Comparative Effectiveness of Social Physical Play and Traditional Exercise Programming

Study Overview
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Brief Summary
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This study will compare the impact of traditional group fitness versus a game-based fitness program, designed to maximize enjoyment, on physical fitness.

Detailed Description
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Fewer than 1 in 10 middle-aged US adults get the recommended amount of aerobic physical activity (PA), greatly increasing their chances of heart disease and stroke. There are over 50 million adults with fitness center memberships, which are used only once per month and, after joining new programs, people quickly stop coming. While many barriers to PA have been cited (e.g., time, cost), the investigators believe that a key, modifiable, and underappreciated barrier is that most adults simply do not enjoy physical activity enough to do it regularly. Studies consistently observe that people who enjoy physical activity more are more likely to be more active in the future. Despite this consistent observation, the investigators are not aware of studies that ask Would an adult PA program designed to maximize enjoyment increase PA adherence and fitness?. In 2015, our team set out to design an exercise program for adults that maximized enjoyment. Taking inspiration from Pickleball, a popular game of modified tennis, our team created PlayFit. PlayFit is an exercise program in which adults come together three times each week to play a range of sports, all modified to 1) reduce effort (e.g., smaller playing area), 2) reduce injuries (e.g., lightweight low-pressure balls) and 3) reduce competitiveness (e.g., teams chosen randomly, minimize physical contact, no keeping score). Pilot work in the summer of 2016 with 22 adults identified five modified sports that all had Metabolic Equivalent (MET) levels between 5.5 and 6.5 and high satisfaction scores (average of 8.0 out of 10). More importantly, the comments suggest that the investigators have created a social, enjoyable experience: that was SO much fun, I've never had so much fun playing soccer. People liked the laughter during the games, no pressure, not competitive and that it's not about ability, it's just about having fun with people. In this study, the investigators propose testing whether PlayFit leads to greater fitness gains, compared to group fitness, to help providers understand in a way that helps providers and fitness center staff understand: What exercise program should I recommend to promote long-term adherence and fitness?. All subjects will be expected to exercise three-times weekly for 60 minutes for 12 months. The investigators will randomly assign 360adults to two conditions: 1) Group Fitness activities and 2) PlayFit. The investigators hypothesize that both PlayFit and Group Fitness will increase Maximum Oxygen Uptake (V02max) significantly at 6 months but, after 12 months, mediated by greater enjoyment and higher adherence, participants randomized to PlayFit will have greater fitness and activity gains at 12 months than Group Fitness. The results of this study have the potential to help patients, providers and fitness center directors by answering the question: What exercise program should be recommended to sedentary adults in order to promote long-term adherence and fitness?

Official Title
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Comparative Effectiveness of Social Physical Play and Traditional Exercise Programming

Conditions
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Group Fitness (Traditional), Group Fitness (Game Play-based)

Intervention / Treatment
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* Behavioral: Group Fitness
* Behavioral: PlayFit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18+ Sedentary (<90 minutes of self-reported moderate-vigorous activity each week) Health care provider must give permission. Exclusion Criteria: History of heart disease, stroke or chest pain. Participating in another research study involving physical activity or weight loss. Planning to have surgery or move in the next year.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Increases in perceived enjoyment lead to increases in physical activity adherence which lead to increases in physical fitness
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group Fitness<br>Subjects will be offered several sessions per week of a traditional group fitness program led by a trained group leader. | Behavioral: Group Fitness<br>* Traditional Group Fitness consisting of aerobic and strength exercises performed in a group setting and led by a trained instructor.<br>|
| Active Comparator: PlayFit<br>Subjects will be offered several sessions per week of a modified sports fitness program, led by a trained group leader. | Behavioral: PlayFit<br>* Modified sports fitness exercise program consisting of games played in groups and led by a trained instructor.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximum Oxygen Uptake (V02Max) | Maximum Oxygen Uptake (V02Max), a measure of aerobic Fitness, will be assessed using a maximal graded treadmill test, using a Bruce protocol and heart rate and expired gas monitoring (74). V02Max is calculated based on the millilitres of oxygen consumed per kilogram of body mass per minute (e.g., mL/(kg·min)). | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Minutes of Moderate-Vigorous Physical Activity (MVPA) | Minutes of Moderate-Vigorous Physical Activity (MVPA) will be measured using an Actigraph GT3X tri-axial accelerometer, which can measure the intensity of PA and the frequency/pattern of activity over time. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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fitness, exercise, physical activity