Commentary

App use increased physical activity


 

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People who used a smartphone pedometer app walked 22% more steps (or about half a mile) per day after 8 weeks than did people in a control group in a small, randomized, open-label study.

The 90 participants in rural western Ireland were older than 16 years and owned an Android smartphone, which they were asked to keep charged and to carry during waking hours. Investigators downloaded the app to all phones and calibrated it to each individual to record step counts accurately. All participants were given physical activity goals and information on the benefits of exercise.

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People who used a smartphone pedometer app walked 22% more steps per day after 8 weeks.

In the first week, the app display was not visible while it recorded baseline activity data. Mean step counts in the first week were 5,138 steps/day in the control group and 4,365/day in the intervention group. That difference was not statistically significant, but the investigators still adjusted for it in final analyses, Dr. Liam G. Glynn and his associates reported in the British Journal of General Practice.

The intervention group was then showed the app’s features and settings and encouraged to interact with the app to help meet activity goals. The control group’s app continued to track steps without any interaction.

Among 40 people in the control group and 37 in the intervention group with follow-up data 7 weeks later, the daily counts decreased by 386 steps in the control group and increased by 1,631 steps in the intervention group (Br. J. Gen. Pract. 2014;64:e384-91).

Participants in both groups increased their walking initially, but only the intervention group maintained the increased activity, accounting for the step count difference between groups at 8 weeks, said Dr. Glynn, a general practice physician at the National University of Ireland, Galway.

The study used the Accupedo-Pro pedometer app because it included preestablished, desirable features such as automatic feedback and tracking of step counts and calories burned, visually appealing graphics of step count history, the ability to input goals, and feedback on goal achievement. The Accupedo-Pro app is available for iPhones and Android devices for $3.99. Hundreds of other activity-tracking apps of varying quality are available for free or for sale.

After researchers adjusted for factors unrelated to the study that may have increased step counts during the study period, they found that the mean daily count at baseline for the intervention group was 4,771 steps/day. The difference between the intervention and control groups by the end of 8 weeks was a mean increase of 1,029 steps/day favoring the app use, a 22% gain, compared with the intervention group’s baseline, Dr. Glynn reported.

That’s enough of a change to be clinically meaningful if it’s maintained, based on a large body of literature on exercise and health, he said. Dr. Glynn and his associates now are following app users in several European countries to monitor long-term health outcomes.

The current study was too small to show a difference in health measures such as blood pressure, weight, or body mass index. And it was too short to show whether or not apps embedded in phones can overcome one of the weak points of separate devices used solely as pedometers or activity trackers – namely, the tendency for many people to stop using them over time.

Dr. Liam G. Glynn

One in three people who owned a fitness tracker stopped using the device in the past year, mainly because they lost interest in tracking their activity level, according to a survey by International Data Corp.

Nonetheless, pedometers and other small hardware-based fitness trackers remain popular. Florida insurer AvMed recently announced that it will cover the cost of the Fitlinxx Pebble activity meter for Medicare Advantage members enrolled in the Walkadoo pedometer-based walking program run by MeYou Health.

Separate data suggest that, among mobile phone customers, 60% in the United States and 57% in Ireland have a smartphone, Dr. Glynn said, and that 90% of U.S. mobile phone users have their phone with them 24 hours a day. Theoretically, a smartphone pedometer app might get more use than a conventional pedometer because it doesn’t require carrying a separate piece of technology.

"This intervention is now firmly on my list (as a clinician) of options for patients to whom I am recommending increased physical activity," Dr. Glynn said in an interview.

He reported having no financial disclosures.

sboschert@frontlinemedcom.com

On Twitter @sherryboschert

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