Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
JMIR Mhealth Uhealth. 2020 Feb 4;8(2):e14615. doi: 10.2196/14615.
Adequate levels of physical activity (PA) and good cardiorespiratory fitness (CRF) are associated with profound health benefits for individuals with mobility disability (MD). Despite the vast amount of research published in the field of PA interventions, little attention has been given to individuals with MD.
The aim of this study was to examine the efficacy of an app-based versus a supervised exercise and health coaching program to support adults with MD to increase levels of PA, CRF, and improve body composition.
Participants with self-perceived MD, aged 18 to 45 years, were included in this 12-week parallel-group randomized controlled trial and allocated at random to an app-based intervention, using commercially available apps-the Swedish Military training app (FMTK), the Acupedo walking app, and the LogMyFood food photography app-or a supervised exercise and health coaching intervention, including 1 weekly supervised exercise session and healthy lifestyle coaching. The primary outcome was the level of moderate-to-vigorous PA (MVPA) measured with accelerometers. Secondary outcomes included CRF measured by a submaximal test performed on a stationary bicycle and body composition measured by bioelectrical impedance. All outcomes were measured at baseline, 6 weeks, and 12 weeks. Linear mixed-effect models were used to assess the between-group differences, as well as the within-group changes through time, in each intervention group.
A total of 110 participants with MD were randomized to an app-based intervention (n=55) or a supervised exercise and health intervention (n=55). The mean age of participants was 34.9 years (SD 6.1), and 81.8% (90/110) of the participants were women. CRF showed a moderate increase in both groups after 12 weeks-1.07 (95% CI -0.14 to 2.27) mL/kg/min increase in the app-based group and 1.76 (95% CI 0.70 to 2.83) mLkg/min increase in the supervised exercise group. However, the intention-to-treat analysis showed no significant differences between the groups in MVPA or CRF after 12 weeks. Waist circumference was significantly lower in the app-based intervention group.
Commercially available apps increased levels of CRF and improved body composition over 12 weeks to the same extent as supervised exercise sessions, showing that both are equally effective. However, neither the app-based intervention nor the supervised exercise intervention increased MVPA.
International Standard Randomized Controlled Trial Number (ISRCTN): 22387524; http://isrctn.com/ISRCTN22387524.
足够的身体活动（PA）水平和良好的心肺适能（CRF）与行动障碍（MD）个体的健康益处密切相关。尽管在 PA 干预领域发表了大量研究，但对 MD 个体的关注甚少。
本研究旨在比较基于应用程序的干预与监督下的运动和健康辅导计划对促进 MD 成人增加 PA 水平、CRF 以及改善身体成分的效果。
本 12 周平行组随机对照试验纳入了自我感知 MD 的参与者，年龄在 18 至 45 岁之间，随机分配到基于应用程序的干预组，使用商业可用的应用程序-瑞典军事训练应用程序（FMTK）、Acupedo 步行应用程序和 LogMyFood 食物摄影应用程序-或监督下的运动和健康辅导干预组，包括每周 1 次监督下的运动和健康辅导。主要结局指标是使用加速度计测量的中等到剧烈强度 PA（MVPA）水平。次要结局指标包括在固定自行车上进行的次最大测试测量的 CRF 和生物电阻抗测量的身体成分。所有结局指标均在基线、6 周和 12 周进行测量。线性混合效应模型用于评估每组之间的差异，以及每组在时间内的变化。
共有 110 名 MD 患者被随机分配到基于应用程序的干预组（n=55）或监督下的运动和健康干预组（n=55）。参与者的平均年龄为 34.9 岁（SD 6.1），81.8%（90/110）的参与者为女性。经过 12 周的治疗，两组的 CRF 均有适度增加-基于应用程序组增加 1.07（95%CI-0.14 至 2.27）mL/kg/min，监督运动组增加 1.76（95%CI 0.70 至 2.83）mL/kg/min。然而，意向治疗分析显示，12 周后 MVPA 或 CRF 两组间无显著差异。基于应用程序的干预组腰围明显降低。
商业可用的应用程序在 12 周内增加了 CRF 和改善了身体成分，效果与监督运动课程相同，表明两者同样有效。然而，基于应用程序的干预或监督运动干预均未增加 MVPA。
国际标准随机对照试验编号（ISRCTN）：22387524；http://isrctn.com/ISRCTN22387524。
