A smartphone-based exercise adherence intervention for people with metabolic syndrome: a feasibility pilot study
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AbstractBackground Despite well-established benefits of exercise in the management of metabolic syndrome, evidence
to support exercise adherence after program completion is lacking. We used a smartphone-based exercise adherence
intervention (Virtual Trainer; Ex-VT) for adults with metabolic syndrome in Hong Kong, China. The objectives were
to measure the feasibility, potential effectiveness, and implementation of Ex-VT in sustaining prescribed exercise
practice for risk reduction in metabolic syndrome.
Methods In this multisite, randomised controlled trial, participants with metabolic syndrome were randomly allocated
to either intervention (Ex-VT) or exercise reference (control) groups using block randomisation with a block size
of ten. Both groups attended four once-weekly group exercise sessions. The Ex-VT group received goal-directed,
person-centered exercise adherence coaching via a smartphone virtual trainer application. Data was collected at
baseline and at 12 weeks. Primary outcome was adherence to exercise prescription, as measured using pedometers
and International Physical Activity Questionnaire. Changes in metabolic syndrome risk indicators (waist
circumference, blood pressure, and blood lipid and glucose concentrations) were also measured after a 12 h fast. Data
analysis was based on intention to treat. The trial is registered with Chinese University of Hong Kong Centre for
Clinical Research and Biostatistics, number CUHK_TMP00056. Ethics approval was obtained from the Joint Chinese
University of Hong Kong–New Territories East Clinical Research Ethics Committee and written consent were
obtained from participants.
Findings Twenty subjects were recruited to the study (recruitment rate: 71·4%), and randomly assigned, 1:1, to Ex-VT
or control groups. They were aged 30–69 (mean 56·85 [SD 7·08]), 65% women, and 55% worked full-time. Two subjects
(one per group) dropped out (retention rate: 90% for both groups). At 12 weeks, participants in the Ex-VT group
demonstrated better adherence with exercise prescription (72%) than those in the control group (48%; p=0·036).
Reductions from baseline in systolic blood pressure (p=0·02), diastolic blood pressure (p=0·045), and waist
circumference (p=0·048) were seen in the Ex-VT group, despite no between-group difference. We found no significant
changes in blood lipid and glucose concentrations. No adverse events were reported.
Interpretation High retention rates suggest that Ex-VT is an acceptable intervention for this population. Preliminary
findings on adherence and metabolic syndrome risk indicators suggest that a large randomised controlled trial
to explore the effects of Ex-VT would be safe, feasible, and warranted.
All Author(s) ListSit JWH, Chair SY, Hui SSC, Choi KC, Chan AWK, Wong EML, Cheng HY
Journal nameLancet
Title of PublicationLANCET
Volume Number388
Issue NumberSupplement 1
PublisherElsevier: Lancet
Pages64 - 64
LanguagesEnglish-United Kingdom
Web of Science Subject CategoriesMedicine, General & Internal;General & Internal Medicine

Last updated on 2020-18-10 at 01:55