Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 1, 2020
Date Accepted: May 14, 2020
Date Submitted to PubMed: Jun 2, 2020
Smartphone applications targeting physical activity in people with rheumatoid arthritis: a quality appraisal and content analysis
ABSTRACT
Background:
Rheumatoid Arthritis (RA) is a disabling, inflammatory joint condition affecting 0.5-1% of the population globally. Physical activity and exercise (PA) are recommended for people with RA but uptake and adherence tends to be low. Smartphone applications (apps) could assist people with RA achieve PA recommendations. However, it is not known whether high quality, evidence-informed PA apps which include behaviour change techniques previously identified as effective for PA uptake and adherence are available for people with RA.
Objective:
This study aimed to 1) systematically identify apps that include aims to facilitate PA for adults with RA; 2) assess app quality and content for inclusion of relevant behaviour change techniques and against recommendations for cardiorespiratory, resistance, flexibility and neuromotor PA and exercise.
Methods:
A systematic search of the UK Apple Appstore and Google Play store was conducted to identify English language apps which promote PA for adults with RA. Two researchers independently assessed app quality (Mobile App Rating Scale (MARS; range 0-5) and content (Behaviour Change Technique Taxonomy v1, World Health Organisation and the American College of Sports Medicine recommendations for PA). Completeness of reporting of PA prescription was evaluated using a modified version of the Consensus of Exercise Reporting Template (range 0-14).
Results:
14,047 apps were identified. Following de-duplication, 2,737 apps were screened for eligibly. Six apps were downloaded (two Apple AppStore, four Google Play store), yielding four unique apps. App quality was mixed (MARS score: 2.25-4.17). Only one app was congruent with all aspects of the PA recommendations. All apps completely or partially recommended flexibility and resistance exercises, three apps completely or partially advised some form of neuromotor exercise but only two offered full or partial guidance on cardiorespiratory exercise. Completeness of exercise reporting was mixed (Consensus of Exercise Reporting Template scores 7-14 points) and between 3-7 behaviour change techniques (BCTs) were identified with two that were common to all apps (Information about health consequences, instruction on how to perform behaviour). Higher quality apps contained a greater number of behaviour change techniques and more closely aligned to PA guidance. No published trials evaluating the effect of the included apps were identified.
Conclusions:
This systematic identification, quality appraisal and content analysis identified only four PA apps of mixed quality and content for use by people with RA. Higher quality apps more closely aligned to PA guidance and included a greater number of BCTs. Only one high quality app (RAISE), including seven BCTs, was fully aligned to PA guidance. The effect of apps on PA uptake and adherence should be established before implementation. Clinical Trial: Not applicable
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