Personalised Exercise-Rehabilitation FOR people with Multiple long-term conditions (PERFORM): protocol for a randomised feasibility trial

Sharon Anne Simpson, Rachael A Evans, Hannah Rosemary Gilbert, Amy Branson, Shaun Barber, Emma McIntosh, Zahira Ahmed, Sarah Gerard Dean, Patrick Joseph Doherty, Nikki Gardiner, Colin Greaves, Paulina Daw, Tracy Ibbotson, Bhautesh Jani, Kate Jolly, Frances Mair, Paula Ormandy, Susan Smith, Sally J Singh, Rod Taylor

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Personalised Exercise-Rehabilitation FOR people with Multiple long-term conditions (PERFORM) is a research programme that seeks to develop and evaluate a comprehensive exercise-based rehabilitation intervention designed for people with multimorbidity, the presence of multiple long-term conditions (MLTCs). This paper describes the protocol for a randomised trial to assess the feasibility and acceptability of the PERFORM intervention, study design and processes.

METHODS AND ANALYSIS: A multicentre, parallel two-group randomised trial with individual 2:1 allocation to the PERFORM exercise-based intervention plus usual care (intervention) or usual care alone (control). The primary outcome of this feasibility trial will be to assess whether prespecified progression criteria (recruitment, retention, intervention adherence) are met to progress to the full randomised trial. The trial will be conducted across three UK sites and 60 people with MLTCs, defined as two or more LTCs, with at least one having evidence of the beneficial effect of exercise. The PERFORM intervention comprises an 8-week (twice a week for 6 weeks and once a week for 2 weeks) supervised rehabilitation programme of personalised exercise training and self-management education delivered by trained healthcare professionals followed by two maintenance sessions. Trial participants will be recruited over a 4.5-month period, and outcomes assessed at baseline (prerandomisation) and 3 months postrandomisation and include health-related quality of life, psychological well-being, symptom burden, frailty, exercise capacity, physical activity, sleep, cognition and serious adverse events. A mixed-methods process evaluation will assess acceptability, feasibility and fidelity of intervention delivery and feasibility of trial processes. An economic evaluation will assess the feasibility of data collection and estimate the costs of the PERFORM intervention.

ETHICS AND DISSEMINATION: The trial has been given favourable opinion by the West Midlands, Edgbaston Research Ethics Service (Ref: 23/WM/0057). Participants will be asked to give full, written consent to take part by trained researchers. Findings will be disseminated via journals, presentations and targeted communications to clinicians, commissioners, service users and patients and the public.


PROTOCOL VERSION: 2.0 (16 May 2023).

Original languageEnglish
Article numbere083255
Number of pages10
JournalBMJ Open
Issue number4
Publication statusPublished - 5 Apr 2024

Bibliographical note

© Author(s) (or their employer(s)) 2024.


  • Humans
  • Quality of Life
  • Feasibility Studies
  • Exercise Therapy
  • Exercise
  • Self-Management
  • Cost-Benefit Analysis
  • Randomized Controlled Trials as Topic
  • Multicenter Studies as Topic

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