scholarly journals Effects of an mHealth Brisk Walking Intervention on Increasing Physical Activity in Older People With Cognitive Frailty: Pilot Randomized Controlled Trial

10.2196/16596 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16596
Author(s):  
Rick YC Kwan ◽  
Deborah Lee ◽  
Paul H Lee ◽  
Mimi Tse ◽  
Daphne SK Cheung ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Function ◽  
Older People ◽  
Behavior Change ◽  
Intervention Group ◽  
Brisk Walking ◽  
Cognitive Frailty ◽  
Mhealth Intervention ◽  
Conventional Behavior ◽  
Walking Time

Background Cognitive frailty is the coexistence of physical frailty and cognitive impairment and is an at-risk state for many adverse health outcomes. Moderate-to-vigorous physical activity (MVPA) is protective against the progression of cognitive frailty. Physical inactivity is common in older people, and brisk walking is a feasible form of physical activity that can enhance their MVPA. Mobile health (mHealth) employing persuasive technology has been successful in increasing the levels of physical activity in older people. However, its feasibility and effects on older people with cognitive frailty are unclear. Objective We aimed to identify the issues related to the feasibility of an mHealth intervention and the trial (ie, recruitment, retention, participation, and compliance) and to examine the effects of the intervention on cognitive function, physical frailty, walking time, and MVPA. Methods An open-label, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for the participants were age ≥60 years, having cognitive frailty, and having physical inactivity. In the intervention group, participants received both conventional behavior change intervention and mHealth (ie, smartphone-assisted program using Samsung Health and WhatsApp) interventions. In the control group, participants received conventional behavior change intervention only. The outcomes included cognitive function, frailty, walking time, and MVPA. Permuted block randomization in 1:1 ratio was used. The feasibility issue was described in terms of participant recruitment, retention, participation, and compliance. Wilcoxon signed-rank test was used to test the within-group effects in both groups separately. Results We recruited 99 participants; 33 eligible participants were randomized into either the intervention group (n=16) or the control (n=17) group. The median age was 71.0 years (IQR 9.0) and the majority of them were females (28/33, 85%). The recruitment rate was 33% (33/99), the participant retention rate was 91% (30/33), and the attendance rate of all the face-to-face sessions was 100% (33/33). The majority of the smartphone messages were read by the participants within 30 minutes (91/216, 42.1%). ActiGraph (58/66 days, 88%) and smartphone (54/56 days, 97%) wearing compliances were good. After the interventions, cognitive function improvement was significant in both the intervention (P=.003) and the control (P=.009) groups. The increase in frailty reduction (P=.005), walking time (P=.03), step count (P=.02), brisk walking time (P=.009), peak cadence (P=.003), and MVPA time (P=.02) were significant only in the intervention group. Conclusions Our mHealth intervention is feasible for implementation in older people with cognitive impairment and is effective at enhancing compliance with the brisk walking training program delivered by the conventional behavior change interventions. We provide preliminary evidence that this mHealth intervention can increase MVPA time to an extent sufficient to yield clinical benefits (ie, reduction in cognitive frailty). A full-powered and assessor-blinded RCT should be employed in the future to warrant these effects. Trial Registration HKU Clinical Trials Registry HKUCTR-2283; http://www.hkuctr.com/Study/Show/31df4708944944bd99e730d839db4756

scholarly journals Effects of an mHealth Brisk Walking Intervention on Increasing Physical Activity in Older People With Cognitive Frailty: Pilot Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Rick YC Kwan ◽  
Deborah Lee ◽  
Paul H Lee ◽  
Mimi Tse ◽  
Daphne SK Cheung ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Function ◽  
Older People ◽  
Behavior Change ◽  
Intervention Group ◽  
Brisk Walking ◽  
Cognitive Frailty ◽  
Mhealth Intervention ◽  
Conventional Behavior ◽  
Walking Time

BACKGROUND Cognitive frailty is the coexistence of physical frailty and cognitive impairment and is an at-risk state for many adverse health outcomes. Moderate-to-vigorous physical activity (MVPA) is protective against the progression of cognitive frailty. Physical inactivity is common in older people, and brisk walking is a feasible form of physical activity that can enhance their MVPA. Mobile health (mHealth) employing persuasive technology has been successful in increasing the levels of physical activity in older people. However, its feasibility and effects on older people with cognitive frailty are unclear. OBJECTIVE We aimed to identify the issues related to the feasibility of an mHealth intervention and the trial (ie, recruitment, retention, participation, and compliance) and to examine the effects of the intervention on cognitive function, physical frailty, walking time, and MVPA. METHODS An open-label, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for the participants were age ≥60 years, having cognitive frailty, and having physical inactivity. In the intervention group, participants received both conventional behavior change intervention and mHealth (ie, smartphone-assisted program using Samsung Health and WhatsApp) interventions. In the control group, participants received conventional behavior change intervention only. The outcomes included cognitive function, frailty, walking time, and MVPA. Permuted block randomization in 1:1 ratio was used. The feasibility issue was described in terms of participant recruitment, retention, participation, and compliance. Wilcoxon signed-rank test was used to test the within-group effects in both groups separately. RESULTS We recruited 99 participants; 33 eligible participants were randomized into either the intervention group (n=16) or the control (n=17) group. The median age was 71.0 years (IQR 9.0) and the majority of them were females (28/33, 85%). The recruitment rate was 33% (33/99), the participant retention rate was 91% (30/33), and the attendance rate of all the face-to-face sessions was 100% (33/33). The majority of the smartphone messages were read by the participants within 30 minutes (91/216, 42.1%). ActiGraph (58/66 days, 88%) and smartphone (54/56 days, 97%) wearing compliances were good. After the interventions, cognitive function improvement was significant in both the intervention (<i>P</i>=.003) and the control (<i>P</i>=.009) groups. The increase in frailty reduction (<i>P</i>=.005), walking time (<i>P</i>=.03), step count (<i>P</i>=.02), brisk walking time (<i>P</i>=.009), peak cadence (<i>P</i>=.003), and MVPA time (<i>P</i>=.02) were significant only in the intervention group. CONCLUSIONS Our mHealth intervention is feasible for implementation in older people with cognitive impairment and is effective at enhancing compliance with the brisk walking training program delivered by the conventional behavior change interventions. We provide preliminary evidence that this mHealth intervention can increase MVPA time to an extent sufficient to yield clinical benefits (ie, reduction in cognitive frailty). A full-powered and assessor-blinded RCT should be employed in the future to warrant these effects. CLINICALTRIAL HKU Clinical Trials Registry HKUCTR-2283; http://www.hkuctr.com/Study/Show/31df4708944944bd99e730d839db4756

scholarly journals The feasibility and effects of virtual-reality motor-cognitive training in community-dwelling older people with cognitive frailty: A pilot randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Rick Yiu Cho Kwan ◽  
Justina Yat Wa Liu ◽  
Kenneth Nai Kuen Fong ◽  
Harry Qin ◽  
Philip Kwok-Yuen Leung ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Cognitive Training ◽  
Walking Speed ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Physical Frailty ◽  
Cognitive Frailty

BACKGROUND Cognitive frailty refers to the coexistence of physical frailty and cognitive impairment and is associated with many adverse health outcomes. While cognitive frailty is prevalent in older people, motor-cognitive training is effective at enhancing cognitive and physical function We propose a virtual reality (VR) simultaneous motor-cognitive training program, which allows older people to practice performing daily activities in a virtual space mimicking real environments. OBJECTIVE We aimed 1) to explore the feasibility of offering VR simultaneous motor-cognitive training to older people with cognitive frailty and 2) to compare its effects with an existing motor-cognitive training program in the community on the cognitive function and physical function of older people with cognitive frailty. METHODS A two-arm (1:1), assessor-blinded, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for participants were: 1) age≥60 years, 2) community dwelling, and 3) with cognitive frailty. Those in the intervention group received cognitive training (i.e., cognitive games) and motor training (i.e., cycling on an ergometer) simultaneously on a VR platform, mimicking the daily living activities of older people. Those in the control group received cognitive training (i.e., cognitive games) on tablet computers and motor training (i.e., cycling on the ergometer) sequentially on a non-VR platform. Both groups received a 30-minute session twice a week for 8 weeks. Feasibility was measured by adherence, adverse outcomes, and successful learning. The outcomes were cognitive function, physical frailty level, and walking speed. RESULTS Seventeen participants were recruited and randomized into either the control group (n=8) or intervention group (n=9). At baseline, the median age was 74.0 years (IQR=9.5) and the median MoCA score was 20.0 (IQR=4.0). No significant between-group differences were found except in the number of chronic illnesses (P=0.043). At post-intervention, the intervention group (Z=-2.673, P=0.008) showed a significantly larger improvement in cognitive function than the control group (Z=-1.187, P=0.235). The reduction in physical frailty in the intervention group (Z=-1.730, P=0.084) was similar to that in the control group (Z=-1.890, P=0.059). The TUG-measured improvement in walking speed was moderate in the intervention group (Z=-0.159, P=0.110), and greater in the control group (Z=-2.521, P=0.012). The recruitment rate was acceptable (17/33, 51.5%). Both groups had a 100% attendance rate. The intervention group had a higher completion rate than the control group. Training was terminated for one participant (1/9, 11.1%) due to minimal VR sickness (VRSQ=18.3/100). Two participants (2/8, 25%) in the control group withdrew due to moderate leg pain. No injuries were observed in both groups. CONCLUSIONS This study provides preliminary evidence that the VR simultaneous motor-cognitive training group experienced greater improvement in cognitive function than the control group, and reduced frailty and improved walking speed. VR training is feasible and safe for older people with cognitive frailty. CLINICALTRIAL ClinicalTrials.gov NCT0446726

Effects of Physically Active Lessons on Movement Behaviors, Cognitive, and Academic Performance in Elementary Schoolchildren: ERGUER/Aracaju Project

2021 ◽  
pp. 1-10
Author(s):  
Luciana L.S. Barboza ◽  
Heike Schmitz ◽  
Julian Tejada ◽  
Ellen Caroline M. Silva ◽  
Advanusia S.S. Oliveira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Academic Performance ◽  
Generalized Estimating Equations ◽  
Controlled Trial ◽  
Intervention Group ◽  
Physical Activities ◽  
Test Time ◽  
Physically Active ◽  
Second Year ◽  
Walking Time

Background: To evaluate the effects of the introduction of physically active lessons on movement behaviors, cognitive, and academic performance in schoolchildren. Methods: This was a cluster-controlled trial. A total of 61 students from the second year of elementary school in a public school in Brazil made up 2 intervention classes (n = 34) with the introduction of physically active lessons and 2 control classes (n = 27). Sedentary behavior, physical activity, cognitive, and academic performance were evaluated in 3 moments, which were compared using models of generalized estimating equations. Results: The intervention was effective for reducing the standing time between the baseline and 3 months while increasing the walking time between baseline and 3 months and baseline and 9 months. There was a reduction in time in stationary activities and increased time in light physical activities between all moments. The intervention group increased their performance in the go/no go test, showing a smaller number of errors between the baseline and 3 months and baseline and 9 months, and a reduction in the test time between baseline and 3 months. No impact on students’ academic performance was observed. Conclusion: Physically active lessons improve movement behaviors and cognitive functions among elementary schoolchildren.

Effect of an mHealth-Based Intervention on Excessive Gestational Weight Gain Prevention among Overweight and Obese Women: A Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Hung Hui Chen ◽  
Ching-Fang Lee ◽  
Jian-Pei Huang ◽  
Li-Kang Chi ◽  
Yvonne Hsiung
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Obese Women ◽  
Third Trimester ◽  
Overweight Women ◽  
Mhealth Intervention ◽  
Excessive Gestational Weight Gain

BACKGROUND Excessive gestational weight gain (GWG) is a public health concern since it can lead to adverse consequences and health problems for expecting mothers and their unborn infants. There is a need to evaluate the effects of a GWG management intervention to reduce the burden and risk among overweight and obese women during pregnancy. OBJECTIVE To explore the efficacy of a mobile health (mHealth) intervention to prevent excessive GWG, overweight and obese pregnant women were invited to use an app and wearable activity tracker (WAT). METHODS A randomized controlled trial with an experimental study design. Ninety-two pregnant women were recruited, and all overweight and obese participants from the two prenatal outpatient clinics in northern Taiwan had, at less than 17 weeks gestation, a prepregnancy body mass index (BMI) ≥ 25 kg/m2. These participants were randomly assigned (1:1) by a random number table; the experimental group received an mHealth-based program using the MyHealthyWeight (MHW) app and a WAT to wear during pregnancy. The control group received standard antenatal treatments without any mHealth-based elements. Two hospital follow-up visits were scheduled at 24-26 weeks in the second trimester and 34-36 weeks in the third trimester. Sociodemographic characteristics, pregnancy physical activity questionnaire (PPAQ), a self-efficacy questionnaire and body weight were measures of interest. A generalized estimating equation (GEE) was used to examine the trajectories and the intervention effect on GWG. RESULTS No difference in GWG was found between the intervention and control groups at baseline. The weight gain trajectory in the entire cohort of women with obesity exhibited a quadratic pattern; compared with the control group, a slight increase in the intervention group was found in the second trimester. Throughout the whole pregnancy, the mHealth intervention group had a significantly lower proportion of excessive GWG in total and weekly weight gain. In particular, obese women in the intervention group, compared with obese women in the control group, gained less weight (average difference of 8.76 kg) in the third trimester. The GEE model indicated that obese women who were aged 35 years, had prepregnancy exercise habits, had perceived self-efficacy of diet, and had more physical activity had lower GWG (p<.05). CONCLUSIONS The mHealth program has shown positive results in significantly managing GWG among obese and overweight women. Among obese women, the second semester trajectory of weight gain and the lower proportion of excessive GWG were more notable than those of overweight women. Although the intervention seems to be more effective among women with obesity, our results show the potential to prevent excessive GWG during pregnancy in both overweight and obese women. Guidance may be provided to health-care professionals who wish to promote healthy diet and physical activity behaviors. CLINICALTRIAL The protocol of the study was registered in ClinicalTrials. gov (NCT04553731).

scholarly journals Strategies and effects of school-based interventions to promote active school transportation by bicycle among children and adolescents: a systematic review

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Dorothea M. I. Schönbach ◽  
Teatske M. Altenburg ◽  
Adilson Marques ◽  
Mai J. M. Chinapaw ◽  
Yolanda Demetriou
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Behavior Change ◽  
Weight Status ◽  
Intervention Group ◽  
School Travel ◽  
Behavior Change Techniques ◽  
School Based ◽  
Active School Travel ◽  
School Based Interventions

Abstract Background Promoting cycling to school may benefit establishing a lifelong physical activity routine. This systematic review aimed to summarize the evidence on strategies and effects of school-based interventions focusing on increasing active school transport by bicycle. Methods A literature search based on “PICo” was conducted in eight electronic databases. Randomized and non-randomized controlled trials with primary/secondary school students of all ages were included that conducted pre-post measurements of a school-based intervention aimed at promoting active school travel by bicycle and were published in English between 2000 and 2019. The methodological quality was assessed using the “Effective Public Health Practice Project” tool for quantitative studies. Applied behavior change techniques were identified using the “BCT Taxonomy v1”. Two independent researchers undertook the screening, data extraction, appraisal of study quality, and behavior change techniques. Results Nine studies investigating seven unique interventions performed between 2012 and 2018 were included. All studies were rated as weak quality. The narrative synthesis identified 19 applied behavior change techniques clustered in eleven main groups according to their similarities and a variety of 35 different outcome variables classified into seven main groups. Most outcomes were related to active school travel and psychosocial factors, followed by physical fitness, physical activity levels, weight status, active travel and cycling skills. Four studies, examining in total nine different outcomes, found a significant effect in favor of the intervention group on bicycle trips to school (boys only), percentage of daily cycling trips to school, parental/child self-efficacy, parental outcome expectations, moderate-to-vigorous intensity physical activity (total, from cycling, before/after school), and total basic cycling skills. Seven of these outcomes were only examined in two studies conducting the same intervention in children, a voluntary bicycle train to/from school accompanied by adults, including the following clustered main groups of behavior change techniques: shaping knowledge, comparison of behavior, repetition and substitution as well as antecedents. Conclusions The applied strategies in a bicycle train intervention among children indicated great potential to increase cycling to school. Our findings provide relevant insights for the design and implementation of future school-based interventions targeting active school transport by bicycle. Trial registration This systematic review has been registered in the international prospective register of systematic reviews “PROSPERO” at (registration number: CRD42019125192).

scholarly journals The effects of a physical activity programme on the psychological wellbeing of older people in a residential care facility: an experimental study

2010 ◽  
Vol 30 (4) ◽  
pp. 609-626 ◽  
Author(s):  
SILVIA CIAIRANO ◽  
MONICA EMMA LIUBICICH ◽  
EMANUELA RABAGLIETTI
Keyword(s):  
Physical Activity ◽  
Experimental Study ◽  
Older People ◽  
Residential Care ◽  
Intervention Group ◽  
Care Facility ◽  
Control Group ◽  
Self Perception ◽  
Residential Care Facility ◽  
Post Test

ABSTRACTThis experimental study aimed to analyse the effects of an aerobic activity intervention delivered by specially trained instructors to a sample of Italian older people living in a residential care facility. We assessed intervention effects on general health perception, perception that one's health represents a limitation for moderate and heavy physical activity, and positive and negative self-perception. The 36-item Short Form Health Survey Questionnaire (SF-36) was administered at pre-test and post-test to a sample of 22 older people (ten in the control group and 12 in the intervention group) of both genders with an average age of 80.6 years. The findings showed that: (a) the perception that one's health can limit moderate and heavy physical activity decreased significantly in the older people belonging to the intervention group between pre- and post-test, while it increased in the control group; (b) positive self-perception was found to be stable in the intervention group, while it decreased in the control group; and (c) there was no interaction between group and time with respect to both general health perception and negative self-perception. The exercise programme seemed to have a particularly positive effect on older people's beliefs about their ability to master successfully the activities of daily living such as walking and moving objects.

scholarly journals Effectiveness of a 3-Month Mobile Phone–Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Anna Ek ◽  
Christina Alexandrou ◽  
Emmie Söderström ◽  
Patrick Bergman ◽  
Christine Delisle Nyström ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Mobile Phone ◽  
Controlled Trial ◽  
Vigorous Physical Activity ◽  
Intervention Group ◽  
Active Transportation ◽  
Randomized Controlled ◽  
Behavior Change Program

BACKGROUND Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking. OBJECTIVE The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA). METHODS For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months. RESULTS No effect on MVPA was observed after 3 months (<i>P</i>=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; <i>P</i>=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was &gt;5 minute MVPA per day. CONCLUSIONS No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA. CLINICALTRIAL ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12889-018-5658-4

scholarly journals Adherence to medication, physical activity and diet among older people living with diabetes mellitus: Correlation between cognitive function and health literacy

IBRO Reports ◽  
2020 ◽  
Vol 9 ◽  
pp. 132-137
Author(s):  
Thaísa Soares Crespo ◽  
João Marcus Oliveira Andrade ◽  
Deborah de Farias Lelis ◽  
Alice Crespo Ferreira ◽  
João Gabriel Silva Souza ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Health Literacy ◽  
Cognitive Function ◽  
Older People ◽  
Adherence To Medication
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