Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

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Effectiveness of a psychological online training to promote physical activity among students: protocol of a randomized-controlled trial

Trials ◽

10.1186/s13063-021-05333-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Lena Violetta Krämer ◽

Nadine Eschrig ◽

Lena Keinhorst ◽

Luisa Schöchlin ◽

Lisa Stephan ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Mixed Model ◽

Controlled Trial ◽

Control Group ◽

Web Based ◽

Intention To Treat ◽

Randomized Controlled ◽

Link Type

Abstract Background Many students in Germany do not meet recommended amounts of physical activity. In order to promote physical activity in students, web-based interventions are increasingly implemented. Yet, data on effectiveness of web-based interventions in university students is low. Our study aims at investigating a web-based intervention for students. The intervention is based on the Health Action Process Approach (HAPA), which discriminates between processes of intention formation (motivational processes) and processes of intention implementation (volitional processes). Primary outcome is change in physical activity; secondary outcomes are motivational and volitional variables as proposed by the HAPA as well as quality of life and depressive symptoms. Methods A two-armed randomized controlled trial (RCT) of parallel design is conducted. Participants are recruited via the internet platform StudiCare (www.studicare.com). After the baseline assessment (t1), participants are randomized to either intervention group (immediate access to web-based intervention) or control group (access only after follow-up assessment). Four weeks later, post-assessment (t2) is performed in both groups followed by a follow-up assessment (t3) 3 months later. Assessments take place online. Main outcome analyses will follow an intention-to-treat principle by including all randomized participants into the analyses. Outcomes will be analysed using a linear mixed model, assuming data are missing at random. The mixed model will include group, time, and the interaction of group and time as fixed effects and participant and university as random effect. Discussion This study is a high-quality RCT with three assessment points and intention-to-treat analysis meeting the state-of-the-art of effectiveness studies. Recruitment covers almost 20 universities in three countries, leading to high external validity. The results of this study will be of great relevance for student health campaigns, as they reflect the effectiveness of self-help interventions for young adults with regard to behaviour change as well as motivational and volitional determinants. From a lifespan perspective, it is important to help students find their way into regular physical activity. Trial registration The German clinical trials register (DRKS) DRKS00016889. Registered on 28 February 2019

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The added value of cognition-targeted exercise versus symptom-targeted exercise for multiple sclerosis fatigue: A randomized controlled pilot trial

PLoS ONE ◽

10.1371/journal.pone.0258752 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0258752

Author(s):

Azza Alketbi ◽

Salah Basit ◽

Nouran Hamza ◽

Lori M. Walton ◽

Ibrahim M. Moustafa

Keyword(s):

Multiple Sclerosis ◽

Clinical Outcome ◽

Outcome Measures ◽

Recruitment Rate ◽

Control Group ◽

Entire Study ◽

Randomized Controlled ◽

Significant Difference ◽

Intervention Protocol

Background Fatigue is considered one of the most common symptoms of multiple sclerosis (MS) and lacks a current standardized treatment. Therefore, the aim of this study was to examine the feasibility and effectiveness of a cognition-targeted exercise versus symptom-targeted exercise for MS fatigue. Methods In this Pilot, parallel-group, randomized controlled trial, sixty participants with multiple sclerosis, were randomly assigned to either a Cognition-Targeted Exercise (CTE) (N = 30, mean age 41) or a Symptom-Targeted Exercise (STE) (N = 30, mean age 42). The participants in the experimental group received eight, 50-minute sessions of weekly Cognitive Behavior Therapy (CBT) in addition to a CTE Program; whereas, participants in the control group received eight, 50-minute sessions of weekly CBT in addition to the standardized physiotherapy program (STE Program). Feasibility was assessed through recruitment rate, participant retention, adherence and safety, in addition to clinical outcome measures, including: (1) Modified Fatigue Impact Scale (MFIS), (2) Work and Social Adjustment Scale (WSAS), (3) Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). All outcome measures were assessed at baseline (pretreatment), following completion of the eight visit intervention protocol, and at 3-months follow-up. Results The recruitment rate was 60% and 93% of participants completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded. A Generalized Estimation Equation Model revealed a significant difference over time as an interaction term during the post and follow up visit for all clinical outcome measures (p < .001). Conclusion The addition of CTE to CBT exhibited positive and more lasting influence on MS fatigue outcomes compared to Symptom-Targeted Exercise (STE). Feasibility and efficacy data from this pilot study provide support for a full-scale RCT of CTE as an integral component of Multiple Sclerosis fatigue management.

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A Group-Based Walking Study to Enhance Physical Activity Among Older Adults: The Role of Social Engagement

Research on Aging ◽

10.1177/0164027520963613 ◽

2020 ◽

pp. 016402752096361

Author(s):

Yujun Liu ◽

Margie E. Lachman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Social Engagement ◽

Treatment Condition ◽

Social Comparisons ◽

Text Messages ◽

Control Group ◽

Group Members

Objectives. The aim of this study was to explore social engagement and social comparisons as mechanisms to increase physical activity among older adults. Methods. Participants (N = 60, mean age = 65.7) were randomly assigned to one of two conditions. Participants in the treatment condition used the application to track their daily walking steps and interact via text messages with their group members for 4 weeks. Participants in the control group used the application only to track their own walking steps. Outcome variables included mean weekly steps, exercise self-efficacy, and social engagement. Results. The results revealed that participants in the experimental condition significantly increased their mean weekly steps and social engagement from the pretest to the posttest whereas the control group did not. These effects were maintained at the 1-month follow up. Discussion. The study expands our understanding of the motivational role of social engagement and social comparison in increasing PA among older adults.

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Bizzy Break! The Effect of a Classroom-Based Activity Break on In-School Physical Activity Levels of Primary School Children

Pediatric Exercise Science ◽

10.1123/pes.25.2.300 ◽

2013 ◽

Vol 25 (2) ◽

pp. 300-307 ◽

Cited By ~ 24

Author(s):

Elaine Murtagh ◽

Maureen Mulvihill ◽

Oonagh Markey

Keyword(s):

Physical Activity ◽

Primary School ◽

School Children ◽

Primary Schools ◽

Intervention Group ◽

Primary School Children ◽

Control Group ◽

Step Counts ◽

Significant Difference

The school has been identified as a key setting to promote physical activity. The purpose of this study was to evaluate the effect of a classroom-based activity break on in-school step counts of primary school children. Data for 90 children (49 boys, 41 girls, 9.3 ± 1.4 years) from three Irish primary schools is presented. In each school one class was randomly assigned as the intervention group and another as controls. Children’s step counts were measured for five consecutive days during school hours at baseline and follow-up. Teachers of the intervention classes led a 10 min activity break in the classroom each day (Bizzy Break!). Mean daily in-school steps for the intervention at baseline and follow-up were 5351 and 5054. Corresponding values for the control group were 5469 and 4246. There was a significant difference in the change in daily steps from baseline to follow-up between groups (p < .05). There was no evidence that girls and boys responded differently to the intervention (p > .05). Children participating in a daily 10 min classroom-based activity break undertake more physical activity during school hours than controls.

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Effects of individualized follow-up with a smartphone-application after cardiac rehabilitation: protocol of a randomized controlled trial

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-019-0148-2 ◽

2019 ◽

Vol 11 (1) ◽

Cited By ~ 2

Author(s):

Pernille Lunde ◽

Asta Bye ◽

Astrid Bergland ◽

Birgitta Blakstad Nilsson

Keyword(s):

Randomized Controlled Trial ◽

Cardiac Rehabilitation ◽

Controlled Trial ◽

Intervention Group ◽

Smartphone Application ◽

Control Group ◽

Power Calculation ◽

Large Sample Size ◽

Randomized Controlled

Abstract Background Cardiac rehabilitation (CR) programs are evidence-based and widely recommended. However, benefits from CR are likely lost among individuals who discontinue their regular exercise routines and healthy habits. One possible approach to enhance adherence to lifestyle advice after completion of CR, may be individualized follow-up enabled by a smartphone application (app). Methods A protocol of a single-blinded, pragmatic randomized controlled trial. The study will take place in the eastern part of Norway, and will include heart patients who have completed CR. Participants will be recruited from two CR centers. Based on power calculation, 113 participants will be included. The intervention group will receive individualized follow-up through an app on a weekly basis throughout a year. The app will be set up with the participant’s own goals, and the follow-up will be based on these individual goals. The control group will receive usual care, including general advice regarding physical activity, exercise and diet. The participants will be assessed at baseline (at completion of CR) and 12 months after baseline. Primary outcome of the study will be peak oxygen uptake. Secondary outcomes include exercise performance, quality of life, health status, health literacy, self-perceived goal achievement, exercise habits, body weight, blood pressure as well as lipids and triglycerides. Discussion To our knowledge, this will be the first study to examine the effects of individualized follow-up with an app for one year, in patients completing CR. Hence, it is reasonable to assume that the study may be groundbreaking. Due to the large sample size and the theoretically based intervention, the study has the potential to generate new knowledge that may improve the design of future technology-based follow-up interventions of patients that have completed rehabilitation. Trial registration ClinicalTrials.gov. NCT03174106. First registration, 19/05/2017.

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Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis

Journal of Telemedicine and Telecare ◽

10.1177/1357633x16628996 ◽

2016 ◽

Vol 23 (2) ◽

pp. 339-346 ◽

Cited By ~ 39

Author(s):

H Shukla ◽

SR Nair ◽

D Thakker

Keyword(s):

Physical Activity ◽

Total Knee Arthroplasty ◽

Literature Review ◽

Systematic Literature Review ◽

Knee Arthroplasty ◽

Knee Extension ◽

Control Group ◽

Randomized Controlled ◽

Significant Difference ◽

Total Knee

Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients’ homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) −0.52, 95% CI −1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI −0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.

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Acupuncture to Treat Primary Dysmenorrhea in Women: A Randomized Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nep239 ◽

2011 ◽

Vol 2011 ◽

pp. 1-11 ◽

Cited By ~ 21

Author(s):

Caroline A. Smith ◽

Caroline A. Crowther ◽

Oswald Petrucco ◽

Justin Beilby ◽

Hannah Dent

Keyword(s):

Randomized Controlled Trial ◽

Treatment Effect ◽

Controlled Trial ◽

Acupuncture Group ◽

Control Group ◽

Primary Dysmenorrhea ◽

Menstrual Pain ◽

Randomized Controlled ◽

Significant Difference

We examined the effectiveness of acupuncture to reduce the severity and intensity of primary dysmenorrhea. A randomized controlled trial compared acupuncture with control acupuncture using a placebo needle. Eligible women were aged 14–25 years with a diagnosis of primary dysmenorrhea. Women received nine sessions of the study treatment over 3 months. The primary outcomes were menstrual pain intensity and duration, overall improvement in dysmenorrhea symptoms and reduced need for additional analgesia, measured at 3, 6 and 12 months from trial entry. A total of 92 women were randomly assigned to the intervention (acupuncture and control ). At 3 months although pain outcomes were lower for women in the acupuncture group compared with the control group, there was no significant difference between groups. Women receiving acupuncture reported a small reduction in mood changes compared with the control group, relative risk (RR) 0.72, 95% confidence interval (CI) 0.53–1.00, . Follow-up at 6 months found a significant reduction in the duration of menstrual pain in the acupuncture group compared with the control group, mean difference –9.6, 95% CI –18.9 to –0.3, , and the need for additional analgesia was significantly lower in the acupuncture group compared with the control group, RR 0.69, 95% CI 0.49–0.96, , but the follow-up at 12 months found lack of treatment effect. To conclude, although acupuncture improved menstrual mood symptoms in women with primary dysmenorrhea during the treatment phase, the trend in the improvement of symptoms during the active phase of treatment, and at 6 and 12 months was non-significant, indicating that a small treatment effect from acupuncture on dysmenorrhea may exist. In the study, acupuncture was acceptable and safe, but further appropriately powered trials are needed before recommendations for clinical practice can be made.

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Effects of a randomized controlled study on the behaviors of overweight schoolchildren

Revista Brasileira de Atividade Física & Saúde ◽

10.12820/rbafs.26e0221 ◽

2021 ◽

Vol 26 ◽

Author(s):

Anastácio Neco de Souza Filho ◽

Thaynã Alves Bezerra ◽

Paulo Felipe Ribeiro Bandeira ◽

Luciana Gatto Azevedo Cabral ◽

José Fernando Vila Nova de Moraes ◽

...

Keyword(s):

Physical Activity ◽

Behavioral Therapy ◽

Vigorous Physical Activity ◽

Randomized Controlled Study ◽

Controlled Study ◽

Control Group ◽

Daily Routine ◽

Randomized Controlled ◽

School Based ◽

Significant Difference

This study aimed to determine the effects of a school-based multi-component intervention on accelerometer- measured physical activity (PA) and sedentary behavior (SB) in schoolchildren overweight. This is a randomized controlled study with overweight schoolchildren, allocated to experimental group (EG; n = 13; 7.6 ± 0.8 years; 42.9% boys) and control group (CG; n = 17; 8.2 ± 0.9 years; 26.7% boys). The EG was submitted to a 10-week school-based intervention, comprised of PA and psychological sessions (behavioral therapy), and nutritional guidance. The CG followed the daily routine of life. The time of PA and SB were measured using accelerometers used for seven days. To compare mean SB, moderate to vigorous physical activity (MVPA) and total physical activity (TPA), generalized estimation equations (GEE) were used. It was observed that the average time in MVPA and TPA increased significantly in EG at the weekend (+ 40.9 min / day, p < 0.001; and + 51.6 min/day, p = 0.035, respectively) and at full week (+ 62.9 min/day, p < 0.001; and + 225.0 9 min/day, p = 0.038, respectively). There was no significant difference in time spent in SB after the intervention in both groups. Thus, it was concluded that the proposed school-based multicomponent intervention was effective in increasing levels of MVPA and TPA in overweight schoolchildren. This finding can optimize future interventions to promote a healthy lifestyle for schoolchildren in the school environment.

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Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

10.21203/rs.3.rs-29932/v1 ◽

2020 ◽

Author(s):

KHALID A ALAHMARI ◽

Paul Silvian Samuel ◽

Irshad Ahmad ◽

Ravi Shankar Reddy ◽

Jaya Shanker Tedla ◽

...

Keyword(s):

Physical Activity ◽

Range Of Motion ◽

Outcome Measures ◽

Ankle Sprain ◽

Low Frequency ◽

Control Group ◽

Significant Difference ◽

Proprioceptive Neuromuscular Facilitation ◽

Experimental Group

Abstract BackgroundStretching is an important part of post-ankle-sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside muscle stimulation has not yet been extensively studied. Therefore the purpose of the present research is to compare the baseline, post- and follow-up effects of the proprioceptive neuromuscular facilitation (PNF) stretching technique combined with transcutaneous electrical nerve stimulation (TENS), as compared against the effects of the PNF stretching technique alone.MethodsSixty subjects with lateral ankle sprains were selected and randomly allocated to three groups: Experimental Group One (EG 1), Experimental Group Two (EG 2), and the Control Group (CG). Subjects in EG 1 received the PNF stretching technique combined with TENS. Subjects in EG2 received the PNF stretching technique alone. Both experimental groups received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, flexibility, proprioception, range of motion, muscle strength, physical activity, and balance. A mixed-model ANOVA was used to analyze the effects of time factors and groups on these outcome measures.ResultsThere was significant interaction (time and group), and the time effect for all the outcome measures (p < 0.05). Physical activity, dorsiflexion, and balance in the medial, lateral, anterolateral, and anteromedial directions did not show a significant difference between the groups. EG 1 showed significant improvement for all the outcome variables between pre- and post-treatment and follow-up when compared to the other groups.ConclusionsThe present study showed that a 12-session treatment program of 3 weeks’ duration that combines PNF stretching with low-frequency TENS for post-ankle sprain subjects, compared against PNF stretching alone, produced significant improvements in balance, proprioception, strength, and range of motion. The study also showed that the treatment effect was sustained even after treatment was ceased after the follow-up assessment in the fifth week.Trial Registration:Human Research Ethics Committee approval for the trial (approval no.: (ECM#2019-26)Clinical trial was also registered in the Clinical Trials Registry – ISRCTN 18013941

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Feasibility and Acceptability of a Physical Activity Tracker and Text Messages to Promote Physical Activity During Chemotherapy for Colorectal Cancer: Pilot Randomized Controlled Trial (Smart Pace II)

JMIR Cancer ◽

10.2196/31576 ◽

2022 ◽

Vol 8 (1) ◽

pp. e31576

Author(s):

Erin L Van Blarigan ◽

Anand Dhruva ◽

Chloe E Atreya ◽

Stacey A Kenfield ◽

June M Chan ◽

...

Keyword(s):

Physical Activity ◽

Digital Health ◽

Controlled Trial ◽

Text Message ◽

Text Messages ◽

Walk Test ◽

Randomized Controlled ◽

6 Minute Walk Test ◽

Minute Walk

Background We conducted a pilot 2-arm randomized controlled trial to assess the feasibility of a digital health intervention to increase moderate-to-vigorous physical activity in patients with colorectal cancer (CRC) during chemotherapy. Objective This study aimed to determine whether a digital health physical activity intervention is feasible and acceptable during chemotherapy for CRC. Methods Potentially eligible patients with CRC expected to receive at least 12 weeks of chemotherapy were identified in person at the University of California, San Francisco, and on the web through advertising. Eligible patients were randomized 1:1 to a 12-week intervention (Fitbit Flex, automated SMS text messages) versus usual care. At 0 and 12 weeks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size measurements, and an optional 6-minute walk test. Participants could not be masked to their intervention arm, but people assessing the body size and 6-minute walk test outcomes were masked. The primary outcomes were adherence (eg, Fitbit wear and text response rate) and self-assessed acceptability of the intervention. The intervention would be considered feasible if we observed at least 80% complete follow-up and 70% adherence and satisfaction, a priori. Results From 2018 to 2020, we screened 240 patients; 53.3% (128/240) of patients were ineligible and 26.7% (64/240) declined to participate. A total of 44 patients (44/240, 18%) were randomized to the intervention (n=22) or control (n=22) groups. Of these, 57% (25/44) were women; 68% (30/44) identified as White and 25% (11/44) identified as Asian American or Pacific Islander; and 77% (34/44) had a 4-year college degree. The median age at enrollment was 54 years (IQR 45-62 years). Follow-up at 12 weeks was 91% (40/44) complete. In the intervention arm, patients wore Fitbit devices on a median of 67 out of 84 (80%) study days and responded to a median of 17 out of 27 (63%) questions sent via SMS text message. Among 19 out of 22 (86%) intervention patients who completed the feedback survey, 89% (17/19) were satisfied with the Fitbit device; 63% (12/19) were satisfied with the SMS text messages; 68% (13/19) said the SMS text messages motivated them to exercise; 74% (14/19) said the frequency of SMS text messages (1-3 days) was ideal; and 79% (15/19) said that receiving SMS text messages in the morning and evening was ideal. Conclusions This pilot study demonstrated that many people receiving chemotherapy for CRC are interested in participating in digital health physical activity interventions. Fitbit adherence was high; however, participants indicated a desire for more tailored SMS text message content. Studies with more socioeconomically diverse patients with CRC are required. Trial Registration ClinicalTrials.gov NCT03524716; https://clinicaltrials.gov/ct2/show/NCT03524716

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