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Long-term physical activity on prescription intervention for patients with insufficient physical activity level-a randomized controlled trial.

ABSTRACT: BACKGROUND:Physical activity (PA) can be used to prevent and treat diseases. In Sweden, licensed healthcare professionals use PA on prescription (PAP) to support patients to increase their PA level. The aim of this randomized controlled trial was to evaluate a 2-year intervention of two different strategies of PAP treatment for patients with insufficient PA level, after a previous 6-month period of ordinary PAP treatment in a primary health care setting. METHODS:We included 190 patients, 27-77?years, physically inactive with metabolic risk factors where the patients were not responding to a previous 6-month PAP treatment with increased PA. The patients were randomized to either enhanced support from a physiotherapist (PT group) or continued ordinary PAP treatment at the health care centre (HCC group). The PAP treatment included an individualized dialogue; an individually dosed PA recommendation, including a written prescription; and a structured follow-up. In addition to PAP, the PT group received aerobic fitness tests and more frequent scheduled follow-ups. The patient PA level, metabolic health, and health-related quality of life (HRQOL) were measured at baseline and at 1- and 2-year follow-ups. RESULTS:At the 2-year follow-up, 62.9% of the PT group and 50.8% of the HCC group had increased their PA level and 31.4% vs. 38.5% achieved ??150?min of moderate-intensity PA/week (difference between groups n.s.). Over 2 years, both groups displayed increased high-density lipoproteins (HDL) (p?=?0.004 vs. baseline), increased mental health status (MCS) (p?=?0.036), and reduced body mass index (BMI) (p?=?0.001), with no difference between groups. CONCLUSION:During long-term PAP interventions, the PA level, metabolic health, and HRQOL increased in patients at metabolic risk without significant differences between groups. The results indicate to be independent of any changes in pharmacological treatment. We demonstrated that the PAP treatment was feasible in ordinary primary care. Both the patients and the healthcare system benefitted from the improvement in metabolic risk factors. Future studies should elucidate effective long-term PAP-treatment strategies. TRIAL REGISTRATION:ClinicalTrials.gov NCT03012516 . Registered on 30 December 2016-retrospectively registered.

SUBMITTER: Lundqvist S

PROVIDER: S-EPMC7493144 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Long-term physical activity on prescription intervention for patients with insufficient physical activity level-a randomized controlled trial.

Lundqvist Stefan S Börjesson Mats M Cider Åsa Å Hagberg Lars L Ottehall Camilla Bylin CB Sjöström Johan J Larsson Maria E H MEH

Trials 20200915 1

<h4>Background</h4>Physical activity (PA) can be used to prevent and treat diseases. In Sweden, licensed healthcare professionals use PA on prescription (PAP) to support patients to increase their PA level. The aim of this randomized controlled trial was to evaluate a 2-year intervention of two different strategies of PAP treatment for patients with insufficient PA level, after a previous 6-month period of ordinary PAP treatment in a primary health care setting.<h4>Methods</h4>We included 190 pa ...[more]

PMID: 32933577

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Project description:Interventions: The intervention arm is named HoPS, an acronym of Home-based Physical Activity for Survivors. HoPS intervention programme aims to improve physical activity level among cancer survivors, in particular breast and colorectal cancer by employing Social Cognitive Theory (SCT) in the development of the programme. It combines of psychoeducation and social media approach to behavioural intervention. Participants of the HoPS will be provided with a non-tailored printed material and gradual tapering down of face-to-face group meetings to improve knowledge and skills of physical activity. While WhatsApp is used as a structured direct remote feedback strategy to allow for supervised home-based physical activity. 1. Face-to-face group meetings There will be 2 meet up sessions for all participants in the HoPS group. The sessions provide a standardized lectures deliver by the researcher using power point slides. The first session of lecture (1-hour duration) will cover the areas of a brief introduction of HoPS programme, physical activity knowledge and goal setting. The second session of lecture (15-minutes duration) will cover for barriers to physical activity and following that a sharing session (15-minutes duration) by a role model (a cancer survivor) to share her experience in engaging in physical activity. In each of the sessions, after the lectures, an exercise session will be conducted by a certified exercise instructor with at least 3 years experienced in coaching for exercise. The duration of this exercise session will be 2 hours and the focus is train the participants on how to perform a proper and correct exercise for cancer survivors. This will involved aerobic exercises and resistance exercis Primary outcome(s): Total MET-minutes/week using validated IPAQ [Baseline, at 8-week (immediately after intervention) and at 16-week post intervention] Study Design: Purpose: Educational / counselling / training; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Efficacy

Project description:BackgroundMobile health (mHealth) interventions can increase physical activity (PA); however, their long-term impact is not well understood.ObjectiveThe primary aim of this study is to understand the immediate and long-term effects of mHealth interventions on PA. The secondary aim is to explore potential effect moderators.MethodsWe performed this study according to the Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched PubMed, the Cochrane Library, SCOPUS, and PsycINFO in July 2020. Eligible studies included randomized controlled trials of mHealth interventions targeting PA as a primary outcome in adults. Eligible outcome measures were walking, moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and energy expenditure. Where reported, we extracted data for 3 time points (ie, end of intervention, follow-up ≤6 months, and follow-up >6 months). To explore effect moderators, we performed subgroup analyses by population, intervention design, and control group type. Results were summarized using random effects meta-analysis. Risk of bias was assessed using the Cochrane Collaboration tool.ResultsOf the 2828 identified studies, 117 were included. These studies reported on 21,118 participants with a mean age of 52.03 (SD 14.14) years, of whom 58.99% (n=12,459) were female. mHealth interventions significantly increased PA across all the 4 outcome measures at the end of intervention (walking standardized mean difference [SMD] 0.46, 95% CI 0.36-0.55; P<.001; MVPA SMD 0.28, 95% CI 0.21-0.35; P<.001; TPA SMD 0.34, 95% CI 0.20-0.47; P<.001; energy expenditure SMD 0.44, 95% CI 0.13-0.75; P=.01). Only 33 studies reported short-term follow-up measurements, and 8 studies reported long-term follow-up measurements in addition to end-of-intervention results. In the short term, effects were sustained for walking (SMD 0.26, 95% CI 0.09-0.42; P=.002), MVPA (SMD 0.20, 95% CI 0.05-0.35; P=.008), and TPA (SMD 0.53, 95% CI 0.13-0.93; P=.009). In the long term, effects were also sustained for walking (SMD 0.25, 95% CI 0.10-0.39; P=.001) and MVPA (SMD 0.19, 95% CI 0.11-0.27; P<.001). We found the study population to be an effect moderator, with higher effect scores in sick and at-risk populations. PA was increased both in scalable and nonscalable mHealth intervention designs and regardless of the control group type. The risk of bias was rated high in 80.3% (94/117) of the studies. Heterogeneity was significant, resulting in low to very low quality of evidence.ConclusionsmHealth interventions can foster small to moderate increases in PA. The effects are maintained long term; however, the effect size decreases over time. The results encourage using mHealth interventions in at-risk and sick populations and support the use of scalable mHealth intervention designs to affordably reach large populations. However, given the low evidence quality, further methodologically rigorous studies are warranted to evaluate the long-term effects.

Project description:BackgroundOnline social networks, such as Facebook™, have extensive reach, and they use technology that could enhance social support, an established determinant of physical activity. This combination of reach and functionality makes online social networks a promising intervention platform for increasing physical activity.PurposeTo test the efficacy of a physical activity intervention that combined education, physical activity monitoring, and online social networking to increase social support for physical activity compared to an education-only control.DesignRCT. Students (n=134) were randomized to two groups: education-only controls receiving access to a physical activity-focused website (n=67) and intervention participants receiving access to the same website with physical activity self-monitoring and enrollment in a Facebook group (n=67). Recruitment and data collection occurred in 2010 and 2011; data analyses were performed in 2011.Setting/participantsFemale undergraduate students at a large southeastern public university.InterventionIntervention participants were encouraged through e-mails, website instructions, and moderator communications to solicit and provide social support related to increasing physical activity through a physical activity-themed Facebook group. Participants received access to a dedicated website with educational materials and a physical activity self-monitoring tool.Main outcome measuresThe primary outcome was perceived social support for physical activity; secondary outcomes included self-reported physical activity.ResultsParticipants experienced increases in social support and physical activity over time but there were no differences in perceived social support or physical activity between groups over time. Facebook participants posted 259 times to the group. Two thirds (66%) of intervention participants completing a post-study survey indicated that they would recommend the program to friends.ConclusionsUse of an online social networking group plus self-monitoring did not produce greater perceptions of social support or physical activity as compared to education-only controls. Given their promising features and potential reach, efforts to further understand how online social networks can be used in health promotion should be pursued.Trial registrationThis study is registered at clinicaltrials.govNCT01421758.

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Long-term physical activity on prescription intervention for patients with insufficient physical activity level-a randomized controlled trial.

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Long-term physical activity on prescription intervention for patients with insufficient physical activity level-a randomized controlled trial.

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