Abstract
BackgroundExergaming is a novel approach to increase motivation for regular physical activity (PA) among sedentary individuals such as patients with type 2 diabetes mellitus (T2DM). Because existing exergames do not offer fitness-level adjusted, individualized workouts and are normally stationary (TV bound), thus not enabling PA anywhere and at any time, we developed a smartphone-based, game-like software application (MOBIGAME) specifically designed for middle-aged T2DM patients to induce a healthier, more active lifestyle as part of successful T2DM treatment and management. In a randomized controlled trial we aim to examine whether our smartphone-based game application can lead to increases in daily PA in T2DM patients that are persistent in the mid to long term and whether these increases are greater than those in a control group.MethodsThis study is designed as a randomized controlled trial. We plan to recruit a total of 42 T2DM patients [45-70 years, body mass index (BMI) ≥25 kg/m2, low daily PA, regular smartphone use].The experimental intervention (duration 24 weeks) includes individualized multidimensional home-based exercise and daily PA promotion administered through MOBIGAME. The control intervention consists of a one-time standard lifestyle counseling including the promotion of baseline activities.The primary outcome is daily PA measured as steps per day. Secondary outcome is exercise adherence measured via the usage data from the participants’ smartphones (experimental intervention) and as self-recorded exercise log entries (control intervention).We will test the hypothesis that there will be differences between the experimental and control group with respect to post-interventional daily PA (as well as all other outcomes) using analysis of covariance. For each analysis, an estimate (with 95% confidence interval) of the difference in outcome between both groups will be reported.DiscussionThis research will investigate the effectiveness of a novel smartphone-based, game-like software application to be used as a way to promote regular daily PA among inactive T2DM patients. The results of this trial may have important implications for future PA-promoting interventions and provide relevant information for the general transferability of such applications to be used as part of the treatment in other chronic diseases.Trial registrationClinicalTrials.gov, NCT02657018. Registered on 11 January 2016. Last status update on 3 May 2016. Kofam.ch, SNCTP-number:SNCTP000001652. Registered on 21 January 2016.
Highlights
Exergaming is a novel approach to increase motivation for regular physical activity (PA) among sedentary individuals such as patients with type 2 diabetes mellitus (T2DM)
Individuals who engage in regular PA, such as the American College of Sports Medicine (ACSM) recommended 30 min of brisk walking on 5 days per week, have a 30% lower risk of developing T2DM as compared to sedentary individuals [13, 15]
PA is a crucial component in the prevention as well as treatment of T2DM [7,8,9,10,11,12] and its comorbidities [13,14,15]
Summary
Exergaming is a novel approach to increase motivation for regular physical activity (PA) among sedentary individuals such as patients with type 2 diabetes mellitus (T2DM). The direct and indirect medical costs accrued by patients with T2DM in the US in 2012 accounted for an estimated $245 billion, while people diagnosed with diabetes created 2.3 times higher average medical expenditures than people without diabetes, underlining the enormous financial burden that is caused by this disease. Both obesity and T2DM are associated with a high level of inactivity [3, 4] that aggravates the physical and mental health status and constitutes a crucial factor in the development of several comorbidities such as hypertension, dyslipidemia, cardiovascular disease, and kidney and nerve disease [2]. Chronic effects of both aerobic and resistance training include improvements in insulin action, blood glucose control and fat oxidation [13]
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