Discussion
stroke, fatigue
STROKE, DISEASE, RECRUITMENT
Our main qualitative and quantitative findings suggest that an individually telehealth-supervised exercise program was suitable to and well-accepted by adults with SLE. However, due to a limited number of participants and the possibility that they were more likely to be motivated to exercise and/or have more stable disease, results could exaggerate the true efficacy of the exercise program itself. Recruiting SLE participants was difficult because COVID-19 was of particular concern in Australia during the time of the study, and people with SLE may have been apprehensive about engaging in an exercise trial during this time. It is unclear why there was a lack of male recruitment; however, this is likely because more women have SLE.To our knowledge, this is the first study to explore telehealth-supervised exercise in SLE using a live video platform. A similar study using a live video to supervise people who have suffered a stroke found high levels of satisfaction with the delivery mode and a high likelihood of participants partaking in supervised telehealth sessions again,An important theme that emerged in our study was the ease and efficiency of exercising at home, with most participants valuing the convenience of not commuting to a centre-based venue. Galloway et al.Limitations of this study include low sample size, limiting the statistical credibility of quantitative and qualitative findings; limited number of validated assessments via telehealth, including the SLE disease activity index (SLEDAI) to measure the change in disease activity; non-randomised methodology; inherent lack of blinding; and short duration of exercise, limiting the potential for physiological adaptions.In this small, exploratory mixed-methods pilot study, we identified that individually supervised telehealth exercise was acceptable, feasible, and satisfying for adults with SLE during a pandemic lockdown. The intervention demonstrated a trend to improvement in perceived QOL, fatigue, and strength outcomes. Although we used data from a previous study to estimate the sample required, our study is underpowered. The effect sizes obtained are modest, and the results, although encouraging, need to be corroborated in a larger, confirmatory investigation, ideally undertaken without the confounding influence of a pandemic and lockdown so that there may be controlled comparison with face-to-face supervised exercise. We recommend that future telehealth-supervised studies include more SLE participants, longer exercise intervention duration, and adopt a randomised and longitudinal study design to measure long-term outcomes.