Effect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease

McDermott, Mary M.; Spring, Bonnie; Berger, Jeffrey S.; Treat‐Jacobson, Diane; Conte, Michael S.; Creager, Mark A.; Criqui, Michael H.; Ferrucci, Luigi; Gornik, Heather L.; Guralnik, Jack M.; Hahn, Elizabeth A.; Henke, Peter K.; Kibbe, Melina R.; Kohlman-Trighoff, Debra; Li, Lingyu; Lloyd‐Jones, Donald M.; McCarthy, Walter J.; Polonsky, Tamar S.; Skelly, Christopher L.; Tian, Lü; Zhao, Lihui; Zhang, Dongxue; Rejeski, W. Jack

doi:10.1001/jama.2018.3275

Cited by 175 publications

(191 citation statements)

References 42 publications

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“…Only one study included adolescents [ 93 ]. Thirteen studies included young adults (age 18-43.9 years) [ 73 , 77 , 79 , 81 - 83 , 86 , 90 , 91 , 94 , 97 , 99 , 102 ], 17 studies included middle-aged adults (age 44-64.9 years) [ 48 , 49 , 57 , 67 - 72 , 78 , 84 , 87 - 89 , 96 , 103 , 104 ], and six studies included older adults (age ≥65 years) [ 76 , 85 , 92 , 95 , 98 , 101 ].…”

Section: Resultsmentioning

confidence: 99%

“…As expected, there was a wide variety of Fitbit devices used in the included studies. Most of them (17/37, 46%) used clip-on devices such as Fitbit Zip [ 76 , 79 , 82 , 83 , 87 , 88 , 90 , 92 , 96 - 98 ], Fitbit One [ 48 , 68 , 81 , 84 , 94 ], and Fitbit Ultra [ 85 ]. Seven studies did not specify which model was used [ 49 , 67 , 69 , 70 , 95 , 101 , 102 ].…”

Section: Resultsmentioning

confidence: 99%

“…Use patterns with these devices were mentioned in 35% (13/37) of the studies. Beside reporting use or wear durations [ 49 , 88 , 103 ], the studies indicated Fitbit use as the frequency at which the subjects wore the device [ 48 , 67 , 93 , 95 , 96 ] and the number of subjects having Fitbit measurements [ 73 , 82 , 87 , 90 , 92 ]. This information was mainly assessed using device data or it was self-reported.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included some form of PA or other healthy lifestyle education component [ 49 , 67 , 68 , 70 , 72 , 73 , 82 , 84 , 86 , 87 , 90 , 99 , 103 ]. Other studies involved usual care [ 48 , 76 , 78 , 83 , 85 , 88 , 93 , 96 - 98 ], financial incentives [ 68 , 82 ], blinded wearables [ 94 , 101 ], or no intervention at all [ 77 , 79 , 81 , 91 , 92 ]. Participants in some control groups were put on a waiting list to receive the same intervention following a delay [ 57 , 69 , 71 , 89 ].…”

Section: Resultsmentioning

confidence: 99%

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Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Ringeval¹,

Wagner²,

Denford³

et al. 2020

J Med Internet Res

153

113

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Background Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. Objective The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. Methods A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. Results Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD −10.62, 95% CI −35.50 to 14.27; P=.40 and standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. Conclusions The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Ringeval¹,

Wagner²,

Denford³

et al. 2020

J Med Internet Res

153

113

View full text Add to dashboard Cite

show abstract

“…Structured exercise, with supervised exercise being preferred and more effective [3], is part of a comprehensive program to manage disability and cardiovascular risk [4]; however, in recent years, various home-based structured programs have been proposed [2] based on indoor [5,6] or outdoor (guided or assisted by wearable technologic devices, etc.) walking [2,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Don’t stop walking: an in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic.

Lamberti

Straudi

Manfredini

et al. 2020

Preprint

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Aims: We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility in the case of strict movement restrictions.Methods: We considered 83 patients (age 72±11, males n=65) enrolled in a rehabilitation program based on two daily 8-minute sessions of slow intermittent in-home walking at a prescribed cadence with circa-monthly hospital visits. During the lockdown period, the program was updated by phone. The 6-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and postlockdown. Body weight (BW), blood pressure (BP), and the ankle-brachial index (ABI) were also determined.Results: Sixty-six patients were measured 117±23 days after their previous visit. A safe, pain-free execution the prescribed sessions, with a median distance covered of 74 km, was reported. Overall, the 6MWD was stable, while PFWD improved (p<0.001). Decreased BW with stable BP and ABI values were also recorded. When considering the outcome values according to the time of enrollment before the lockdown, new-entry subjects (≤3 months; n=35) obtained significant improvements, while those previously enrolled (>3 months; n= 31) were stable.Conclusion: In PAD patients, a structured exercise program easily performed in a home corridor and guided with phone assistance was adhered to by patients and showed effectiveness in maintaining mobility and risk factor control during the COVID-19 pandemic. Safe structured exercise may involve frail subjects regardless of walking ability, type of home and external conditions.

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Use of a Wearable Activity Monitor in a Home-Based Exercise Intervention for Peripheral Artery Disease

Müllenheim

Ábrahám

Noury-Desvaux

2018

JAMA

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this reason that fosfomycin and nitrofurantoin have come back into use. The population chosen is thus highly relevant.Merely being hospitalized or being infected by an extendedspectrum β-lactamase-producing Escherichia coli is not a known criterion for complicated UTI. As stated in the protocol, women with consensus criteria for complicated UTI were excluded. Fever, an indicator of pyelonephritis (whether uncomplicated or complicated), was an absolute exclusion criterion; no patient with fever was included. We did solicit from patients any feelings of subjective fever, however. Lower back or flank pain and nausea unaccompanied by fever were not absolute exclusion criteria; the few patients presenting with these symptoms were admitted to the study if there were alternate explanations and no objective evidence for pyelonephritis could be found. These patients were evenly distributed between the 2 study groups by randomization.No one knows where the cutoff between recurrence and reinfection lies, probably because there is not one cutoff for all patients. We therefore evaluated on both days 14 and 28 after therapy completion. Whichever may be better, their results were similar: each time point showed statistically significant superiority of nitrofurantoin in both clinical and microbiologic outcomes. The wider difference in success by day 28 argues for recurrence because randomization would have distributed patients with reinfections more evenly.The reviews cited by Barros regarding whether fosfomycin resistance is overestimated include surveillance studies conducted before substantial increases in the drug's use. More recent reports indicate high resistance rates (up to 45% in China, where the drug is being used extensively). 4 Because genes encoding fosfomycin-modifying enzymes are plasmid-mediated, 5 wider increases in resistance are a real concern.We hope that readers do not conclude that fosfomycin is not a useful treatment for uncomplicated UTI. The problem is rather how this agent is administered. A single 3-g dose does not appear to be optimal. Physicians can do better by patients-and by this drug. Strategies for optimized dosing need to be studied.

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Effect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease

Abstract: clinicaltrials.gov Identifier: NCT02462824.

Cited by 175 publications

References 42 publications

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Don’t stop walking: an in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic.

Use of a Wearable Activity Monitor in a Home-Based Exercise Intervention for Peripheral Artery Disease

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