Motivational program to promote physical activity
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Transcript of Motivational program to promote physical activity
WCPT-AWP Congress 2013
Hana Al-Sobayel, MSc, PhDEinas Al-Eisa, MSc, PhD
KING SAUD UNIVERSITYRIYADH, SAUDI ARABIA
COMBINED MOTIVATION PROGRAM AND PEDOMETER USE TO PROMOTE PHYSICAL ACTIVITY: A RANDOMIZED
CONTROLLED TRIAL
WCPT-AWP Congress 2013
WCPT-AWP Congress 2013
Saudi Women’s Health
WCPT-AWP Congress 2013
Physical Inactivity a Major Risk
According to MOH / WHO 2012 - 2013
hypertension diabetes hyperlipedeamia obesity central obesity smoking physical inactivity0
5
10
15
20
25
30
35
40
Risk Factors for NCD (%)
WCPT-AWP Congress 2013
Non-Communicable Diseases Cause of Death
According to WHO 2010
WCPT-AWP Congress 2013
Globally, 31% of adults aged 15+ were insufficiently active (men 28% and women 34%)
(WHO 2008)
WCPT-AWP Congress 2013
In May 2004, the 57th World Health Assembly (WHA) endorsed the WorldHealth Organization (WHO) Global Strategy on Diet, Physical Activityand Health. The Strategy was developed through a wide-ranging series ofconsultations with all concerned stakeholders in response to a request fromMember States at World Health Assembly 2002 (Resolution WHA55.23).
WCPT-AWP Congress 2013
Conference on healthy lifestyle and non-communicable diseases in the Arab world and the Middle east
WCPT-AWP Congress 2013
Relevance
Alarming level of physical inactivity among the Saudi population: inactivity prevalence 97% (Al-Nozha et al, 2007; Al-Rafaee & Al-Hazzaa, 2001)
Saudi populations studied: males, children, adolescents
(Al-Hazzaa, 2002; Al-Hazzaa & Sulaiman, 1993)
WCPT-AWP Congress 2013
Saudi Females?
The literature suggests a specific gender-based consideration when making recommendations to promote physical activity
gender as a primary consideration (White et al.,
2005)
Prevalence of obesity related to sedentary life style has been escalating among Saudi females
(El-Hazmi & Warsy, 2000)
How active?? Step count..
KSA vs Target Step count0
2000
4000
6000
8000
10000
12000
KSATarget
(Al-Eisa and Al-Sobayel 2012)
Step counts around the world
Country0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
KSAUKUSACanadaGerJapanSwissFinlandAust
(Al-Eisa and Al-Sobayel 2012)
WCPT-AWP Congress 2013
Prescribing PA
There is no universally accepted method to promote physical activity due to the multiple factors that influence physical activity
WCPT-AWP Congress 2013
Why walking?
The most likely to increase physical activity: • a population level (Hillsdon & Thorogood, 1996)
• for sedentary adults (Ogilvie et al, 2007)
• Physical & psychological health benefits• Low intensity & high accessibility• Ease to physically perform • Low cost
(Blacklock et al., 2007; Duncan & Mummery, 2005; Manson et al., 2002; Rhodes et al, 2006)
WCPT-AWP Congress 2013
Pedometer Promote PA?
Using a pedometer can provide a reminder to be more active
Pedometers when used in combination with other strategies improved physical activity
(Chan et al., 2004; Dinger et al., 2007; De Cocker et al., 2008)
WCPT-AWP Congress 2013
Objective
Effectiveness of the use of a pedometer, in addition to a motivational education program, in improving adherence to a walking program , and improving physical activity levels and general
health parameters of Saudi women.
WCPT-AWP Congress 2013
Methods
Inclusion criteria
-Saudi females (18-45 yrs)
-Residing in Riyadh -Able to read and write
Exclusion criteria
-History of fracture or surgery to the back, pelvis, or lower limb- Contraindications to increased walking - Current complain of conditions affecting the ability to walk - Pregnancy- Eating disorders- Conditions affecting cognitive function or communication
WCPT-AWP Congress 2013
Measurement of walking
Pedometers are small devices that can be worn at the waist or ankle, and are capable of counting number of steps (Vitolins et al, 2000)
Pedometers are considered valid and reliable tools with which to measure physical activity
(Tudor-Locke, 2004)
WCPT-AWP Congress 2013
Measurement of Health Parameters
BMIBlood pressure
Heart rateBlood glucose level
Percutaneous oxygen saturation (SpO2) ,Fat composition
WCPT-AWP Congress 2013
Intervention
A single 2 hour educational session:conducted by two senior physical therapists, both of whom were
experienced in patient education, and included information regarding the importance of physical activity and provision of a
handout on the benefits of regular walking .
Weekly motivational text messages sent to the participants’ mobile phones .
WCPT-AWP Congress 2013
Study group (n=81) Control group (n=80)
2 hrs educational sessionWeekly motivational text
messagesPedometer daily record
2 hrs educational sessionWeekly motivational text
messages
Procedure
WCPT-AWP Congress 2013
Results
WCPT-AWP Congress 2013
Participants
WCPT-AWP Congress 2013
Step Count
1 2 3 4 5 6 7 85000
5200
5400
5600
5800
6000
6200
Step count
Weeks
Aver
age
Step
Cou
nt
WCPT-AWP Congress 2013
Low step count
The social & environmental context could be a barrier to increasing physical activities.
(Mabry et al. 2010 )
Prevalence of physical inactivity is high among women world wide.
(WHO 2009)
Step count did not improve after the intervention
WCPT-AWP Congress 2013
Environment
WCPT-AWP Congress 2013
Effectiveness of the Intervention
Adherence to the intervention by the experimental group was significantly higher (p = 0.021)
Other measures: no significant difference
90%
40%
Intervention Control
WCPT-AWP Congress 2013
Health outcomes
No change of health outcomes:Good health status on baseline
Short term intervention
Combining pedometer with an intervention toolkit on physical activity did no difference in Denmark.
(Petersen et al. 2012 )
WCPT-AWP Congress 2013
What’s Next
“Number of steps or walking duration may not be a good estimator of time being active, and that a considerable
underestimation may occur”.(Bussmann & van den Berg-Emon 2013)
Consider physical behavious not only physical activity
Need for multi-sectorial interventions
Consider context and beliefs
WCPT-AWP Congress 2013
WCPT-AWP Congress 2013
Acknowledgment
King Saud University
King Abdulaziz City for Science & Technology