Exercise and comorbidity: the i3-S strategy for developing comorbidity-related adaptations to exercise therapy

AbstractPurpose: Exercise therapy is effective in a wide range of chronic diseases. Comorbid disease necessitates adaptations to exercise therapy. Guidance on how to develop such adaptations is currently not available. We present an innovative strategy for the development of comorbidity-related adaptations to exercise therapy in an index disease. Method: We previously developed comorbidity-related adaptations to exercise therapy in osteoarthritis. We now broaden this approach into a general strategy for the development of comorbidity-related adaptations to exercise therapy in an index disease. Results: The i3-S strategy consists of four steps. The first three steps involve creating an inventory of comorbid disease, an inventory of contraindications and restrictions on exercise therapy, and an inventory of potential adaptations to exercise therapy. In the fourth step, this information is synthesized into guidance on comorbidity-related adaptations to exercise therapy in the index disease. The adaptations c...