{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:38:09Z","timestamp":1792103889734,"version":"4.4.0"},"reference-count":89,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AOK Baden-Wuerttemberg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Physical exercise has been shown to be effective in the treatment of non-communicable chronic diseases. However, patients with multiple chronic diseases (multimorbidity) have received little attention in health policy. This pilot trial served as a proof of concept of a 6-months person-oriented exercise intervention for people at risk of or with diagnosed cardiovascular diseases, diabetes mellitus type 2, overweight and\/or hip\/knee osteoarthritis, regarding effects on health outcomes as well as adherence and safety. The intervention (\u2018MultiPill-Exercise\u2019) was designed to promote physical exercise participation, considering an individual perspective by addressing personal and environmental factors. Outcomes were assessed at baseline (t0) and after three- (t3) and six-months (t6). The primary outcome was self-reported physical exercise participation in minutes\/week comparing t3 and t6 vs. t0. Secondary outcomes included cardio-respiratory fitness (maximum oxygen uptake VO2peak during incremental cycling ergometry), isometric peak torque of knee extensors and flexors, health-related quality of life (Veterans Rand 12 with its subscales of perceived general health (GH), mental health (MCS), and physical health (PCS)) and blood levels. Adherence to exercise (% of attended sessions during the first 12-weeks of the intervention) and adverse events were monitored as well. Data were analyzed using a non-parametric procedure for longitudinal data, estimating rank means (MRank) and relative treatment effects (RTE) as well as linear-mixed effect models for parametric data. The primary endpoint of physical exercise participation was significantly higher at t3 and t6 compared to baseline (t3 vs. t0: MRank = 77.1, p &lt; 0.001, RTE: 0.66; t6 vs. t0: MRank = 70.6, p &lt; 0.001, RTE = 0.60). Improvements at both follow-up time points compared to t0 were also found for relative VO2peak (t3 vs. t0 = 2.6 mL\/kg\/min, p &lt; 0.001; t6 vs. t0 = 2.0 mL\/kg\/min, p = 0.001), strength of knee extensors (t3 vs. t0 = 11.7 Nm, p = 0.007; t6 vs. t0= 18.1 Nm, p &lt; 0.001) and GH (t3 vs. t0 = 16.2, p = 0.003; t6 vs. t0 = 13.4, p = 0.008). No changes were found for MCS, PCS and for blood levels. Overall exercise adherence was 77%. No serious adverse events were recorded. Results of this pilot trial represent a first proof of concept for the intervention \u2018MultiPill-Exercise\u2019 that will now be implemented and evaluated in a real-world health care setting.<\/jats:p>","DOI":"10.3390\/ijerph19159469","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T21:41:37Z","timestamp":1659476497000},"page":"9469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Proof of Concept of a 6-Month Person-Oriented Exercise Intervention \u2018MultiPill-Exercise\u2019 among Patients at Risk of or with Multiple Chronic Diseases: Results of a One-Group Pilot Trial"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5827-2664","authenticated-orcid":false,"given":"Simone","family":"Schweda","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany"},{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4582-6119","authenticated-orcid":false,"given":"Barbara","family":"Munz","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany"},{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-4202","authenticated-orcid":false,"given":"Christof","family":"Burgstahler","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany"},{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Michael","family":"Niess","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany"},{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4373-5539","authenticated-orcid":false,"given":"Inka","family":"Roesel","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany"},{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"},{"name":"Institute for Clinical Epidemiology and Applied Biostatistics, University of Tuebingen, 72074 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7051-7385","authenticated-orcid":false,"given":"Gorden","family":"Sudeck","sequence":"additional","affiliation":[{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"},{"name":"Institute of Sports Science, Eberhard Karls University, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6818-6276","authenticated-orcid":false,"given":"Inga","family":"Krauss","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany"},{"name":"Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Physical inactivity: The biggest public health problem of the 21st century","volume":"43","author":"Blair","year":"2009","journal-title":"Br. 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