Physical activity is the most potent intervention we have in medicine - more powerful than any drug
Apps that prompt users to stand up and move every hour or to aim for a certain number of daily steps do help people add movement and exercise to their daily routines, a recent trial suggests.
For the study, users of an app called MyHeart Counts were assigned to four coaching interventions, and each intervention helped increase step counts by a few hundred steps per day, according to the report in The Lancet Digital Health.
"Physical activity is the most potent intervention we have in medicine - more powerful than any drug," said senior study author Dr. Euan Ashley of Stanford University in California.
"Physical activity helps with essentially every major disease category – heart disease, diabetes, multiple cancers, musculoskeletal, mental health and many more," he told Reuters Health by email. "Getting people to exercise just a little more can have a dramatic effect on health."
The MyHeart Counts app monitors physical activity, sleep quality and self-reported happiness and physical well-being. Adult users were randomly assigned to receive one of 24 options based on four combinations of four different seven-day interventions. The interventions included daily prompts to complete 10,000 steps, prompts to stand after an hour of sitting, instructions to read physical activity guidelines from the American Heart Association website, or e-coaching based on the participant's personal activity patterns.
Of 2,075 people who volunteered for the study, 493 completed the full set of interventions and participated for 35 days or longer. These users were 74% male, 87% white and in their mid-40s, on average.
Before the interventions, volunteers' average daily step count was nearly 3,000. Averages rose by 319 steps for the American Heart Association website-prompt group, 267 steps for the hourly standing group, 254 steps for the personalized e-coaching group and 226 steps for the 10,000 daily step-prompt group, researchers found.
No intervention was more effective than the others, and no statistically meaningful effects were observed on sleep duration or quality, daily time walking or self-reported happiness.
One limitation is that participants were not representative of the wider population, the researchers note. Also, volunteers who used a smartwatch in conjunction with their phone tended to log higher step counts, suggesting the phone-only users might not have been carrying it with them at all times and some of their activity was not captured.
"The good news is that it didn't take much to trigger more activity and it didn't really have to be that sophisticated a reminder," Ashley said. "The bad news is that it didn't change their physical activity by much. However, a 10% increase is still worthwhile if you can implement in large populations."
Ashley and colleagues are now testing an updated version of the app , which will be available for Android and iPhone. They're building the interventions in collaboration with Google and the US Food and Drug Administration to test possibilities for conducting clinical trials on digital platforms.
"We'd aim to personalize the triggers more," he said. "For example, asking people what motivates them and then using that as part of their prompt."
Future studies should also look at longer interventions, as well as "gamification" potential for smartphone apps, such as competition, collaboration, rewards and support, said Dr. Mitesh Patel of the University of Pennsylvania in Philadelphia.
Patel, who wasn't involved in the current study, directs the Penn Medicine Nudge Unit, which investigates gamification of physical activity in clinical trials.
"If you are interested in improving your physical activity levels, the smartphone in your pocket can track your activity levels," he told Reuters Health by email. "Simple interventions through mobile applications can help to increase your engagement in healthy behaviours like physical activity."
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