Nike fuel band study

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Presentation given to outline an ongoing research study which is evaluating “The Nike+ Fuelband as a motivational tool to encourage adherence to exercise prescription for the teenager with congenital heart disease”.


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Nike fuel band study

  1. 1. HYPOTHESIS: The Nike+ FuelBand is a motivational tool for exercise prescription in the teenager with congenital heart disease Dr AG Stuart, Cardiologist Sports Cardiology UK
  2. 2. EXERCISE & SPORT “ Exercise is bunk. If you are healthy, you don’t need it, if you are sick, you shouldn’t take it. ” Henry Ford
  3. 3. EXERCISE & SPORT “ If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health. ” Regimen (Book 1) Hippocrates 460-370 BC
  4. 4. REGULAR EXERCISE Regular exercise Incidence General health benefits • Diabetes mellitus • Lipid profile • Colon cancer • Osteoporosis • Anxiety / depression • Dementia • Hypertension
  5. 5. Specific benefits in heart disease “Exercise is one of the cheapest- and most effective- interventions for reducing the morbidity and mortality of cardiovascular disease.” Booth J Appl Physiol 2000;88:774-787 AHA Scientific Statement April 2013 Promotion of Physical Activity in Children and Adults with Congenital Heart Disease Longmuir et al Circulation 2013 DOI:10.1161/CIR.0b013e318293688F “Most patients with congenital heart defects are relatively sedentary” “counselling to encourage daily participation in appropriate physical activity should be a core component of every patient encounter….” REGULAR EXERCISE
  6. 6. HOW DOES EXERCISE HELP?
  7. 7. Q: HOW DOES EXERCISE HELP? • Improving endothelial function • Improving cardiac function • Improving skeletal muscle function A: MULTIFACTORIAL
  8. 8. HEART FAILURE AND EXERCISE “Chronic heart failure is associated with skeletal muscle abnormalities which cause fatigue / lactic acidosis” Hambrecht et al JACC 1997;29:1067-73 Muscle biopsy 41% increase in mitochondrial density, shift from type 11 to type 1 fibres Exercise tests femoral venous lactate related to mitochondrial density not leg blood flow Regular physical exercise increased oxidative enzyme activity in skeletal muscle vs inactive controls6 months exercise training (18 patients)
  9. 9. WHY IS EXERCISE PRESCRIPTION NOT USED?
  10. 10. Q: WHY IS EXERCISE PRESCRIPTION NOT USED? A1: MOST CARDIOLOGISTS DO NOT KNOW HOW TO PRESCRIBE EXERCISE* *Swan 2000, Lewin 2002
  11. 11. < 20% patients given exercise advice (Swan, 2000) < 20% units had exercise program (Lewin, 2002) A1: MOST CARDIOLOGISTS DO NOT KNOW HOW TO PRESCRIBE EXERCISE* *Swan 2000, Lewin 2002
  12. 12. Q: WHY IS EXERCISE PRESCRIPTION NOT USED? A2: MOST EXERCISE PRESCRIPTIONS ARE INEFFECTIVE IN TEENAGERS** **Metcalf 2012
  13. 13. Physical activity interventions have only a small effect in children’s overall activity levels. Approx 4 mins walking / running per day. (Metcalf 2012) A2: MOST EXERCISE PRESCRIPTIONS ARE INEFFECTIVE IN TEENAGERS** **Metcalf 2012
  14. 14. TEENAGERS DON’T LIKE BEING TOLD WHAT TO DO...
  15. 15. GAMIFICATION “The use of game thinking and game mechanics in a non-game context to engage users and solve problems. Used to improve user engagement.”* * Marczwski 2012
  16. 16. THE NIKE+ FUELBAND • 3 axis wrist worn accelerometer • 3 sizes / 2 colours • Set up using • Links to mobile phone / computer • Output : • calories • Nike Fuel Points • steps
  17. 17. THE NIKE+ FUELBAND 1.Setup (age / height / weight)
  18. 18. THE NIKE+ FUELBAND 1.Setup (age / height / weight) 2.Set Goal (say 2,000 points?)
  19. 19. THE NIKE+ FUELBAND 1.Setup (age / height / weight) 2.Set Goal (say 2,000 points?) 3.Join Nike+
  20. 20. THE NIKE+ FUELBAND 1.Setup (age / height / weight) 2.Set Goal (say 2,000 points?) 3.Join Nike+ 4.Sync (phone / computer)
  21. 21. THE NIKE+ FUELBAND
  22. 22. CHARTS OF PROGRESS
  23. 23. REWARDS & SOCIAL CAPITAL
  24. 24. Exercise prescription in the teenager with congenital heart disease THE STUDY Q1: DOES THE USE OF THE NIKE FUELBAND INCREASE PHYSICAL ACTIVITY IN THE STUDY GROUP?
  25. 25. THE STUDY Q2: DO ‘FUEL POINTS’ CORRELATE WITH MEASUREMENTS OF PHYSICAL ACTIVITY USING A CONVENTIONAL UNIAXIAL ACCELEROMETER? Q1: DOES THE USE OF THE NIKE FUELBAND INCREASE PHYSICAL ACTIVITY IN THE STUDY GROUP? Exercise prescription in the teenager with congenital heart disease
  26. 26. • Prospective, intervention study • Adolescents attending BCHC • Identified Heartsuite database • Consent obtained via routine OP review • n =30 ; 13-18yrs old • All requiring long term follow up • Exclusions: learning disability / lack of computer access / recent surgical intervention (<6 months) Exercise prescription in the teenager with congenital heart disease THE STUDY
  27. 27. • Prospective, intervention study • 3 symptom categories • asymptomatic / NYHA 2 / NYHA 3 or 4 • 3 measures of activity • Actigraph • FuelBand • Non weartime diary Exercise prescription in the teenager with congenital heart disease THE STUDY
  28. 28. MEASURES OF ACTIVITY Actigraph 7164 •“Hip worn” •7 day activity counts •10hrs for 4 days minimum Nike FuelBand Non-weartime diary •“Wrist worn” •Daily activity counts •Gamified & social aspects •Enables capture of activity when no accelerometer is being worn Exercise prescription in the teenager with congenital heart disease
  29. 29. • Recruitment Exercise prescription in the teenager with congenital heart disease • Consent • Haemodynamic and clinical assessment • Advised to exercise “as much as possible” up to 60 mins / day PRE LAUNCH STUDY SCHEDULE
  30. 30. • Recruitment • Baseline assessment Exercise prescription in the teenager with congenital heart disease • Actigraph issued • Wear 7 days (not water!) • Record diary • Calculate Fuelpoints (target 750/1500/2500) WEEK 1 STUDY SCHEDULE
  31. 31. • Recruitment • Baseline assessment • FuelBand intervention Exercise prescription in the teenager with congenital heart disease • FuelBand issued • Points prescribed • Link to study Facebook & Twitter WEEK 2 - 9 STUDY SCHEDULE
  32. 32. • Recruitment • Baseline assessment • FuelBand intervention • Reassesssment Exercise prescription in the teenager with congenital heart disease • Actigraph issued • FuelBand used • Comparison actigraph/ Fuelband WEEK 10 STUDY SCHEDULE
  33. 33. • Recruitment • Baseline assessment • FuelBand intervention • Reassessment • Data Analysis Exercise prescription in the teenager with congenital heart disease • Actisoft software v3.2 • Total FuelBand point/week • Statistical tests WEEK 10 Repeated measures ANOVA between groups at baseline and follow-up. Paired T tests for assessment of change in PA between baseline and Fuelband intervention stage. Bland Altman used to correlate levels of physical activity between FuelBand and Actigraph. STUDY SCHEDULE
  34. 34. EXPECTED RESULTS AND ANTICIPATED VALUE OF STUDY Anticipated significant increase in activity associated with FuelBand intervention. This will enable self and peer motivation of exercise participation. Potential for significant health benefit, self efficacy and development of “exercise habit”.
  35. 35. LIMITATIONS OF STUDY Requirement to use expensive device and need for internet and computer/smartphone access and competent IT skills. Social media use may not be acceptable in younger patients. Benefit may be time limited. Hand based exercise only assessed. Funding identified ( GUCH Research Fund). Study adopted by UHBristol (4 months delay). Submitted for IRAS and ethics approval – awaited.
  36. 36. FINAL HYPOTHESIS: The Nike+ FuelBand is a motivational tool for exercise prescription in the teenager with congenital heart disease

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