B-FIT training guide

Patients with a neuromuscular disease (NMD, muscular disease or neuromuscular disorder) often have difficulty to stay sufficiently active due to muscle weakness, fatigue and pain. Insufficient physical inactivity causes impaired physical fitness, with limitations in activities of daily living and a further increase in complaints as a result.

There is increasing evidence for the beneficial effects of aerobic exercise in a wide variety of slowly progressive NMD, but the evidence is inconclusive. This hampers the development of clear guidelines, and, consequently, adequate application of aerobic exercise in daily practice. There appears to be a large support need among practitioners, particulary with respect to screening procedures (to assess the need and safety for aerobic exercise) and dosing of exercise programs.

Therefore, we developed a training guide, called B-FIT, to support practitioners to prescribe and evaluate individualized home-based aerobic exercise in slowly progressive neuromuscular diseases. The B-FIT training guide was developed by a working group of experts, including researchers, rehabiltiation physicians, physical therapists and people with NMD.

The training guide consists of a general introduction, a manual for therapists and a patient workbook. The full version of the B-FIT training guide can be downloaded here. The manual for therapists (short version) and the patient workbook can also be downloaded separately.

Manual for therapists

The manual for therapists contains background on training principles for the general population and NMD. It provides practical support to practitioners for making a needs assessment and for prescribing, monitoring and evaluating aerobic exercise for NMD patients. Work protocols have been included for the various steps in the care pathway with corresponding registration forms.

Patient workbook

The patient workbook contains practical instructions for the patient, the exercise program and the log with which the program can be monitored and adjusted if necessary.

The 5 visits with corresponding registration forms have been outlined below.

Visit (purpose) Activities Registration form
1. Medical history Activity list Appendix 1
2. Additional testing Submaximal exercise test Determine anaerobic threshold Prepare training schedule Appendix 2 Appendix 3 Calculation tool
3. Start exercise program Start exercise program
4. Interim evaluation Submaximal exercise test Determine anaerobic threshold Prepare training schedule Appendix 2 Appendix 3 Calculation tool
5. Final evaluation Submaximal exercise test Evaluation form training Overview training results Appendix 2 Appendix 5 Training results


    Instruction video

    The instruction video below explains all the required actions by the physical therapist based on the 5 visits as described in the manual for therapists.