Our findings suggest that Wii-based exercise can be an effective tool to improve physical fitness, functional mobility and motor proficiency of adults with DS, including crucial measures such as aerobic capacity and lower limb strength. Exergames using Wii Fit or other equipment can be appealing alternatives for adults with DS to engage in regular physical activity, preventing sedentary behaviour and decreasing the risk to develop cardiovascular diseases.

BackgroundIt is estimated that 23% of adults and 55% of older adults do not meet the recommended levels of physical activity. Thus, improving the levels of physical activity is of paramount importance, but it requires the use of low-cost resources that facilitate universal access without depleting the health system. The high number of apps available constitutes an opportunity, but it also makes it quite difficult for the layperson to select the most appropriate app. Furthermore, the information available in the app stores is often insufficient, lacks quality, and is not evidence based, and the systematic reviews fail to assess app quality using standardized and validated instruments.ObjectiveThe objective of this study was to systematically assess the features, content, and quality of the most popular apps that can be used to measure and, potentially, promote physical activity.MethodsSystematic searches were conducted on Apple App Store, Google Play, and Windows Phone Store between December 2017 and January 2018. Apps were included if their primary objective was to assess the aspects of physical activity, if they had a user rating of at least 4, if their number of ratings was ≥100, and if they were free. Apps meeting these criteria were independently assessed by two reviewers regarding their general and technical information, aspects of physical activity, presence of behavioral change techniques, and quality. Data were analyzed using means and SDs or frequencies and percentages.ResultsOf 51 apps included, none specified the age of the target group and only one mentioned the involvement of health professionals. Most apps offered the possibility to work in background (n=50) and allowed data sharing (n=40). Regarding physical activity, most apps measured steps and distance (n=11) or steps, distance, and time (n=17). Only 18 apps, all of which measured number of steps, followed the guidelines on recommendations for physical activity. On average, 5.5 (SD 1.8) behavioral change techniques were identified per app; the most frequently used techniques were “provide feedback on performance” (n=50) and “prompt self-monitoring of behavior” (n=50). The overall quality score was 3.88 (SD 0.34).ConclusionsAlthough the overall quality of the apps was moderate, the quality of their content, particularly the use of international guidelines on physical activity, should be improved. Additionally, a more in-depth assessment of apps should be performed before releasing them for public use, particularly regarding their reliability and validity.

BackgroundThe usability of electronic health (eHealth) and mobile health apps is of paramount importance as it impacts the quality of care. Methodological quality assessment is a common practice in the field of health for different designs and types of studies. However, we were unable to find a scale to assess the methodological quality of studies on the usability of eHealth products or services.ObjectiveThis study aimed to develop a scale to assess the methodological quality of studies assessing usability of mobile apps and to perform a preliminary analysis of of the scale’s feasibility, reliability, and construct validity on studies assessing usability of mobile apps, measuring aspects of physical activity.MethodsA 3-round Delphi panel was used to generate a pool of items considered important when assessing the quality of studies on the usability of mobile apps. These items were used to write the scale and the guide to assist its use. The scale was then used to assess the quality of studies on usability of mobile apps for physical activity, and it assessed in terms of feasibility, interrater reliability, and construct validity.ResultsA total of 25 experts participated in the Delphi panel, and a 15-item scale was developed. This scale was shown to be feasible (time of application mean 13.10 [SD 2.59] min), reliable (intraclass correlation coefficient=0.81; 95% CI 0.55-0.93), and able to discriminate between low- and high-quality studies (high quality: mean 9.22 [SD 0.36]; low quality: mean 6.86 [SD 0.80]; P=.01).ConclusionsThe scale that was developed can be used both to assess the methodological quality of usability studies and to inform its planning.

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Mobile applications reach a high number of individuals at low costs. This systematic review investigated the effectiveness of mobile application-based interventions to increase physical activity (PA) and self-efficacy and to decrease sedentarism. Randomized controlled trials (RCTs) and quasi-RCTs investigating the effect of PA interventions using an app compared to no intervention or traditional interventions were included. Pooled effects using the standardized mean difference (SMD) or the weighted mean difference (WMD) were calculated and the overall quality of the evidence was rated using the GRADE. Eleven studies were included. In the short term, pooled estimates showed a small and positive effect in the number of steps favoring interventions using a mobile app when compared with no interventions (WMD = 1579.04, 95%CI 454.04 to 2703.38) and with traditional interventions (WMD = 665.96, 95%CI 167.92 to 1164.00). For self-efficacy and at follow-up, results favoured traditional interventions (WMD = −8.20, 95%CI −14.25 to −2.15). Non-significant results were found for the remaining comparisons. The quality of the evidence ranged from very low to low. There is very low to low quality evidence that interventions using mobile apps running on smartphones, when combined with traditional interventions, are superior to traditional interventions in the short term. Further high-quality studies are required.

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