Exercise as it relates to Disease/There's an app for that- Mobile applications and the influence of physical activity among young people

This is a journal analysis of the paper 'Smartphone apps to improve fitness and increase physical activity among young people: protocol of the Apps for IMproving FITness' by A.Direito and colleagues. The analysis was conducted by a student from the University of Canberra in the subject: Health Disease and Exercise

What is the background to this research?
One of the top ten risk factors for global mortality is Inactivity or an insufficient amount of physical activity (PA) The World health organisation recorded in 2010 that that 81% of students between the ages of 11–17 years were in sufficiently active (doing less that 60mins of moderate to vigorous exercise). In this study 84% of girls were not meeting the physical activity recommendations, while 78% of boys did not. Given the global severity of the outcome of insufficient activity and the large percentage of children/adolescents not reaching the recommended limit, an effective intervention must be developed.

As our world develops more and more everyday, our technology becomes more relied upon and can even encourage a sedentary lifestyle. In 2014 73% of teenagers, between 13-17years owned a Smartphone, which is a dramatic increase from 37% in the United States This high usage and ownership of smart phones creates an opportunity to engage in promoting the use of mobile fitness applications.

Where is the research from?
Artur Direito and colleagues conducted this paper over The Faculty of Medical and Health Science, national Institute for Health innovation and the University of Auckland, Auckland NewZealand in 2016

What kind of research was this?
This research study was a 3-arm, parallel-randomised control trail.

What did the research involve?
Participants of the study joined through advertisements in newspapers, mailing lists and flyers in community settings and schools. Eligable participants had to be between the ages of 14 and 17 year, owned a smart phone or ipod touch and were capable but not achieving the PA recommendations. 51 The adolescents were chosen and split into 1 of 3 groups (Control, Immersive app- 'Zombie run', and non-immersive app – 'Get running'). To set a baseline comparison participants were recorded through a cardiovascular fitness test, (1mile walk/run) self reported questionnaires on PA and psychological variables, and wore an accelerometer. The control group was told to continue their normal exercise regime, the Immersive app group were given the app ‘Zombie, Run’ a theme based narrative application and the non-immersive group’s app was ‘ Get running’ where participants would record and be reminded of weekly runs. This study ran for a total of 8 weeks, and participants visited 3 times during the study.

What were the basic results?
Direito and colleagues found a increase in the primary outcome- being the cardiovascular fitness test when compared to the control group (immersive app group completed 28.4 sec faster, and the non-immersive group completed the test 24.7 sec faster), the increase was not significant. The secondary outcomes addressed the questionnaire and accelerometer. There were no effects found for the self reported questionnaires or perceived enjoyment, competence, or self -efficacy. The accelerometer also did not have a significant effect on the average time spent engaging in moderate to vigorous physical activity.

How did the researchers interpret the results?
The researchers interpreted these results as an insignificant way to improve the physical activity in adolescents, despite the abundance of mobile fitness applications to improve health behaviour. While fitness applications have the potential to change our behaviour towards PA and health the researchers found their results are also consistent with similar studies, with approximately only 20% of participants consistently using the app.

What conclusions should be taken away from this research?
While mobile fitness applications promote a change in lifestyle, the apps alone do not improve fitness an promote PA in adolescents. Smart phones and applications among young people are increasing, more influential or individual approaches with the applications may provide extra encouragement to continuous use.

What are the implications of this research?
Self reported questionnaires can often be skewed, as the participant is more likely to overestimate the actual level of physical activity. One of the biggest limiting factors of this paper is the use of only two applications. While two applications are easy to follow and record changes among participants, not every person will respond to the same stimuli.