Exercise as it relates to Disease/Can your smartphone help you become more physically active?

this is an analysis of "Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled by trial by L. Glynn, P. Hayes, M. Casey, F. Glynn, A. Alvarez-Iglesias, J. Newell, G. ÓLaighin, D. Heaney, M. O'Donnell and A. Murphy, 2014"

statement: this has been created by U3100647.

What is the background to this research?
The reduction of the amount Physical activity being conducted and the increase in rates of obesity are major public health issue around the world. According to the world health organisation in 2008 Globally, around 31% of adults aged 15 and over were Physical inactivity (men 28% and women 34%) and approximately 3.2 million deaths each year are attributed to insufficient levels of physical activity.

In Australia from 2011–2012 60% of the adult population did not meet the recommended levels of physical activity per day and nearly 70% of Australian adults are either sedentary or have low levels of physical activity.

Figure 1: Prevalence of insufficient physical activity in persons aged 18 and over, by sex, 2011–12



Source: AIHW analysis of unpublished ABS 'Australian Health Survey, 2011–12.

These levels of physical inactivity are alarming as physical inactivity has been linked to increased risks of devolving a number of different conditions including:

•	High blood pressure

•	Coronary heart disease’s

•	Stroke

•	Breathlessness

•	Stiff joints

•	Poor posture

•	Osteoporosis

•	Mental health issues (anxiety, depression, etc.)

•	Certain cancers

•	Overweight/ Obesity

so finding a way to increase the amount of physically activity people are doing every day is vital to assist in improving not only the health of Australians but the health of the entire world. At the same time advancements in technology have allow for the creation of smart phones and applications on them devices that promote physical activity, and with 79% of the Australian population under the age of 55 owning a smart phone, is the use of these apps and effective away to promote and increase the amount of physical activity being conducted.

Where is the research from?
This research was conducted at the National University of Ireland, with the primary researcher being a senior faculty member of the national university of Ireland. He has 96 publications in the area of health and every member on his team has between 4 and 179 publications each. Funding for this research was awarded by the European Union’s Northern Periphery Program 2007–2013.

What kind of research was this?
This research was an 8-week, open-label, randomised controlled trial in rural, primary care in the west of Ireland, which consisted of a control group and an intervention group. randomised controlled trial are if conducted correctly as the gold standard in reach

What did the research involve?
This randomised controlled trial had participants who were Android smartphone users of >16 years of age. In the study they provided all participants with similar physical activity goals and information on the benefits of exercise. The intervention group was provided with a smartphone app and detailed instructions on how to use it to achieve these goals. The way the study measured change in physical activity was by measuring the difference in daily steps count between the baseline and the follow-up. There method used to test for improvements in physical activity is a common test used by many organisations and publication to test levels of physical activity. with technology becoming more mainstream that counts your steps it’s also an easy way for health professionals to be able to simply represent to a client what their level of activity is.

What were the basic results?
From the two study groups (the control and the intervention group) a total of 90 participants were involved. Before the start of the intervention the average baseline daily step count at for intervention and control groups was 4365 and 5138 steps per day respectively. At the end of the 8-week intervention the average step count for the control group actually decreased by 386 steps, whereas for the intervention group at the end of the 8 weeks the average step count went up by a 1,631 step. along with the step count they also took basic health checks and they found that the intervention group had slight improvements in systolic and diastolic blood pressure as well as body weight.

From this the researchers concluded that the use of the smartphone app did increase physical activity over the 8-week period. And with the improvement of steps being over 1000 steps per day they concluded that this magnitude in change is clinically meaningful and, if continued, is expected to result in long term health benefits such as reduced cardiovascular and diabetes risk.

What conclusions can we take from this research?
From this research we can conclude that the use of smart phone apps can assist in the improvement of physical activity, at least for an 8-week period. With that though an improvement of over 1,500 steps a day is excellent for someone that is currently physically inactive and it will assist in decreasing their chance of developing other health issues. But the main issue is, will the participant keep using the apps after the 8-week period.

Another issue with this is there are a large number of smart phone applications available to the public some free others you have to pay for. Which this is good but of all those apps the challenge is to find the applications that actually work in improving physically activity, be that though an interactive game or a simpler apps like the step counter that was used in this study. finally once it has improved the physically activity of the person will it keep the person physical active or will they just use it for a while then no longer us it. As coherence to any physical activity is an issue with lot of interventions and this will more then likely be no exception in this one.

Practical advice
The use of a smartphone application to assist in the improvement of physical activity can and has been shown to be able ton make some major improvements in the amount of physically activity being conducted. But along with the use of the smart phone application, behavioural changes will also need to take place otherwise the likely hood that improvements in physically activity maintained are low.

From a clinical (and personal training) view the use of smart phones apps may be useful for helping track what the client has done and as a way for them to be held more reliable for what physical activity they are doing, outside of their clinical (personal training) sessions.

But keep in mind that this method won’t work for everyone, as smart phones go flat, and also not all applications are available across all devices

Further information/resources
•	Effectiveness of a smartphone application for improving healthy lifestyles, a randomized clinical trial (EVIDENT II): study protocol, J. Recio-Rodríguez, C. Martín-Cantera, N. González-Viejo, A. Gómez-Arranz, M. Arietaleanizbeascoa, Y. Schmolling-Guinovart, J. Maderuelo-Fernandez, D. Pérez-Arechaederra, E. Rodriguez-Sanchez, M. Gómez-Marcos, L. García-Ortiz, http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-254

•	Better health with smartphone apps, Harvard Health publications, http://www.health.harvard.edu/staying-healthy/better-health-with-smartphone-apps

•	How to pick the good from the bad smartphone health app, theconversation, http://theconversation.com/how-to-pick-the-good-from-the-bad-smartphone-health-apps-58508

•	Mobile Devices and Apps for Health Care Professionals: Uses and Benefits, C. Ventola, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029126/

•	The Future of Medicine Is in Your Smartphone, ERIC J. TOPOL, http://www.wsj.com/articles/the-future-of-medicine-is-in-your-smartphone-1420828632