljournals.se/jrm
All respondents perceived barriers to the application
of AE in their practice in one or more domains (Fig.
2). In specialized centres, the barriers reported most
often were, physical inability to perform at a training
level (73%), poor motivation (55%), comorbidities
(55%), risk of overwork weakness (45%), and fatigue
(45%). Respondents working in primary care, most
often reported general safety (58%), poor motivation
(58%), lack of knowledge about AE prescription in
NMD (42%) and comorbidities (42%) as barriers.