Validity and reliability of an app-based medical device to empower individuals in evaluating their physical capacities.

BACKGROUND: Cardiorespiratory fitness and muscle strength are valid markers of health and strong predictors of mortality and morbidity. The tests used to measure these variables require in-person visits with specialized equipment and trained personnel-leading to organizational constraints both for patients and hospitals, and making them difficult to implement at a large scale. In this context, technologies embedded in smartphones offer new opportunities to develop remote tests. OBJECTIVES: This study aimed to test the validity and reliability of MediEval, a newly developed app-based medical device that allows individuals to perform the 6-minute walk test (6MWT) and the 30-second sit-to-stand (30s-STS) test on their own using GPS signal and camera detection with a skeleton extraction algorithm. METHODS: A total of 53 healthy adults performed the two tests in three different sessions to determine the intra- and inter-day reproducibility. Test validity was assessed by comparing the results obtained from the app to gold standard measures. Pearson correlations and concordance correlation coefficients, the relative measurement error, intraclass correlation coefficients, the standard error of measure and the minimal detectable change were computed for each test.s. RESULTS: The results revealed high to excellent validity of the app in comparison to gold standards (ρ = 0.84 for the 6MWT and ρ = 0.99 for the 30s-STS test) with low relative measurement error. The mean differences between the app and the gold standard measures were 8.96m for the 6MWT and 0.28 repetition for the 30s-STS test. Both tests had good test-retest reliability (ICCs = 0.77). The minimal detectable changes were respectively 97.56 meters for the 6MWT and 7.37 repetitions for the 30s-STS test. CONCLUSION: The MediEval medical device proposes valid and reproducible measures of the 6MWT and the 30s-STS test. This device holds promise for monitoring the physical activity of large epidemiologic cohorts while refining patient experience and improving the scalability of the healthcare system. Considering minimal detectable change values, it may be important to ask participants to perform several tests and average them to improve accuracy. Future studies in clinical context are needed to evaluate the responsiveness and the smallest detectable changes of the device for specific populations with chronic diseases.

Digital intervention promoting physical activity among obese people (DIPPAO) randomised controlled trial: study protocol.

INTRODUCTION: Physical inactivity and excessive sedentary behaviours are major preventable causes in both the development and the treatment of obesity and type 2 diabetes mellitus (T2DM). Nevertheless, current programmes struggle to engage and sustain physical activity (PA) of patients over long periods of time. To overcome these limitations, the Digital Intervention Promoting Physical Activity among Obese people randomised controlled trial (RCT) aims to evaluate the effectiveness of a group-based digital intervention grounded on gamification strategies, enhanced by social features and informed by the tenets of the self-determination theory and the social identity approach. METHODS AND ANALYSIS: This trial is a two-arm parallel RCT testing the effectiveness of the Kiplin digital intervention on obese and patients with T2DM in comparison to the usual supervised PA programme of the University Hospital of Clermont-Ferrand, France. A total of 50 patients will be randomised to one of the two interventions and will follow a 3-month programme with a 6-month follow-up postintervention. The primary outcome of the study is the daily step count change between the baseline assessment and the end of the intervention. Accelerometer data, self-reported PA, body composition and physical capacities will also be evaluated. To advance our understanding of complex interventions like gamified and group-based ones, we will explore several psychological mediators relative to motivation, enjoyment, in-group identification or perceived weight stigma. Finally, to assess a potential superior economic efficiency compared with the current treatment, we will conduct a cost-utility analysis between the two conditions. A mixed-model approach will be used to analyse the change in outcomes over time. ETHICS AND DISSEMINATION: The research protocol has been reviewed and approved by the Local Human Protection Committee (CPP Ile de France XI, No 21 004-65219). Results will inform the Kiplin app development, be published in scientific journals and disseminated in international conferences. TRIAL REGISTRATION NUMBER: NCT04887077.

Use of mHealth to Increase Physical Activity Among Breast Cancer Survivors With Fatigue: Qualitative Exploration.

BACKGROUND: Physical activity has shown beneficial effects in the treatment of breast cancer fatigue; nevertheless, a significant portion of patients remain insufficiently physically active after breast cancer. Currently most patients have a smartphone, and therefore mobile health (mHealth) holds the promise of promoting health behavior uptake for many of them. OBJECTIVE: In this study, we explored representations, levers, and barriers to physical activity and mHealth interventions among inactive breast cancer patients with fatigue. METHODS: This was an exploratory, qualitative study including breast cancer patients from a French cancer center. A total of 4 focus groups were conducted with 9 patients; 2 independent groups of patients (groups A and B) were interviewed at 2 consecutive times (sessions 1 to 4), before and after their participation in a 2-week mHealth group experience consisting of (1) a competitive virtual exercise group activity (a fictitious world tour), (2) participation in a daily chat network, and (3) access to physical activity information and world tour classification feedback. We used a thematic content analysis. RESULTS: Several physical activity levers emerged including (1) physical factors such as perception of physical benefit and previous practice, (2) psychological factors such as motivation increased by provider recommendations, (3) social factors such as group practice, and (4) organizational factors including preplanning physical activity sessions. The main barriers to physical activity identified included late effects of cancer treatment, lack of motivation, and lack of time. The lack of familiarity with connected devices was perceived as the main barrier to the use of mHealth as a means to promote physical activity. The tested mHealth group challenge was associated with several positive representations including well-being and good habit promotion and being a motivational catalyzer. Following feedback, modifications were implemented into the mHealth challenge. CONCLUSIONS: mHealth-based, easily accessed group challenges were perceived as levers for the practice of physical activity in this population. mHealth-based group challenges should be explored as options to promote physical activity in a population with fatigue after breast cancer.