Exercise and Technology to Reduce Risk in a Rural Population With Metabolic Syndrome
Condition: Metabolic Syndrome X
MeSH terms: Metabolic Syndrome; Syndrome
Study type: Interventional

Summary: 
      Cardiovascular diseases are the leading cause of death among Canadians. In those with
      diabetes, cardiovascular complications are responsible for more than 70% of deaths. While
      there is much interest in identifying and treating risk factors, the exact biological
      mechanisms, their measurement and optimal ways to prevent and manage them are poorly
      understood.

      Physical activity and regular exercise can prevent diabetes and effectively manage risk
      factors, but most Canadians do not exercise enough to beneficially manage risk. Tailored
      exercise prescribed by a family physician has shown promise as a means to increase fitness
      and reduce risk, but optimal implementation practices remain unknown - especially in rural
      and remote communities with reduced access to healthcare. Mobile health technologies have
      proved to be a beneficial tool to achieve blood pressure and blood glucose control in
      patients with diabetes. These technologies may address the limited access to health
      interventions in rural and remote regions. However, the potential as a tool to support
      exercise-based prevention activities unknown.

      Therefore, this study was undertaken to investigate the effects of a tailored exercise
      prescription alone or supported by mobile health technologies to improve cardiovascular risk
      factors in rural community-dwelling adults at risk for cardiovascular disease and type 2
      diabetes.

      Adults with cardiovascular risk factors were recruited from rural communities and randomized
      to either: 1) an intervention group receiving an exercise prescription and devices for
      monitoring of risk factors with a smartphone data portal equipped with a mobile health
      application; or 2) an active control group receiving only an exercise prescription.

      It was hypothesized that the intervention group would reduce their risk to a greater extent
      than the active control group following 12 weeks, and that these improvements would be better
      maintained in the intervention group at 24 and 52 weeks compared to the active control group.
    


Intervention name(s): Mobile Health; Exercise Prescription
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants monitored their blood pressure 3x per week, blood glucose 1x per week, pedometer steps daily and body weight monthly. Measures from devices were transferred or inputted to a smartphone data portal. Planned exercise was logged electronically on the smartphone.; An exercise program was prescribed tailored to participant fitness level (using the Step Test Exercise Prescription (STEP-TM) protocol). Briefly, STEP-TM required participants to step up and down a set of 2 steps 20 times at a comfortable pace. A predictive equation including post-test heart rate, time to complete test, age, body weight and sex was used to calculate fitness. An exercise program was prescribed including aerobic exercise most days of the week for 30-60 minutes in duration at a target heart rate tailored to fitness level. Light resistance training was also prescribed 2-4 times per week.
Allocation: Randomized
Intervention model: Parallel Assignment
Primary purpose: Prevention
Keywords: Mobile health; Metabolic syndrome; Exercise prescription; Exercise intervention; Disease prevention; Rural health