Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 10, 2020
Date Accepted: Jan 4, 2021
Efficiency of an mHealth App and Chest-Wearable Remote Exercise Monitoring Intervention in Patients with Type 2 Diabetes: Prospective Multicenter Randomized Controlled Trial
ABSTRACT
Background:
Exercise has been recommended as a cornerstone for diabetes management. Supervised exercise is more efficient than unsupervised exercise, but is less convenient and accessible.
Objective:
To determine the feasibility and efficiency of exercise on type 2 diabetes under remote monitoring using fitness application and heart rate band compared with traditional exercise.
Methods:
This is a multi-center randomized controlled trial (RCT). Type 2 diabetic patients without severe complications or comorbidities were recruited. Subjects in both groups were prescribed with individualized moderate- to vigorous- physical activity (MVPA) for at least 150 minutes per week. Participants in the app group were suggested to follow the exercise videos on the application, and to wear heart rate band to determine whether they had reached target heart rate. Exercise duration and intensity were recoreded by the application. Cardiopulmonary endurance, indices of body composition, and other parameters were assessed before and after intervention. The study had an average follow-up of 3 months.
Results:
101 subjects were enrolled and 85 completed the study. Two groups were similar in baseline characteristics except that subjects in the app group were slightly younger and less likely to have hypertension. Self-reported exercise duration in control group was longer than app-recorded duration in app group (214 vs 193 min/week). And higher proportion of subjects in the control group met the 150-min MVPA criterion for diabetes than that in the app group (71% vs 42%). However, compared with control group, app group had a larger increase in cardiopulmonary endurance (-2.0 vs 1.0 beats/min, p=0.023) and a larger decrease in body-fat percentage (-1.8 vs-0.8%, p=0.013). There was no difference in HbA1c reduction between two groups, yet more subjects in app group stopped taking anti-diabetic drugs or lowered drug dosage, compared with those in the control group. There were no serious adverse events in both groups.
Conclusions:
This is the first RCT in China that tested the feasibility and efficiency of exercise under remote monitoring using fitness application and heart rate band. This study suggestes that exercise supervised by application and heart rate band is more efficient than unsupervised exercise in patients with type 2 diabetes. Clinical Trial: This is a prospective, multi-center, randomized controlled trial (RCT) (Chinese Clinical Trial Registry number, ChiCTR1800015963).
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