Web-based physical activity promotion in young people with CF: a randomised controlled trial

Narelle S Cox; Beverley Eldridge; Sarah Rawlings; Julianna Dreger; Jennifer Corda; Jennifer Hauser; Brenda M Button; Jennifer R Bishop; Amanda Nichols; Anna Middleton; Nathan Ward; Tiffany Dwyer; Ruth Dentice; Raynuka Lazarus; Paul O'Halloran; Joanna Y T Lee; Christie Mellerick; Kelly Mackintosh; Melitta McNarry; Craig Anthony Williams; Anne E Holland; Youth Activity Unlimited – A Strategic Research Centre of the UK Cystic Fibrosis Trust

doi:10.1136/thorax-2022-218702

Web-based physical activity promotion in young people with CF: a randomised controlled trial

Thorax. 2023 Jan;78(1):16-23. doi: 10.1136/thorax-2022-218702. Epub 2022 Sep 30.

Authors

Narelle S Cox^{1

2}, Beverley Eldridge^{3

4}, Sarah Rawlings^{5

6}, Julianna Dreger⁵, Jennifer Corda⁷, Jennifer Hauser⁸, Brenda M Button^{9

10

11}, Jennifer R Bishop¹², Amanda Nichols⁶, Anna Middleton¹³, Nathan Ward¹⁴, Tiffany Dwyer^{15

16}, Ruth Dentice¹⁷, Raynuka Lazarus¹², Paul O'Halloran³, Joanna Y T Lee⁵, Christie Mellerick⁵, Kelly Mackintosh¹⁸, Melitta McNarry¹⁸, Craig Anthony Williams¹⁹, Anne E Holland^{5

2

9}; Youth Activity Unlimited – A Strategic Research Centre of the UK Cystic Fibrosis Trust

Affiliations

¹ Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia [email protected].
² Institute for Breathing and Sleep, Melbourne, Victoria, Australia.
³ College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
⁴ Children's Medical Research Institute, Melbourne, Victoria, Australia.
⁵ Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia.
⁶ Monash Health, Melbourne, Victoria, Australia.
⁷ Physiotherapy, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
⁸ Tasmanian Adult CF Service, Royal Hobart Hospital, Hobart, Tasmania, Australia.
⁹ Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.
¹⁰ Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.
¹¹ Faculty of Medicine, Monash University, Melbourne, Victoria, Australia.
¹² Respiratory Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
¹³ Physiotherapy, Sydney Children's Hospital Network Westmead, Sydney, New South Wales, Australia.
¹⁴ Physiotherapy, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
¹⁵ Discipline of Physiotherapy, Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
¹⁶ Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
¹⁷ Physiotherapy, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
¹⁸ College of Engineering, Swansea University, Swansea, UK.
¹⁹ Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK.

PMID: 36180067
DOI: 10.1136/thorax-2022-218702

Abstract

Background: Physical activity levels are known to decline following hospitalisation for people with cystic fibrosis (pwCF). However, optimal physical activity promotion strategies are unclear. This study investigated the effect of a web-based application (ActivOnline) in promoting physical activity in young pwCF.

Methods: Multicentre randomised controlled trial with assessor blinding and qualitative evaluation. People with CF (12-35 years) admitted to hospital for a respiratory cause were eligible and randomised to the 12-week ActivOnline intervention (AO) or usual care (UC). The primary outcome was change in device-based time spent in moderate-to-vigorous physical activity (MVPA) from baseline to post-intervention. Follow-up was at 6 months from hospital discharge when qualitative evaluation was undertaken.

Results: 107 participants were randomised to AO (n=52) or UC (n=55). Sixty-three participants (59%) contributed to the intention-to-treat analysis. Mean (SD) age was 21 (6) years (n=46, <18 years). At baseline, physical activity levels were high in both groups (AO 102 (52) vs UC 127 (73) min/day). There was no statistically significant difference in MVPA between groups at either timepoint (post-intervention mean difference (95% CI) -14 mins (-45 to 16)). Uptake of the intervention was low with only 40% (n=21) of participants accessing the web application.

Conclusion: A web-based application, including individualised goal setting, real-time feedback and motivation for behavioural change, was no better than usual care at promoting physical activity in young pwCF following hospital discharge. High levels of baseline physical activity levels in both groups, and limited engagement with the intervention, suggest alternative strategies may be necessary to identify and support young pwCF who would benefit from enhanced physical activity.

Trial registration number: ACTRN12617001009303, 13 July 13 2017.

Keywords: Cystic Fibrosis; Exercise; Pulmonary Rehabilitation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Cystic Fibrosis* / therapy
Exercise*
Humans
Internet
Young Adult

Associated data

ANZCTR/ACTRN12617001009303