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Irvin L, Madden LA, Marshall P, Vince RV. Digital Health Solutions for Weight Loss and Obesity: A Narrative Review. Nutrients 2023; 15:nu15081858. [PMID: 37111077 PMCID: PMC10145832 DOI: 10.3390/nu15081858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Personal exercise programmes have long been used and prescribed for weight loss and the improvement of quality of life in obese patients. While individualised programmes are usually the preferred option, they can be more costly and challenging to deliver in person. A move to digital programmes with a wider reach has commenced, and demand has increased due to the SARS-CoV-2 pandemic. In this review, we evaluate the current status of digital exercise programme delivery and its evolution over the past decade, with a focus on personalisation. We used specific keywords to search for articles that met our predetermined inclusion and exclusion criteria in order to provide valuable evidence and insights for future research. We identified 55 studies in total in four key areas of focus, from the more recent development of apps and personal digital assistants to web-based programmes and text or phone call interventions. In summary, we observed that apps may be useful for a low-intensity approach and can improve adherence to programmes through self-monitoring, but they are not always developed in an evidence-based manner. Engagement and adherence are important determinants of weight loss and subsequent weight maintenance. Generally, professional support is required to achieve weight loss goals.
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Affiliation(s)
- Liam Irvin
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7RX, UK
| | - Leigh A Madden
- Centre for Biomedicine, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Phil Marshall
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7RX, UK
| | - Rebecca V Vince
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7RX, UK
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2
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Keawtep P, Kamnardsiri T, Boripuntakul S, Wichayanrat W, Worakul P, Sungkarat S. Feasibility of Internet-Based Physical-Cognitive Exercise for Health Benefits of Middle-Aged Obese Women. J Prim Care Community Health 2023; 14:21501319231189961. [PMID: 37522590 PMCID: PMC10392207 DOI: 10.1177/21501319231189961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Obesity in middle-aged women markedly increases the risk for non-communicable diseases, neurodegenerative diseases, and physical and cognitive problems. Exercise, particularly combined physical-cognitive exercise, has been demonstrated to have beneficial effects on both physical and cognitive health. However, middle-aged women often face barriers to engaging in exercise, which include time constraints, lack of motivation, and enjoyment. Incorporating an exercise program into a technology-based intervention in the home environment may help overcome these barriers and promote health benefits. Therefore, this study aimed to assess the feasibility of home-based, physical-cognitive internet-based exercise for middle-aged obese women. METHODS A total of 33 middle-aged obese women were enrolled in the study. Participants performed an intervention for 60 min/day, 3 days/week for 3 months. Feasibility outcomes (adherence, adverse events, physical performances, obesity parameters, and enjoyment of the program) were measured. RESULTS Average exercise adherence was 91.67%, and no adverse events were reported in this feasibility study. At the end of the training period, body weight and BMI were significantly decreased compared to baseline. As for physical performances, both cardiorespiratory fitness and lower limb muscle power were significantly improved at post-training when compared to baseline. Furthermore, the participants experienced a high level of exercise enjoyment, and it was maintained over the 3-month training period. CONCLUSION These findings suggest that home-based, internet-based physical-cognitive exercise was safe and feasible for reducing obesity parameters, improving physical function, maintaining enjoyment over the course of training, and facilitating adherence to exercise in middle-aged obese women.
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3
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Bogaards FA, Gehrmann T, Beekman M, van den Akker EB, van de Rest O, Hangelbroek RWJ, Noordam R, Mooijaart SP, de Groot LCPGM, Reinders MJT, Slagboom PE. PLIS: A metabolomic response monitor to a lifestyle intervention study in older adults. FASEB J 2022; 36:e22578. [PMID: 36183353 DOI: 10.1096/fj.202201037r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/07/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022]
Abstract
The response to lifestyle intervention studies is often heterogeneous, especially in older adults. Subtle responses that may represent a health gain for individuals are not always detected by classical health variables, stressing the need for novel biomarkers that detect intermediate changes in metabolic, inflammatory, and immunity-related health. Here, our aim was to develop and validate a molecular multivariate biomarker maximally sensitive to the individual effect of a lifestyle intervention; the Personalized Lifestyle Intervention Status (PLIS). We used 1 H-NMR fasting blood metabolite measurements from before and after the 13-week combined physical and nutritional Growing Old TOgether (GOTO) lifestyle intervention study in combination with a fivefold cross-validation and a bootstrapping method to train a separate PLIS score for men and women. The PLIS scores consisted of 14 and four metabolites for females and males, respectively. Performance of the PLIS score in tracking health gain was illustrated by association of the sex-specific PLIS scores with several classical metabolic health markers, such as BMI, trunk fat%, fasting HDL cholesterol, and fasting insulin, the primary outcome of the GOTO study. We also showed that the baseline PLIS score indicated which participants respond positively to the intervention. Finally, we explored PLIS in an independent physical activity lifestyle intervention study, showing similar, albeit remarkably weaker, associations of PLIS with classical metabolic health markers. To conclude, we found that the sex-specific PLIS score was able to track the individual short-term metabolic health gain of the GOTO lifestyle intervention study. The methodology used to train the PLIS score potentially provides a useful instrument to track personal responses and predict the participant's health benefit in lifestyle interventions similar to the GOTO study.
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Affiliation(s)
- Fatih A Bogaards
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands.,Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Thies Gehrmann
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands
| | - Marian Beekman
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik Ben van den Akker
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Leiden Computational Biology Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Ondine van de Rest
- Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Roland W J Hangelbroek
- Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Raymond Noordam
- Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Simon P Mooijaart
- Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Marcel J T Reinders
- Leiden Computational Biology Center, Leiden, The Netherlands.,Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - P Eline Slagboom
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Rick P, Sánchez-Martín M, Singh A, Navas-León S, Borda-Mas M, Bianchi-Berthouze N, Tajadura-Jiménez A. Investigating psychological variables for technologies promoting physical activity. Digit Health 2022; 8:20552076221116559. [PMID: 35923757 PMCID: PMC9340353 DOI: 10.1177/20552076221116559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 07/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers' and developers' use of this research to inform new digital applications. Objectives This study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA. Methods We conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2. Results We identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity. Conclusions We identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.
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Affiliation(s)
- Patricia Rick
- Department of Psychology, Universidad Loyola
Andalucía, Spain
| | | | - Aneesha Singh
- UCL Interaction Centre, University College London, UK
| | | | - Mercedes Borda-Mas
- Department of Personality, Assessment, and Psychological Treatment, Universidad de Sevilla, Spain
| | | | - Ana Tajadura-Jiménez
- UCL Interaction Centre, University College London, UK,DEI Interactive Systems group, Department of Computer Science and
Engineering, Universidad Carlos III de
Madrid, Spain,Ana Tajadura-Jiménez, Universidad Carlos
III de Madrid, Av. de la Universidad, 30, 28911 Leganés, Madrid, Spain.
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Rapidly adapting an effective health promoting intervention for older adults-choose to move-for virtual delivery during the COVID-19 pandemic. BMC Public Health 2022; 22:1172. [PMID: 35690744 PMCID: PMC9188419 DOI: 10.1186/s12889-022-13547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 (COVID) pandemic shifted way of life for all Canadians. ‘Stay-at-home’ public health directives counter transmission of COVID but may cause, or exacerbate, older adults’ physical and social health challenges. To counter unintentional consequences of these directives, we rapidly adapted an effective health promoting intervention for older adults—Choose to Move (CTM)—to be delivered virtually throughout British Columbia (BC). Our specific objectives were to 1. describe factors that influence whether implementation of CTM virtually was acceptable, and feasible to deliver, and 2. assess whether virtual delivery retained fidelity to CTM’s core components. Methods We conducted a 3-month rapid adaptation feasibility study to evaluate the implementation of CTM, virtually. Our evaluation targeted two levels of implementation within a larger socioeconomic continuum: 1. the prevention delivery system, and 2. older adult participants. We implemented 33 programs via Zoom during BC’s 1st wave acute and transition stages of COVID (April–October 2020). We conducted semi-structured 30-45 min telephone focus groups with 9 activity coaches (who delivered CTM), and semi-structured 30-45 min telephone interviews with 30 older adult participants, at 0- and 3-months. We used deductive framework analysis for all qualitative data to identify themes. Results Activity coaches and older adults identified three key factors that influenced acceptability (a safe and supportive space to socially connect, the technological gateway, and the role of the central support unit) and two key factors that influenced feasibility (a virtual challenge worth taking on and CTM flexibility) of delivering CTM virtually. Activity coaches also reported adapting CTM during implementation; adaptations comprised two broad categories (time allocation and physical activity levels). Conclusion It was feasible and acceptable to deliver CTM virtually. Programs such as CTM have potential to mitigate the unintended consequences of public health orders during COVID associated with reduced physical activity, social isolation, and loneliness. Adaptation and implementation strategies must be informed by community delivery partners and older adults themselves. Pragmatic, virtual health promoting interventions that can be adapted as contexts rapidly shift may forevermore be an essential part of our changing world.
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Melton PA, Sims OT, Oh H, Truong DN, Atim K, Simon C. African American Ethnicity, Hypertension, Diabetes, and Arthritis Independently Predict Co-occurring Depression and Obesity among Community-dwelling Older Adult Alabamians. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:344-353. [PMID: 33685384 DOI: 10.1080/19371918.2021.1895019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although obesity and depression are quite common among older adults, surprisingly published literature has not examined factors associated with co-occurring depression and obesity among older adults. The knowledge that fills this gap would be advantageous for public health social workers and other health professionals who provide health care and public health services to older adults. The objectives of this study were to access the prevalence of and independent predictors of co-occurring depression and obesity among older adults in the state of Alabama. A retrospective analysis was conducted using a statewide survey of Alabamian community-dwelling older adults (n = 1,166). Binomial logistic regression was used to examine predictors of co-occurring depression and obesity. The prevalence of co-occurring depression and obesity among older adults was 16%. In the multivariate analysis, African American ethnicity (OR = 1.505, CI: 1.019-2.223), hypertension (OR = 1.593, CI: 1.050-2.416), diabetes (OR = 1.768, CI: 1.188-2.632), and arthritis (OR = 1.640, CI: 1.096-2.454) were positively associated with co-occurring depression and obesity). Older age (OR = 0.963, CI: 0.942-0.985) and higher levels of physical activity (OR = 1.640, CI: 1.096-2.454) were negatively associated with co-occurring depression and obesity. There is a need for the development and implementation of suitable interventions to prevent and manage co-occurring depression and obesity among older adults, particularly older adults with arthritis, hypertension, diabetes, or of African American ethnicity.
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Affiliation(s)
- Pamela A Melton
- School of Social Work, Tulane University, New Orleans, Louisiana, USA
| | - Omar T Sims
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Integrative Center for Healthy Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Hyejung Oh
- Department of Social Work, School of Social Sciences & Education, California State University Bakersfield, Bakersfield, California, USA
| | - Duong N Truong
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Collat School of Business, University of Alabama at Birmingham, Alabama, USA
| | - Kasey Atim
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cassandra Simon
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
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Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience 2020; 42:1547-1578. [PMID: 33001410 PMCID: PMC7528158 DOI: 10.1007/s11357-020-00272-3] [Citation(s) in RCA: 175] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
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Affiliation(s)
- Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Deaglan McCullough
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK.
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Claire Stewart
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Buyl R, Beogo I, Fobelets M, Deletroz C, Van Landuyt P, Dequanter S, Gorus E, Bourbonnais A, Giguère A, Lechasseur K, Gagnon MP. e-Health interventions for healthy aging: a systematic review. Syst Rev 2020; 9:128. [PMID: 32493515 PMCID: PMC7271471 DOI: 10.1186/s13643-020-01385-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Healthy aging (HA) is a contemporary challenge for population health worldwide. Electronic health (e-Health) interventions have the potential to support empowerment and education of adults aged 50 and over. OBJECTIVES To summarize evidence on the effectiveness of e-Health interventions on HA and explore how specific e-Health interventions and their characteristics effectively impact HA. METHODS A systematic review was conducted based on the Cochrane Collaboration methods including any experimental study design published in French, Dutch, Spanish, and English from 2000 to 2018. RESULTS Fourteen studies comparing various e-Health interventions to multiple components controls were included. The target population, type of interventions, and outcomes measured were very heterogeneous across studies; thus, a meta-analysis was not possible. However, effect estimates indicate that e-Health interventions could improve physical activity. Positive effects were also found for other healthy behaviors (e.g., healthy eating), psychological outcomes (e.g., memory), and clinical parameters (e.g., blood pressure). Given the low certainty of the evidence related to most outcomes, these results should be interpreted cautiously. CONCLUSIONS This systematic review found limited evidence supporting the effectiveness of e-Health interventions, although the majority of studies show positive effects of these interventions for improving physical activity in older adults. Thus, better quality evidence is needed regarding the effects of e-Health on the physiological, psychological, and social dimensions of HA. SYSTEMATIC REVIEW REGISTRATION The review protocol was registered in PROSPERO (registration number: CRD42016033163).
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Affiliation(s)
- Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Idrissa Beogo
- École des sciences infirmières et des études de la santé/School of Nursing and Health Studies, Université de Saint-Boniface, Winnipeg, Manitoba Canada
| | - Maaike Fobelets
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Carole Deletroz
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, CH-1011 Lausanne, Switzerland
| | - Philip Van Landuyt
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Samantha Dequanter
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ellen Gorus
- Faculty of Medicine and Pharmacy, Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, Quebec Canada
- Research Center of the Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, Quebec Canada
| | - Anik Giguère
- Faculty of Medicine, Université Laval, Quebec, Canada
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
| | - Kathleen Lechasseur
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
| | - Marie-Pierre Gagnon
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
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Ballin M, Hult A, Björk S, Dinsmore J, Nordström P, Nordström A. Digital exercise interventions for improving measures of central obesity: a systematic review. Int J Public Health 2020; 65:593-605. [PMID: 32410008 PMCID: PMC7224590 DOI: 10.1007/s00038-020-01385-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/22/2020] [Accepted: 05/02/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES We aimed to systematically review the potential benefits of digital exercise interventions for improving measures of central obesity including visceral adipose tissue (VAT) and anthropometric surrogates for VAT in overweight or centrally obese adults aged 18 or over. METHODS A systematic literature search was conducted in three databases up until March 2020 (PROSPERO registration nr CRD42019126764). RESULTS N = 5 studies including 438 participants (age 48-80) with body mass index ≥ 25 kg/m2 met the eligibility criteria and were included. The duration of the interventions ranged from 8 to 24 weeks. No study measured the primary outcome VAT, although in N = 4 studies, waist circumference (WC) decreased by between 1.3 and 5.6 cm in the intervention groups. CONCLUSIONS This systematic review shows that there is no evidence for the effects of digital exercise on VAT, although digital exercise may decrease WC. These findings highlight the need for additional randomized controlled trials to confirm the findings with respect to WC, and to further investigate the effects of digital exercise on VAT. Together, this may have important implications for reducing the burden of physical inactivity and obesity.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden.
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden
| | - Sabine Björk
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - John Dinsmore
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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The effect of e-health interventions promoting physical activity in older people: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2020; 17:7. [PMID: 32336996 PMCID: PMC7175509 DOI: 10.1186/s11556-020-00239-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/30/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction The objectives of this review paper were to synthesize the data from randomized controlled trials in the literature to come to a conclusion on the effects of e-health interventions on promoting physical activity in older people. Methods The Medline, CINAHL, Embase, PsycINFO, and SportDiscus databases were searched for articles about studies that 1) recruited subjects with a mean age of > 50 years, 2) tested e-health interventions, 3) employed control groups with no or less advanced e-health strategies, 4) measured physical activity as an outcome, 5) were published between 1st January 2008 and 31st May 2019, and 6) employed randomized controlled trials. The risk of bias in individual studies was assessed using the Physiotherapy Evidence Database scale. To examine the effects of the interventions, variables quantifying the amount of physical activity were extracted. The within-group effects of individual studies were summarized using Hedges g and 95% confidence intervals. Between-group effects were summarized by meta-analyses using RevMan 5.0 with a random effect model. Results Of the 2810 identified studies, 38 were eligible, 25 were included in the meta-analyses. The within-group effect sizes (Hedges g) of physical activity in the intervention group at T1 ranged from small to large: physical activity time (0.12 to 0.84), step counts (− 0.01 to 11.19), energy expenditure (− 0.05 to 0.86), walking time (0.13 to 3.33), and sedentary time (− 0.12 to − 0.28). The delayed effects as observed in T2 and T3 also ranged from small to large: physical activity time (0.24 to 1.24) and energy expenditure (0.15 to 1.32). In the meta-analysis, the between-group effect of the e-health intervention on physical activity time measured by questionnaires, physical activity time measured by objective wearable devices, energy expenditure, and step counts were all significant with minimal heterogeneity. Conclusion E-health interventions are effective at increasing the time spent on physical activity, energy expenditure in physical activity, and the number of walking steps. It is recommended that e-health interventions be included in guidelines to enhance physical activity in older people. Further studies should be conducted to determine the most effective e-health strategies.
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Tropea P, Schlieter H, Sterpi I, Judica E, Gand K, Caprino M, Gabilondo I, Gomez-Esteban JC, Busnatu S, Sinescu C, Kyriazakos S, Anwar S, Corbo M. Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review. J Med Internet Res 2019; 21:e12805. [PMID: 31573902 PMCID: PMC6774233 DOI: 10.2196/12805] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations. OBJECTIVE This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care. METHODS We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes. RESULTS After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain. CONCLUSIONS Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.
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Affiliation(s)
- Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Hannes Schlieter
- Chair of Wirtschaftsinformatik, esp. Systems Development, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Irma Sterpi
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Elda Judica
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Kai Gand
- Chair of Wirtschaftsinformatik, esp. Systems Development, Faculty of Business and Economics, Technische Universität Dresden, Dresden, Germany
| | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Inigo Gabilondo
- Neurology Department, Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
| | - Juan Carlos Gomez-Esteban
- Neurology Department, Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Stefan Busnatu
- Universitatea de Medicina si Farmacie "Carol Davila", Bucuresti, Romania
| | - Crina Sinescu
- Universitatea de Medicina si Farmacie "Carol Davila", Bucuresti, Romania
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Sadia Anwar
- Department of Business Development and Technology, Aarhus University, Aarhus, Denmark
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
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12
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Grace-Farfaglia P. Social Cognitive Theories and Electronic Health Design: Scoping Review. JMIR Hum Factors 2019; 6:e11544. [PMID: 31325290 PMCID: PMC6676794 DOI: 10.2196/11544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/24/2018] [Accepted: 03/31/2019] [Indexed: 12/30/2022] Open
Abstract
Background There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change. Objective This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications. Methods The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed. Results Expressive interaction tools were found in 48.6% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8%). The vast majority of studies (100%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9%). Conclusions This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution.
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13
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Jahangiry L, Farhangi MA, Shab-Bidar S, Rezaei F, Pashaei T. Web-based physical activity interventions: a systematic review and meta-analysis of randomized controlled trials. Public Health 2017; 152:36-46. [PMID: 28734170 DOI: 10.1016/j.puhe.2017.06.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 04/11/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES It was estimated that approximately 60% of the world's population is classified as inactive or insufficiently active. This meta-analysis investigated the effect of web-based interventions on different types of physical activity (PA) measurements in general population and potential moderating variables. STUDY DESIGN PubMed, CINAHL, EBSCOhost, PsycINFO, Scopus, Ovid, and ScienceDirect literature searches were conducted to identify studies investigating the effect of web-based interventions on PA. METHODS Randomized controlled trials on PA changes reported in moderate to vigorous intensity, walking, and step count in the intervention group in comparison with the control group were pooled with a fixed-effects model separately. RESULTS A total of 22 studies comprising 16,476 and 14,475 subjects in intervention and control groups respectively were included. Web-based interventions had positive and significant effect on increasing PA. Of 14 trials reporting moderate to vigorous physical activity (MVPA), five showed a significant increase in the MVPA level after the intervention. There was significant heterogeneity between studies (P < 0.001 and I2 = 67.8%). Of six trials that reported the number of steps by using the pedometer, three showed a significant increase for the step counts in intervention groups (P < 0.001 and I2 = 93.3%), of 14 trials assessed PA level by reporting walking minutes per week, four studies showed a significant increase in walking minutes. There was significant heterogeneity between studies (P < 0.001, I2 = 68.1%). Overall, the effect of web-based interventions seemed to be influenced by the characteristics of mean age of participants, trial duration, and study quality (P < 0.05). CONCLUSION The web-based PA interventions had a positive significant effect on increasing all the three types of PA among the general population. However, the effects appear to depend on the design of the study, age, and duration of studies.
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Affiliation(s)
- Leila Jahangiry
- Health Education and Health Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Azadi Street, Golgasht Street, Tabriz, Iran; Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Rezaei
- Department of Social Medicine, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - T Pashaei
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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14
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van de Rest O, Schutte BAM, Deelen J, Stassen SAM, van den Akker EB, van Heemst D, Dibbets-Schneider P, van Dipten-van der Veen RA, Kelderman M, Hankemeier T, Mooijaart SP, van der Grond J, Houwing-Duistermaat JJ, Beekman M, Feskens EJM, Slagboom PE. Metabolic effects of a 13-weeks lifestyle intervention in older adults: The Growing Old Together Study. Aging (Albany NY) 2016; 8:111-26. [PMID: 26824634 PMCID: PMC4761717 DOI: 10.18632/aging.100877] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
For people in their 40s and 50s, lifestyle programs have been shown to improve metabolic health. For older adults, however, it is not clear whether these programs are equally healthy. In the Growing Old Together study, we applied a 13-weeks lifestyle program, with a target of 12.5% caloric restriction and 12.5% increase in energy expenditure through an increase in physical activity, in 164 older adults (mean age=63.2 years; BMI=23-35 kg/m2). Mean weight loss was 4.2% (SE=2.8%) of baseline weight, which is comparable to a previous study in younger adults. Fasting insulin levels, however, showed a much smaller decrease (0.30 mU/L (SE=3.21)) and a more heterogeneous response (range=2.0-29.6 mU/L). Many other parameters of metabolic health, such as blood pressure, and thyroid, glucose and lipid metabolism improved significantly. Many 1H-NMR metabolites changed in a direction previously associated with a low risk of type 2 diabetes and cardiovascular disease and partially independently of weight loss. In conclusion, 25% reduction in energy balance for 13 weeks induced a metabolic health benefit in older adults, monitored by traditional and novel metabolic markers.
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Affiliation(s)
- Ondine van de Rest
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands
| | - Bianca A M Schutte
- Department of Molecular Epidemiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Joris Deelen
- Department of Molecular Epidemiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Stephanie A M Stassen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Erik B van den Akker
- Department of Molecular Epidemiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.,The Delft Bioinformatics Lab, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Diana van Heemst
- Department of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | | | | | - Milou Kelderman
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Centre for Drug Research, Leiden University, Leiden 2300 RA, The Netherlands
| | - Simon P Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | | | - Marian Beekman
- Department of Molecular Epidemiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands
| | - P Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
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15
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van Hees VT, Thaler-Kall K, Wolf KH, Brønd JC, Bonomi A, Schulze M, Vigl M, Morseth B, Hopstock LA, Gorzelniak L, Schulz H, Brage S, Horsch A. Challenges and Opportunities for Harmonizing Research Methodology: Raw Accelerometry. Methods Inf Med 2016; 55:525-532. [PMID: 27714396 DOI: 10.3414/me15-05-0013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 06/07/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Raw accelerometry is increasingly being used in physical activity research, but diversity in sensor design, attachment and signal processing challenges the comparability of research results. Therefore, efforts are needed to harmonize the methodology. In this article we reflect on how increased methodological harmonization may be achieved. METHODS The authors of this work convened for a two-day workshop (March 2014) themed on methodological harmonization of raw accelerometry. The discussions at the workshop were used as a basis for this review. RESULTS Key stakeholders were identified as manufacturers, method developers, method users (application), publishers, and funders. To facilitate methodological harmonization in raw accelerometry the following action points were proposed: i) Manufacturers are encouraged to provide a detailed specification of their sensors, ii) Each fundamental step of algorithms for processing raw accelerometer data should be documented, and ideally also motivated, to facilitate interpretation and discussion, iii) Algorithm developers and method users should be open about uncertainties in the description of data and the uncertainty of the inference itself, iv) All new algorithms which are pitched as "ready for implementation" should be shared with the community to facilitate replication and ongoing evaluation by independent groups, and v) A dynamic interaction between method stakeholders should be encouraged to facilitate a well-informed harmonization process. CONCLUSIONS The workshop led to the identification of a number of opportunities for harmonizing methodological practice. The discussion as well as the practical checklists proposed in this review should provide guidance for stakeholders on how to contribute to increased harmonization.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Alexander Horsch
- Prof. Dr. Alexander Horsch, Department of Computer Science, UiT - The Arctic University of Norway, Tromsø, Norway, E-mail:
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16
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Perras MGM, Strachan SM, Fortier MS, Dufault B. Impact of a randomized possible selves experiment on new retirees' physical activity and identity. Eur Rev Aging Phys Act 2016; 13:7. [PMID: 27570564 PMCID: PMC5002317 DOI: 10.1186/s11556-016-0167-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 08/09/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Retirement is not always associated with greater engagement in physical activity. Previous interventions informed by possible selves, a type of future-oriented self-representation, proved useful to increase physical activity in young adults. We thus wanted to explore if a similar intervention would yield favorable outcomes in new retirees. We also examined whether possible selves could help increase identity relative to the physical activity context. Identity circumscribes the meanings which help individuals define who they are in a given role (i.e., what it means to be a physically active person). The strength of identification as a physically active person increases when individuals endorse these meanings more strongly. Possible selves may be tied to identity as they allow individuals to imagine themselves as physically active, which has been argued to incite changes to one's sense of self. Hence, the overall aim of this study was to determine whether a possible selves intervention would increase physical activity behaviour and physical activity identity in a group of newly-retired individuals. METHODS A total of 294 participants were randomized into one of three groups: (a) a repeated group with three possible selves image generation exposures, (b) a one-time group with one possible selves image generation exposure, or (c) a control group. Participants completed self-report measures at baseline and follow-up assessments were taken at weeks 4, 8, and 12 of the study. The measures for the outcomes of interest were the Godin Leisure Time Exercise Questionnaire and the modified Exercise Identity Scale. RESULTS Repeated measures mixed-effects models analyses with maximum likelihood estimation revealed no significant differences between groups on physical activity behaviour (p = 0.34) or physical activity identity (p = 0.97) at follow-up time points. However, a time effect was found for physical activity (p <.01) and physical activity identity (p <.01), which increased across time (baseline-to-12-week follow-up) in all three groups. Such a time effect (inconsequential to group assignment) suggests that the observed increases in physical activity and identity cannot be attributed to an exposure to a possible selves intervention. CONCLUSIONS While the intervention failed to significantly increase physical activity identity and physical activity in newly retired individuals, we suggest future research directions for interventions targeting new retired individuals.
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Affiliation(s)
- Mélanie G. M. Perras
- School of Human Kinetics, University of Ottawa, 125 University Private, Ottawa, Ontario K1N 6N5 Canada
| | - Shaelyn M. Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2 Canada
| | - Michelle S. Fortier
- School of Human Kinetics, University of Ottawa, 125 University Private, Ottawa, Ontario K1N 6N5 Canada
| | - Brenden Dufault
- George and Fay Yee Centre for Healthcare Innovation, College of Medicine, University of Manitoba, 735 McDermot Ave, Winnipeg, MB R3E 0T6 Canada
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17
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Abstract
The number of older adults living in the USA, 65 years of age and older, has been steadily increasing. Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2010, indicate that more than one-third of older adults, 65 years of age and older, were obese. With the increased rate of obesity in older adults, the purpose of this paper is to present research on different methods to prevent or manage obesity in older adults, namely dietary interventions, physical activity interventions, and a combination of dietary and physical activity interventions. In addition, research on community assistance programs in the prevention of obesity with aging will be discussed. Finally, data on federal programs for older adults will also be presented.
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Affiliation(s)
- Stella Lucia Volpe
- Department of Nutrition Sciences, Drexel University, Room 381, 3rd Floor, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA.
| | - Deeptha Sukumar
- Department of Nutrition Sciences, Drexel University, Room 381, 3rd Floor, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, Drexel University, Room 381, 3rd Floor, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA
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18
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Broekhuizen K, de Gelder J, Wijsman CA, Wijsman LW, Westendorp RGJ, Verhagen E, Slagboom PE, de Craen AJ, van Mechelen W, van Heemst D, van der Ouderaa F, Mooijaart SP. An Internet-Based Physical Activity Intervention to Improve Quality of Life of Inactive Older Adults: A Randomized Controlled Trial. J Med Internet Res 2016; 18:e74. [PMID: 27122359 PMCID: PMC4917725 DOI: 10.2196/jmir.4335] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 09/29/2015] [Accepted: 01/21/2016] [Indexed: 12/03/2022] Open
Abstract
Background Increasing physical activity is a viable strategy for improving both the health and quality of life of older adults. Objective The aim of this study was to assess if an Internet-based intervention aimed to increase physical activity was effective in improving quality of life of inactive older adults. In addition, we analyzed the effect of the intervention on quality of life among those participants who successfully reached their individually targeted increase in daily physical activity as indicated by the intervention program, as well as the dose-response effect of increasing physical activity on quality of life. Methods The intervention was tested in a randomized controlled trial and was comprised of an Internet program—DirectLife (Philips)—aimed at increasing physical activity using monitoring and feedback by accelerometry and feedback by digital coaching (n=119). The control group received no intervention (n=116). Participants were inactive 60-70-year-olds and were recruited from the general population. Quality of life and physical activity were measured at baseline and after 3 months using the Research ANd Development 36-item health survey (RAND-36) and wrist-worn triaxial accelerometer, respectively. Results After 3 months, a significant improvement in quality of life was seen in the intervention group compared to the control group for RAND-36 subscales on emotional and mental health (2.52 vs -0.72, respectively; P=.03) and health change (8.99 vs 2.03, respectively; P=.01). A total of 50 of the 119 participants (42.0%) in the intervention group successfully reached their physical activity target and showed a significant improvement in quality of life compared to the control group for subscales on emotional and mental health (4.31 vs -0.72, respectively; P=.009) and health change (11.06 vs 2.03, respectively; P=.004). The dose-response analysis showed that there was a significant association between increase in minutes spent in moderate-to-vigorous physical activity (MVPA) and increase in quality of life. Conclusions Our study shows that an Internet-based physical activity program was effective in improving quality of life in 60-70-year-olds after 3 months, particularly in participants that reached their individually targeted increase in daily physical activity. Trial Registration Nederlands Trial Register: NTR 3045; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3045 (Archived by WebCite at http://www.webcitation.org/6fobg2sjJ)
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Affiliation(s)
- Karen Broekhuizen
- Leiden University Medical Center, Department of Gerontology and Geriatrics, Leiden, Netherlands
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