Gamifying exercise boosted physical activity among patients with peripheral artery disease
A fully home-based intervention for patients with peripheral artery disease used gamification and automated coaching to increase patients' average daily step count by nearly 2,000 steps over the course of a 16-week intervention and eight-week follow-up.
Gamification increased physical activity in patients with peripheral artery disease (PAD) compared with usual care and a control intervention, a randomized clinical trial found.
To assess an intervention to improve supervised exercise therapy for walking performance, the trial, conducted from October 2020 through January 2024, provided patients with a wearable fitness tracker. After a two-week run-in period to calculate a baseline step count, each patient was told their baseline step count by text message and asked to select a goal step increase of 33%, 40%, or 50% above their baseline, or a custom goal at least 1,500 steps greater than their baseline.
Patients were randomized to attention control (n=52) or to the gamification intervention (n=51). The gamification group was entered into a 16-week game involving points and levels that was run automatically. Participants also picked a family member or friend to receive an email each week summarizing their performance and got automated biweekly text messages providing education and motivation. Attention control patients received a daily message telling them whether they had met their step goal the previous day. No intervention occurred during an eight-week postintervention follow-up period. Results were published Dec. 3 by the Journal of the American Heart Association.
Compared with controls, gamification participants had a greater increase in mean daily steps from baseline during the intervention period (adjusted difference, 920 steps [95% CI, −22 to 1,861 steps]; P=0.06) that became statistically significant during the follow-up period (adjusted difference, 1,074 steps [95% CI, 133 to 2,015 steps]; P=0.03). The gamification group also reported a clinically meaningful reduction in exertional lower-extremity symptoms.
“The intervention tested in this trial represents the first fully home-based, fully automated approach to increase physical activity in patients with PAD, a population that benefits greatly from increasing physical activity but faces challenges in accessing effective center-based exercise programs,” wrote the study authors. “This intervention may represent a scalable approach for increasing physical activity in patients with PAD who are not able to participate in supervised exercise therapy.”