Possible Impact of a 12-Month Web- and Smartphone-Based Program to Improve Long-term Physical Activity in Patients Attending Spa Therapy: Randomized Controlled Trial

Florie Fillol, Ludivine Paris, Sébastien Pascal, Aurélien Mulliez, Christian-François Roques, Sylvie Rousset, Martine Duclos, Florie Fillol, Ludivine Paris, Sébastien Pascal, Aurélien Mulliez, Christian-François Roques, Sylvie Rousset, Martine Duclos

Abstract

Background: Lack of physical activity (PA) and sedentary behaviors are leading risk factors for noncommunicable diseases (NCDs). Web- and smartphone-based interventions are effective in increasing PA in older adults and in patients with NCD. In many countries, spa therapy, commonly prescribed to patients with NCD, represents an ideal context to initiating lifestyle changes.

Objective: This study aimed to evaluate, in patients attending spa therapy, the effectiveness of an intervention combining a face-to-face coaching and, when returning home, a web- and smartphone-based PA program on the achievement of PA guidelines (PAG) 12 months after the end of spa therapy.

Methods: This was a 12-month, prospective, parallel-group randomized controlled trial. Patients were enrolled during spa therapy and randomized 1:1 to intervention or control group who received PA usual advice. From the end of spa therapy, PA, weight, waist circumference, and quality of life of the participants were assessed by phone every 2 months. Primary outcome was meeting PAG (PA ≥600 metabolic equivalent of task) at 12 months. Secondary outcomes were meeting current PAG at 6 months; sedentary time, weight, waist circumference, PA, and quality of life at 6 and 12 months. Objective use data of the web- and smartphone-based PA program were collected. Analytic methods included intention to treat and constrained longitudinal data analyses.

Results: The study sample included 228 participants (n=176, 77.2% females) with a mean age of 62.4 (SD 6.7) years and a mean BMI of 28.2 (SD 4.2) kg/m2. Approximately 53.9% (123/228) of the participants were retired. No group differences were found for any baseline variable. At 12 months, the proportion of patients achieving PAG was significantly higher in intervention group than in the control group (81% vs 67% respectively, odds ratio 2.34, 95% CI 1.02-5.38; P=.045). No difference between intervention and control group was found neither in achieving PAG at 6 months nor for sedentary time, weight, and waist circumference at 6 and 12 months. Regarding quality of life, the physical component subscale score was significantly higher at 12 months in the intervention group than in the control group (mean difference: 4.1, 95% CI 1.9-6.3; P<.001). The mean duration use of the program was 7.1 (SD 4.5) months. Attrition rate during the first 2 months was 20.4% (23/113) whereas 39.8% (45/113) of the participants used the program for at least 10 months.

Conclusions: PA increased in both the intervention group and the control group. However, at 12 months, more participants met PAG in the intervention group compared with the controls. This indicates that the web- and smartphone-based program could have maintained PA in the intervention group. In addition, a spa therapy seems to be an ideal time and framework to implement PA education.

Trial registration: ClinicalTrials.gov NCT02694796; https://ichgcp.net/clinical-trials-registry/NCT02694796.

Keywords: aged; exercise; follow-up studies; internet; mobile phone; older adults; physical activity; quality of life; sedentary behavior; spa.

Conflict of interest statement

Conflicts of Interest: FF was an employee of Biomouv SAS Inc and SP was the chief executive officer of Biomouv SAS Inc, who provided the web and smartphone-based physical activity program. CFR was the president of the Association Française pour la Recherche Thermale Scientific Committee.

©Florie Fillol, Ludivine Paris, Sébastien Pascal, Aurélien Mulliez, Christian-François Roques, Sylvie Rousset, Martine Duclos. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.06.2022.

Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards of Reporting Trials) flowchart. IPAQ: International Physical Activity Questionnaire.
Figure 2
Figure 2
Change in the percentage of PA guidelines achievement (total PA MET≥600) marginal values according to constrained longitudinal data analysis model for each group over time. MET: metabolic equivalent of task; PA: physical activity.
Figure 3
Figure 3
International Physical Activity Questionnaire scores for total, moderate, intense, and walking physical activity margin values according to constrained longitudinal data analysis model for each group over time. MET: metabolic equivalent of task; PA: physical activity.
Figure 4
Figure 4
Sedentary times marginal values according to constrained longitudinal data analysis model for each group over time.
Figure 5
Figure 5
Weight and waist circumference marginal values according to constrained longitudinal data analysis model for each group over time.
Figure 6
Figure 6
SF-12 scores (PCS and MCS) marginal values to constrained longitudinal data analysis model for each group over time. MCS: mental component subscale; PCS: physical component subscale; SF-12: Short Form Health Survey-12.

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