B-FIT! A guideline to individualized exercise in post-polio syndrome

In individuals with post-polio syndrome (PPS), symptoms of muscle weakness,
fatigue and pain may lead to reduced physical activity and a sedentary
lifestyle. Physical inactivity causes deconditioning (i.e. reduced physical
fitness), which in turn, worsens health and physical functioning and threatens
the independence of this ageing population. Successfully breaking this vicious
circle of inactivity requires personally tailored physical activity programs
including aerobic exercise to improve physical fitness, but clear guidelines
are lacking. Therefore, we recently developed the B-FIT training guidelinethat
gives healthcare professionals and patients support in the prescription and
evaluation of personalized aerobic training in PPS. B-FIT was successfully
applied in a pilot study in rehabilitation centers in the Netherlands,
demonstrating its potential for clinical practice. However, a more
comprehensive study is required to determine the efficacy of the B-FIT training
program to improve physical fitness in PPS and to evaluate the patient and
healthcare professional satisfaction with the use of the B-FIT aerobic training
guideline on a larger international scale.

Primary objective:
(1) To evaluate the efficacy of the B-FIT aerobic training program on physical
fitness of individuals with PPS in the US and the Netherlands.

Secondary objective:
(2) To evaluate the patient and healthcare professional satisfaction with the
use of the B-FIT aerobic training guideline in individuals with PPS in the
US and the Netherlands
(3) To evaluate the efficacy of the B-FIT aerobic training program on daily
activity, quality of life and perceived physical functioning of individuals
with
PPS in the US and the Netherlands.

A multicenter, single group, pre-post intervention study

Participants will receive a 4-month personalized physical training program
according to the B-FIT training guidelines, with two low intensity and one high
intensity trianing session a week.

The intervention consists of a 4-month home-based training program, with 2 low
intensity sessions and 1 high intensity session per week. Study assessments
take place at baseline (T-1, T0), directly after intervention (T1) and 3 months
after intervention (T2). During assessments, participants perform an exercise
tests and fill out questionnaires. The duration of these assessments will be
approximately 1.5 hours. Additionally, patients will be asked to wear a heart
rate- and step count monitor for 7 consecutive days directly after T0, T1 and
T2. To check for contra-indications for exercise, a physician will thoroughly
examine the participants according to the guidelines by the American College of
Sports Medicine (ACSM). The study patients are recruited in PPS centers of
excellence in the Netherlands and the United States. In the Netherlands, all
outcome research and training program- related visits are conducted at the
Amsterdam UMC, location AMC. The AMC is well experienced in providing exercise
therapy in patients with different neuromuscular diseases. Therefore, the
occurrence of medical events is considered minimal. Considering the positive
effects of exercise therapy known from preliminary research it can be concluded
that the benefits outweigh the burden and minimal risk associated with this
study.