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PAI e-Health with Type 2 Diabetes

Study Summary Medicine & Science in Sports & Exercise, American College of Sports Medicine

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

The aim of this study was to investigate the efficacy, feasibility, acceptability and safety of a PAI (Personal Activity Intelligence) e-Health Program for people with Type 2 Diabetes (T2D).

For this 12-week study, 30 participants already diagnosed with T2D who were not meeting PA (physical activity) guidelines were randomly assigned to either the PAI e-Health program or the PA attention control group.

Based on the heart rate response to physical activity, PAI provides an individualized metric that enables people to track their own PAI score. The higher the intensity of activity, the faster PAI points are amassed. An individual’s PAI score reflects their PA from the past 7 days. To minimize the risk of premature mortality, the maintenance of a PAI score of ≥100 is ideal.

Inspired by participant feedback from prior PAI related studies, researchers at the Centre for Research on Exercise at the University of Queensland created the PAI e-Health Program. To increase the effectiveness of the PAI approach, this unique program design integrates support for behavior change, in addition to experience with diverse PA intensities. Evaluation of the efficacy of the PAI e-Health Program was based on glycemic control, exercise capacity, body composition, cardiorespiratory fitness, duration of sleep and participants’ health related quality of life, as compared with the PA attention control group. Feasibility and acceptability were based on participant feedback and their achievement of scores of ≥100 PAI.

Participants attended 4 sessions for assessment — 2 of which involved baseline testing prior to the trial, and 2 sessions took place 12 weeks post-trial. Glycemic control and other relevant profiles and physical measurements were taken and a quality of life survey was issued.

Using the PAI metric, participants in the PAI e-Health Program downloaded the PAI Health APP to be used with their wrist-worn heart rate monitors. Individuals in the PA attention control group were supplied with a pamphlet detailing the importance of exercise in diabetes management and the suggestion to accumulate 210 minutes per week of moderate exercise or 125 minutes per week of vigorous exercise. It should be noted that during the trial, 2 participants in the intervention group and 3 in the control group withdrew.

Findings showed that participants in the intervention group were able to maintain ≥100 PAI. The PAI e-Health group earned an average PAI score of 119.7, with participants achieving ≥100 PAI on 56.4% of the days. Significant health benefits are realized by the maintenance of a PAI Score of ≥50, and participants achieved this on 79.6% of the days.

Ultimately, the PAI e-Health group improved their capacity for exercise (63 s longer during the CPET than the control group), and lost 1.3% more body fat percentage compared with the control group.

An unexpected, yet noteworthy finding involved the extended duration of sleep experienced by the intervention group. Intervention participants slept 67.2 minutes per night longer than the control group. Given the strong evidence that sleep disturbances are a common issue for people with T2D, in addition to the marked relationship between short sleep duration and elevated HbA1c, this would be an interesting subject for future studies.

In terms of acceptability, 80% of participants who completed this study stated their intention to continue using PAI monitoring.

This study concluded that the PAI e-Health Program is feasible, efficient, acceptable and safe for the T2D population. Clinicians often have difficulty communicating personalized exercise recommendations for people with T2D, and wearable technology combined with applications such as PAI can be useful in supporting patient behavior change and self-regulation.

To read the full study click here

Reference: Medicine & Science in Sports & Exercise. The American College of Sports Medicine
Personal Activity Intelligence e-Health Program in People with Type 2 Diabetes: A Pilot Randomized Controlled Trial
Jeff S. Coombes1, Shelleye.Keating1, Gregore I. Mielke1, Robert G.. Fassett1, Brookek.Coombes2,
Kaitlyn P. O’leary1, Emily R. Cox1, And Nicola W. Burton3
1Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of
Queensland, St. Lucia, Queensland, AUSTRALIA; 2School of Allied Health Sciences, Griffith University, Queensland,
AUSTRALIA; and 3School of Applied Psychology, Griffith University, Brisbane, AUSTRALIA

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