Personal Activity Intelligence e-Health Program in People with Type 2 Diabetes: A Pilot Randomized Controlled Trial

Abstract

Introduction: Innovative strategies are needed to enable people with type 2 diabetes (T2D) to self-manage physical activity (PA). Personal Activity Intelligence (PAI) is a new metric that uses the heart rate response to PA to inform the user as to whether they are doing enough PA to reduce the risk of premature mortality. The PAI score reflects PA over the previous 7 d with the goal to maintain a score ≥100. The aim of this study was to investigate the feasibility, acceptability, and efficacy of the PAI e-Health Program in people with T2D. Methods: Thirty participants with T2D who were not meeting PA guidelines were randomly assigned to 12 wk of either 1) PAI e-Health Program or 2) PA attention control. The PAI e-Health Program consisted of receiving a wrist-worn heart rate monitor and an app with the PAI metric, and attending 4 Â 2 h•wk −1 sessions of exercise and counseling. Feasibility and acceptability of the program were evaluated by achievement of a PAI score ≥100 and participant feedback. Efficacy was determined from changes in glycemic control, cardiorespiratory fitness, exercise capacity (time-on-test), body composition, sleep time, and health-related quality of life. Results: Program participants in the PAI e-Health Program had a mean ± SD PAI score of 119.7 ± 60.6 and achieved ≥100 PAI on 56.4% of the days. The majority of participants (80%) intended to continue to use PAI monitoring. Compared with control, the PAI group significantly improved their exercise capacity (mean difference, 95% confidence interval) (63 s, 17.9-108.0 s), sleep time (67.2 min, 7.2-127.1 min), total percent body fat (−1.3%, −2.6% to −0.1%), and gynoid fat percent (−1.5%, −2.6 to −0.5). Conclusions: The PAI e-Health Program is feasible, acceptable, and efficacious in people with T2D.

Effect of personal activity intelligence (PAI) monitoring in the maintenance phase of cardiac rehabilitation: a mixed methods evaluation

“…At the end of the trial period, many participants indicated they were intending to continue to wear the smartwatch and monitor PAI or were still considering continuation. This is line with the pilot randomised PAI e-health program used for people with type 2 diabetes which reported 80% of participants intended to continue PAI monitoring [ 9 ]. Participants stated they would recommend the device to others based on their interest in the PAI concept and its ability to monitor their health.…”

“…Several studies utilising the PAI algorithm have been conducted across China and America [ 25 , 35 – 37 , 51 ]. Recently, a randomised controlled trial was implemented which monitored PAI in people with diabetes [ 9 ].…”

Temporal changes in personal activity intelligence and the risk of incident dementia and dementia related mortality: A prospective cohort study (HUNT)

“… 29 Others demonstrated that individuals with type 2 diabetes using PAI (PAI-App and wearable heart rate monitor) over 12 weeks significantly increased their exercise capacity and sleep time, and decreased body fat percentage and sex-specific adiposity when compared with their peers following contemporary PA recommendations. 16 The introduction of PAI in everyday life has the potential to turn a theoretical association of PA into a daily encouraging process through monitoring and challenging the device-wearer to achieve a practical goal every day. Sharing this metric with physicians may motivate and encourage patients to augment their PA to increase weekly PAI scores.…”

“…Healthy individuals who regularly attain a weekly PAI score ≥100 have high age- and sex-specific CRF levels, more favourable cardiovascular risk factor profiles 14 , 16 , 17 and a lower risk of all-cause and cardiovascular mortality when compared with their inactive counterparts, independent of whether contemporary PA recommendations are met or not. 18 , 19 Regularly obtaining a weekly PAI score ≥100 has also been associated with a reduced risk of premature mortality in patients with established cardiovascular disease (CVD) 20 when compared with their inactive counterparts.…”

“…A PAI score of 100 per week can be obtained by performing any type of PA volume and intensity if heart rate is elevated above a certain threshold often enough. 15 Healthy individuals who regularly attain a weekly PAI score ≥100 have high age-and sex-specific CRF levels, more favourable cardiovascular risk factor profiles 14,16,17 and a lower risk of all-cause and cardiovascular mortality when compared with their inactive counterparts, independent of whether contemporary PA recommendations are met or not. 18,19 Regularly obtaining…”