Benefit of Wearing an Activity Tracker in Sarcoidosis
Condition: Sarcoidosis; Fatigue
MeSH terms: Sarcoidosis
Study type: Interventional

Summary: 
      Sarcoidosis causes many disabling symptoms, including fatigue, muscle weakness, and exercise
      limitations. Physical activity programs have been shown to improve physical performance and
      decrease fatigue in sarcoidosis.

      Objectives: The aim of this study was to evaluate (1) the effect of continuous activity
      monitoring using an electronic activity tracker (AT), compared to controls, and (2) the
      effect of additional personal coaching on exercise performance and fatigue of sarcoidosis
      patients.

      Method: This prospective, randomized clinical trial included 54 sarcoidosis patients who
      received an AT (Group Ia: 27 with coaching and Group Ib: 27 without). Exercise capacity and
      fatigue scores (Fatigue Assessment Scale) were evaluated at baseline and after three months.
      A historical group of sarcoidosis patients (Group II; n=41) from an earlier study who did not
      follow a physical activity program served as controls.
    

Detailed description: 
      Sarcoidosis patients often suffer not only from organ-related symptoms but also from
      disabling non-specific, non-organ-related symptoms, such as fatigue, reduced muscle strength,
      loss of physical condition, reduction of physical activity (PA) in daily life and pain.
      Fatigue is the most frequently reported in sarcoidosis patients disregarding the clinical
      presentation, varying from 50 to 90%. This may persist after other signs of sarcoidosis
      activity have resolved, and adversely impacts major life areas, including quality of life
      (QoL) and work ability.

      So far, there is promising evidence for the benefits of physical training in sarcoidosis.
      Interventions involving technology that is readily accessible on a daily basis to monitor
      activity levels can support care providers in encouraging patients to achieve behavioral
      changes. These interventions may be an effective strategy to provide PA-coaching without
      increasing time demands on primary care providers. Moreover, they give patients an
      opportunity to keep up a more active lifestyle with direct feedback and monitor their
      physical performance over time. Counseling, guidance and support using e-health technology
      had been found to be very helpful for patients who want to improve their PA. The use of
      commercially available, technology-based wearable activity trackers (ATs) such as Fitbit is
      growing for research and recreational purposes, both among healthy persons and among those
      with chronic illness. Beneficial effects of AT-based counseling have been demonstrated in
      patients with chronic diseases. In a recent study by our group we found that wearing an AT
      stimulated patients to be more physically active.

      The aim of this study was to evaluate (1) the effect of continuous activity monitoring using
      an electronical AT and (2) the effect of additional personal coaching of sarcoidosis
      patients. The outcome measures were exercise performance and fatigue.

      Intervention All participants received a Fitbit for free. They were encouraged to improve
      their physical fitness, which was assessed at baseline. The patients in the intervention
      group (group Ia) engaged in a three-month physical therapist-guided activity program. The
      guidance was based on the input from the AT and the questionnaires. The weekly FAS scores,
      Fitbit-measured parameters and brief daily questions were combined in a web-based dashboard
      accessible to the assigned physical therapist. The information was used for goal setting,
      encouraging, and identifying barriers and facilitators for patients becoming more active. The
      coaching procedure included weekly action planning and feedback, modelling of behaviors and
      problem solving, and individual decision making by email and/or telephone. The coaching
      physical therapist acted as facilitator, and assisted participants in making choices and
      achieving success in terms of reaching self-selected goals.

      Although the patients in group Ib did not receive the guidance from a physical therapist,
      their daily activity was also computed with the Fitbit Charge HR (Brand name), and patients
      were also able to use a Fitbit and monitor app to monitor their performance, questionnaire
      results and progress.

      Self-report feedback questionnaires at follow-up (12 weeks) were used to determine
      participants' experience with data from the Fitbit tracker itself and coaching, if
      applicable.
    

Intervention name(s): Physical Activity using an Activity Tracker
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This prospective, randomized clinical trial included 54 sarcoidosis patients who received an AT (Group Ia: 27 with coaching and Group Ib: 27 without). Exercise capacity and fatigue scores (Fatigue Assessment Scale) were evaluated at baseline and after three months. A historical group of sarcoidosis patients (Group II; n=41) from an earlier study who did not follow a physical activity program served as controls.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Physical Activity; Exercise Capacity; Activity Tracker