The article we comment this month entitled “Online Personal Training in Patients With Marfan Syndrome: A Randomized Controlled Study of Its Impact on Quality of Life and Physical Capacity” by Jouini et al presents a novel study that may be very useful in clinical practice.
In patients with Marfan Syndrome (MFS), there is no established or validated physical exercise program and it is still recommended to minimize physical activity to reduce the risk of aortic dilation, dissection and possible rupture.
Therefore, the aim of this study was to evaluate the effects of a 3-month personalized e-training program on quality of life (QoL) and cardiovascular and muscular capacity in adult patients with MFS. As a resume, it is a randomized study in which patients with MFS were randomized in a 1:1 ratio to either a training group or a control group.
The trial included a 3-month online supervised training program. Seventy patients with MFS were compared with healthy subjects. They were randomized into a training group (MFS-T) and a control group (MFS-C). The training consisted of 2 supervised online sessions weekly for 3months. The primary outcome was QoL, assessed using the Medical Outcomes Study Short-Form 36 questionnaire. Baseline QoL in all dimensions was lower in patients with MFS.
As a result, postintervention, significant improvements were observed in the MFS-T group relative to the MFS-C group: QoL (+20.2±14.3 versus +0.7±0.5), peak oxygen uptake (+34% versus +14%), muscle elasticity index (11.5±8.2 versus +1.2±1.7), reduced blood pressures during isometric squats (systolic −19±30 versus 0±6; diastolic −27±39 versus +2±15), and reduced pulse wave velocity at rest (−1.20±1.89 versus −0.40±1.61) and postexercise (−0.42±0.45 versus +0.08±0.48). The aortic diameter remained stable in both groups (MFS-T−0.19±1.1 versus MFS-C+0.11±0.78). After training, QoL remained lower in MFS-T than in healthy subjects, but peak oxygen uptake, pulse wave velocity at rest, and postexercise were similar to those of healthy subjects
Although the study has some limitations recognized by the authors such as the size of the population, the randomization process and the low risk of the patient , the result is very interesting and should be taken into account.
As authors recommend it should be consider a multicenter approach in order to strengthen the statistical power of the study and reach conclusions with more scientific strength.
This is therefore a novel and highly interesting study that opens avenues for treatment guidance in patients with Marfan syndrome in whom, until now, we have been restrictive from the point of view of physical exercise practice. On the other hand, the initiative is greatly appreciated in groups of patients who are not so common in our daily practice but who undoubtedly require comprehensive management and advice aimed at improving their quality of life in a global way.
Our mission: To reduce the burden of cardiovascular disease.