Influence Of Monetary Incentives On Exercise Compliance & Health Among Hyperglycemic Adults: Preliminary Analysis.

Abstract

A major obstacle in exercise-based rehabilitation is exercise compliance. Monetary incentives are associated with greater exercise compliance and improvements in health, yet an ideal monetary system has yet to be identified. PURPOSE: To examine exercise compliance and health outcome measures associated with fixed- vs. incremental-loss monetary systems during an exercise training in a clinical population. METHODS: 17 male (n=7) and female (n=10), previously inactive (no planned physical activity), hyperglycemic (T2DM, n=9; pre-diabetes, n=8), adults (53±2 yrs.) completed a supervised exercise training program (3 days/wk for 8 wks). All participants started with $48 ($6/wk x 8 wks). For the fixed-loss group, $2 was deducted for each missed exercise session. For the incremental-loss group, progressively more was deducted for each session missed per week: $1 for the first, $2 for the second, and $3 for the third/final session of the week. Exercise compliance, body fat percentage ([BF%] assessed via dual x-ray absorptiometry), and fitness determined by a 6-minute walk test (6MWT) were assessed before and after exercise training. Similar to cardiopulmonary rehabilitation programs, acute responses to exercise including heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, as well as blood glucose were monitored immediately before and 5-minutes after each exercise session. RESULTS: Exercise compliance was similar between the fixed- vs. incremental-loss group (90±4% vs. 92±3%, p=0.63). No significant differences were observed between groups or in response to exercise training for BF%. Similar improvements were observed in the 6MWT for the fixed-loss (1534±99 vs. 1799±99 ft., p<0.001) and incremental-loss (1455±93 vs. 1585±93 ft., p=0.04) groups. Similar reductions were also observed in average acute blood glucose response from pre to post-exercise in the fixed- (131±18 vs. 114±11 mg/dL, p=0.03) and incremental-loss (152±23 vs. 132±19 mg/dL, p=0.01) group. No significant differences were detected in acute response to exercise for HR, SBP or DBP. CONCLUSION: Regardless of loss system, modest monetary incentives appear to promote high exercise compliance that was associated with meaningful health benefits including improved fitness and blood glucose control for hyperglycemia individuals.