With the plethora of physical fitness apps available on various mobile app stores across multiple devices, it’s a wonder no one has gotten around to determining their effectiveness in motivating user’s exercise habits.

Foregoing the anecdotal evidence available, there has been little research done on apps overall to determine their impact on patient health.

This goes for apps that monitor diet, vitals, lab data, physical activity, medication adherence, and more.

As such, there is ample room for innovative researchers to investigate the rise of mobile apps and device impact on patient care. Some researchers are already pioneering the field of apps for physical activity. They are using small population samples that have been tracked using apps — many of the studies have yielded positive results [1-3]. However, as one study noted, a randomized control trial is needed to help elucidate the exact impact of an app on physical activity [3].

Recognizing this wide playing field, researchers from the National University of Ireland in Galway, Ireland, are launching a two-group parallel randomized control trial to investigate whether an app can increase physical activity in terms of the number of steps taken a day [4]. Patients will be included if they are over the age of 16 and are an active Android phone user.

Exclusion criteria includes non-Android smartphone users, those with acute psychiatric illness, pregnant women, and those that cannot undertake moderate exercise. The patients will have their phones loaded with Accupedo, which will run in the background but be inaccessible to the user. They will engage in normal activity for one week to establish a baseline of activities, whereupon the intervention group will have Accupedo activated and advised to achieve 10,000 steps per day. In comparison, the control group will be advised to walk an additional 30 minutes a day, and their phone will be engaged to send data to the researchers.

The study will continue for a further 7 weeks, with follow-up. The primary objective consists of determining the mean number of steps taken over the length of the study. Secondary objectives include changes in blood pressure, heart rates, BMI, and a psychological evaluation.

Several facets of this study are very intriguing. The rational supplied by the authors in the selection of their app, and the device, should be recognized by future researchers. Accupedo was chosen based upon the papers by Boulos et al and Rabin et a [5,6]. Based upon those studies, Accupedo was deemed to be suitable as it was easy to download, easy to use, has an active step count, data sharing, can run in the background, and is affordable [4]. The Android based smartphone was chosen because it was the only OS to support Accupedo. However, at this time an iOS version is available.

This study is very exciting, as it is one of the first RCTs coming out evaluating mobile apps in practice. At iMedicalApps, our recent evaluations of mHealth research has found lack of efficacy, with numerous studies identifying failures of app design, outcomes, and information provided. This next phase in app studies may help push the field of mHealth further, and lend credence to their utilization in practice.

References

1. Turner-mcgrievy GM, Beets MW, Moore JB, Kaczynski AT, Barr-anderson DJ, Tate DF. Comparison of traditional versus mobile app self-monitoring of physical activity and dietary intake among overweight adults participating in an mHealth weight loss program. J Am Med Inform Assoc. 2013;20(3):513-8.
2.Vankipuram M, Mcmahon S, Fleury J. ReadySteady: app for accelerometer-based activity monitoring and wellness-motivation feedback system for older adults. AMIA Annu Symp Proc. 2012;2012:931-9.
3.Carter MC, Burley VJ, Nykjaer C, Cade JE. Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. J Med Internet Res. 2013;15(4):e32.
4.Glynn LG, Hayes PS, Casey M, et al. SMART MOVE – a smartphone-based intervention to promote physical activity in primary care: study protocol for a randomized controlled trial. Trials. 2013;14:157.
5.Boulos MN, Wheeler S, Tavares C, Jones R. How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX. Biomed Eng Online. 2011;10:24.
6. Rabin C, Bock B. Desired features of smartphone applications promoting physical activity. Telemed J E Health. 2011;17(10):801-3.