Effect of mindfulness on physical activity in primary healthcare patients: a randomised controlled trial pilot study

Peter Nymberg, Susanna Calling, Emelie Stenman, Karolina Palmér, Eva Ekvall Hansson, Kristina Sundquist, Jan Sundquist, Bengt Zöller, Peter Nymberg, Susanna Calling, Emelie Stenman, Karolina Palmér, Eva Ekvall Hansson, Kristina Sundquist, Jan Sundquist, Bengt Zöller

Abstract

Increased physical activity can have health benefits among inactive individuals. In Sweden, the healthcare system uses physical activity on prescription (PAP) to motivate patients to increase their physical activity level. Mindfulness may further heighten the internal motivation to engage in physical activity. However, previous research has not demonstrated clear evidence of such an association.

Aim: Examine the feasibility of the study design as a preparation for a full-scale study, and examine the differences, between three interventions, in change over time in physical activity levels and in related variables.

Method: Comparison between three different interventions in an ordinary primary health care setting: PAP, mindfulness, and a combination of PAP and mindfulness. Physical activity was measured with self-report and ACTi Graph GT1X activity monitor. Statistical analysis was performed with a mixed-effect model to account for repeated observations and estimate differences both within groups and between groups at 3- and 6-months follow-up.

Results: Between September 2016 and December 2018, a total of 88 participants were randomised into three groups. The total dropout rate was 20.4%, the attendance rate to the mindfulness courses (52% > 6 times) and the web-based mindfulness training (8% > 800 min) was low according to the stated feasibility criteria. Eleven participants were excluded from analysis due to low activity monitor wear time. Neither the activity monitor data nor self-reported physical activity showed any significant differences between the groups.

Conclusion: The study design needs adjustment for the mindfulness intervention design before a fully scaled study can be conducted. A combination of PAP and mindfulness may increase physical activity and self-rated health more than PAP or mindfulness alone.

Trial registration: ClinicalTrials.gov, registration number NCT02869854 . Regional Ethical Review Board in Lund registration number 2016/404.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT diagram over included patients from baseline to 6-month follow-up
Fig. 2
Fig. 2
Change in percentage sedentary in 1 the three groups over time. Differences between and within the groups are estimated by a mixed-effect model. *Maximum and minimum value of all observations
Fig. 3
Fig. 3
Change in percentage light physical activity (LIPA), in the three groups over time. Differences between and within the groups are estimated by a mixed-effect model. **Maximum and minimum value of all observations
Fig. 4
Fig. 4
Change in percentage moderate to vigorous physical activity (MVPA), in the three groups over time. Differences between and within the groups are estimated by a mixed-effect model. *Moderate to vigorus physical activity. **Maximum and minimum value of all observations
Fig. 5
Fig. 5
Change in units of self-reported leisuretime activity in the three groups over time. Differences between and within the groups are estimated by a mixed-effect model. *Maximum and minimum value of all observations
Fig. 6
Fig. 6
Change in units of self reported daily activity in the three groups over time. Differences between and within the groups are estimated by a mixed-effect model. *Maximum and minimum value of all observations
Fig. 7
Fig. 7
Change in units of self-rated health in the three groups over time. Differences between and within the groups are estimated by a mixed-effect model. *Maximum and minimum value of all observations

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