Introduction
Many type 2 diabetes patients show insufficient levels of physical activity and are
often unmotivated to change physical activity behaviors. This study investigated whether
a newly developed smartphone game delivering individualized exercise and physical
activity promotion through an elaborate storyline can generate sustained improvements
in daily physical activity (steps/day).
Study design
Thirty-six participants were enrolled in this 24-week RCT between August 2016 and
April 2018. After baseline assessment, participants were randomized in equal numbers
to the intervention or control condition. Data analysis was performed in May–June
2018.
Setting/participants
Inactive, overweight type 2 diabetes patients, aged 45–70 years, were recruited through
advertising and from hospitals and diabetes care centers in the Basel, Switzerland,
metropolitan area.
Intervention
Participants were instructed to play the innovative smartphone game (intervention
group) or to implement the recommendations from the baseline lifestyle counseling
(control group) autonomously during the 24-week intervention period.
Main outcome measures
Primary outcomes were changes in daily physical activity (steps/day); changes in aerobic
capacity, measured as oxygen uptake at the first ventilatory threshold; and changes
in glycemic control, measured as HbA1c.
Results
Daily physical activity increased by an average of 3,998 (SD=1,293) steps/day in the
intervention group and by an average of 939 (SD=1,156) steps/day in the control group.
The adjusted difference between the two groups was 3,128 steps/day (95% CI=2,313,
3,943, p<0.001). The increase in daily physical activity was accompanied by an improved aerobic
capacity (adjusted difference of oxygen uptake at the first ventilatory threshold
of 1.9 mL/(kg·min), 95% CI=0.9, 2.9, p<0.001). Glycemic control (HbA1c) did not change over the course of the intervention.
Conclusions
A novel, self-developed smartphone game, delivering multidimensional home-based exercise
and physical activity promotion, significantly increases daily physical activity (steps/day)
and aerobic capacity in inactive type 2 diabetes patients after 24 weeks. The ability
of the game to elicit a sustained physical activity motivation may be relevant for
other inactive target groups with chronic diseases.
Trial registration
This study is registered at www.clinicaltrials.gov NCT02657018.
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Article Info
Publication History
Published online: May 22, 2019
Identification
Copyright
© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
