Technical issues in exercise video consultations do not negatively impact exercise intensity for participants with complex chronic conditions: a retrospective audit.

Objective: Clinician experiences with technical issues during video consultations can have a negative impact on their willingness to use technology in practice. The objective of this study was to evaluate the presence and impact of technical issues during exercise video consultations on exercise intensity achieved in-session for people with complex chronic conditions. Methods: Twenty-one people (9 men, 12 women, mean age: 50 ± 14 years) with kidney or liver disease and at least one feature of the metabolic syndrome who participated in an exercise video consultation intervention were included. All treatment notes from consultations were audited for exercise intensity, presence and types of technical issue experienced, troubleshooting techniques attempted and resolutions. Between-group comparisons were conducted to examine differences in exercise intensity indicators between sessions with and without technical issues. Results: Out of 270 video consultations, 15% (n = 40) experienced technical issues, primarily related to audio-visual quality. Presence of technical issues did not result in lower exercise intensity based on any measure. Many sessions (46%) did not meet prescribed intensity targets, primarily due to participant fatigue, pain, and session time constraints. Conclusions: Technical issues in this exercise video consultation intervention were not common and did not adversely affect exercise intensity attainment in-session. However, many participants did not achieve target intensities, possibly due to metabolic co-morbidities. These findings support the viability of video consultations for exercise delivery, emphasizing the need for tailored training and support to optimize exercise in complex patient populations. Future research should explore strategies to enhance exercise intensity during virtual consultations for people with metabolic co-morbidities.