The Effects of a Lifestyle Intervention Supported by the InterWalk Smartphone App on Increasing Physical Activity Among Persons With Type 2 Diabetes: Parallel-Group, Randomized Trial.
Study Goal
The researchers aimed to determine whether an app-based interval walking training (IWT) program could increase moderate-and-vigorous physical activity (MVPA) over 52 weeks compared to standard care in individuals with type 2 diabetes.
Results Summary
The study found no significant increase in MVPA time with the app-based IWT compared to standard care, but it did observe improvements in physical health-related quality of life and a marginal reduction in waist circumference in the IWT group. No differences were noted in other secondary outcomes like physical fitness or weight.
Population
Individuals with type 2 diabetes referred to municipality-based lifestyle programs (mean age 59.6 years, 59.8% male).
Effective Dosage
3 times per week for 30-60 minutes of interval walking training.
Duration
52 weeks (with initial 12-week structured program).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
standard care + InterWalk app-based interval walking training (IWT) | no change | objectively measured MVPA time (minutes/day) | individuals with T2D | 0.6 [-4.6 to 5.8] minutes/day | No changes in MVPA time were observed | #1 |
standard care + the standard exercise program (StC) | no change | objectively measured MVPA time (minutes/day) | individuals with T2D | -0.2 [-3.8 to 3.3] minutes/day | No changes in MVPA time were observed | #2 |
standard care + InterWalk app-based interval walking training (IWT) | increase | physical health-related quality of life (HRQoL) | individuals with T2D | 4.3 (95% CI 1.8 to 6.9) SF-12 points | Physical HRQoL increased by a mean of 4.3 (95% CI 1.8 to 6.9) 12-item Short-Form Health Survey (SF-12) points more in the IWT group compared with the StC group | #3 |
standard care + InterWalk app-based interval walking training (IWT) | decrease | waist circumference | individuals with T2D | -2.3 (95% CI -4.1 to -0.4) cm | waist circumference apparently decreased a mean of -2.3 (95% CI -4.1 to -0.4) cm more in the IWT group compared with the StC group | #4 |
standard care + InterWalk app-based interval walking training (IWT) | no change | self-rated mental health-related quality of life (HRQoL), physical fitness, weight | individuals with T2D | no significant change | No between-group differences were observed among the remaining key secondary outcomes | #5 |
BACKGROUND: Effective and sustainable implementation of physical activity (PA) in type 2 diabetes (T2D) health care has in general not been successful. Efficacious and contemporary approaches to support PA adherence and adoption are required. OBJECTIVE: The primary objective of this study was to investigate the effectiveness of including an app-based (InterWalk) approach in municipality-based rehabilitation to increase moderate-and-vigorous PA (MVPA) across 52 weeks compared with standard care among individuals with T2D. METHODS: The study was designed as a parallel-group, randomized trial with 52 weeks' intervention and subsequent follow-up for effectiveness (52 weeks from baseline). Participants were recruited between January 2015 and December 2016 and randomly allocated (2:1) into 12 weeks of (1) standard care + InterWalk app-based interval walking training (IWT; IWT group; n=140), or (2) standard care + the standard exercise program (StC group; n=74). Following 12 weeks, the IWT group was encouraged to maintain InterWalk app-based IWT (3 times per week for 30-60 minutes) and the StC group was encouraged to maintain exercise without structured support. Moreover, half of the IWT group (IWTsupport group, n=54) received additional motivational support following the 12-week program until 52-week follow-up. The primary outcome was change in objectively measured MVPA time (minutes/day) from baseline to 52-week follow-up. Key secondary outcomes included changes in self-rated physical and mental health-related quality of life (HRQoL), physical fitness, weight, and waist circumference. RESULTS: Participants had a mean age of 59.6 (SD 10.6) years and 128/214 (59.8%) were men. No changes in MVPA time were observed from baseline to 52-week follow-up in the StC and IWT groups (least squares means [95% CI] 0.6 [-4.6 to 5.8] and -0.2 [-3.8 to 3.3], respectively) and no differences were observed between the groups (mean difference [95% CI] -0.8 [-8.1 to 6.4] minutes/day; P=.82). Physical HRQoL increased by a mean of 4.3 (95% CI 1.8 to 6.9) 12-item Short-Form Health Survey (SF-12) points more in the IWT group compared with the StC group (Benjamini-Hochberg adjusted P=.007) and waist circumference apparently decreased a mean of -2.3 (95% CI -4.1 to -0.4) cm more in the IWT group compared with the StC group but with a Benjamini-Hochberg adjusted P=.06. No between-group differences were observed among the remaining key secondary outcomes. CONCLUSIONS: Among individuals with T2D referred to municipality-based lifestyle programs, randomization to InterWalk app-based IWT did not increase objectively measured MVPA time over 52 weeks compared with standard health care, although apparent benefits were observed for physical HRQoL. TRIAL REGISTRATION: ClinicalTrials.gov NCT02341690; https://clinicaltrials.gov/ct2/show/NCT02341690.