Nike fuel band study

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

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

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

REGULAR EXERCISE

Regular exercise

Incidence

General health benefits

• Diabetes mellitus • Lipid profile • Colon cancer• Osteoporosis • Anxiety / depression • Dementia• Hypertension

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

HOW DOES EXERCISE HELP?

Q: HOW DOES EXERCISE HELP?

• Improving endothelial function• Improving cardiac function• Improving skeletal muscle function

A: MULTIFACTORIAL

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 testsfemoral 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)

WHY IS EXERCISE PRESCRIPTION NOT USED?

Q: WHY IS EXERCISE PRESCRIPTION NOT USED?A1: MOST CARDIOLOGISTS DO NOT KNOW HOW TO PRESCRIBE EXERCISE*

*Swan 2000, Lewin 2002

< 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

Q: WHY IS EXERCISE PRESCRIPTION NOT USED?A2: MOST EXERCISE PRESCRIPTIONS ARE INEFFECTIVE IN TEENAGERS**

**Metcalf 2012

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

TEENAGERS DON’T LIKE BEING TOLD WHAT TO DO...

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

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

THE NIKE+ FUELBAND

1.Setup (age / height / weight)

THE NIKE+ FUELBAND


2.Set Goal (say 2,000 points?)

THE NIKE+ FUELBAND



3.Join Nike+

THE NIKE+ FUELBAND



3.Join Nike+4.Sync (phone / computer)

THE NIKE+ FUELBAND

CHARTS OF PROGRESS

REWARDS & SOCIAL CAPITAL

Exercise prescription in the teenager with congenital heart diseaseTHE STUDY

Q1: DOES THE USE OF THE NIKE FUELBAND INCREASE PHYSICAL ACTIVITY IN THE STUDY GROUP?

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

• 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)


• Prospective, intervention study• 3 symptom categories

• asymptomatic / NYHA 2 / NYHA 3 or 4• 3 measures of activity

• Actigraph• FuelBand• Non weartime diary


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


• Recruitment


• Consent• Haemodynamic and clinical

assessment• Advised to exercise “as much

as possible” up to 60 mins /day

PRE LAUNCH

STUDY SCHEDULE

• Recruitment• Baseline assessment


• Actigraph issued• Wear 7 days (not water!)• Record diary• Calculate Fuelpoints (target

750/1500/2500)

WEEK 1

STUDY SCHEDULE

• Recruitment• Baseline assessment• FuelBand intervention


• FuelBand issued• Points prescribed• Link to study Facebook &

Twitter

WEEK 2 - 9

STUDY SCHEDULE

• Recruitment• Baseline assessment• FuelBand intervention• Reassesssment


• Actigraph issued • FuelBand used• Comparison actigraph/

Fuelband

WEEK 10

STUDY SCHEDULE

• Recruitment• Baseline assessment• FuelBand intervention• Reassessment• Data Analysis


• 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

EXPECTED RESULTS AND ANTICIPATED VALUE OF STUDYAnticipated 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”.

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.

FINAL HYPOTHESIS: The Nike+ FuelBand is a motivational tool for exercise prescription in the teenager with congenital heart disease

Nike fuel band study

Health & Medicine

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