Impact of a Mobile Telerehabilitation Solution on Metabolic Health Outcomes and Rehabilitation Adherence in Patients With Obesity: Randomized Controlled Trial

Abstract

Background Obesity is a major public health issue. Combining exercise training, nutrition, and therapeutic education in metabolic rehabilitation (MR) is recommended for obesity management. However, evidence from randomized controlled studies is lacking. In addition, MR is associated with poor patient adherence. Mobile health devices improve access to MR components. Objective The aim of this study is to compare the changes in body composition, anthropometric parameters, exercise capacity, and quality of life (QOL) within 12 weeks of patients in the telerehabilitation (TR) program to those of usual care patients with obesity. Methods This was a parallel-design randomized controlled study. In total, 50 patients with obesity (BMI>30 kg/m²) were included in a TR group (TRG) or a usual care group (UCG) for 12 weeks. Patients underwent biometric impedance analyses, metabolic exercise tests, actimetry, and QOL and satisfaction questionnaires. The primary outcome was the change in fat mass at 12 weeks from baseline. Secondary outcomes were changes in body weight, metabolic parameters, exercise capacity, QOL, patients’ adhesion, and satisfaction. Results A total of 49 patients completed the study. No significant group × time interaction was found for fat mass (TRG: mean 1.7 kg, SD 2.6 kg; UCG: mean 1.2 kg, SD 2.4 kg; P=.48). Compared with the UCG, TRG patients tended to significantly improve their waist to hip ratios (TRG: −0.01 kg, SD 0.04; UCG: +0.01 kg, SD 0.06; P=.07) and improved QOL physical impact (TRG: +21.8, SD 43.6; UCG: −1.2, SD 15.4; P=.005). Significant time effects were observed for body composition, 6-minute walk test distance, exercise metabolism, sedentary time, and QOL. Adherence (95%) and satisfaction in the TRG were good. Conclusions In adults with obesity, the TR program was not superior to usual care for improving body composition. However, TR was able to deliver full multidisciplinary rehabilitation to patients with obesity and improve some health outcomes. Given the patients’ adherence and satisfaction, pragmatic programs should consider mobile health devices to improve access to MR. Further studies are warranted to further establish the benefits that TR has over usual care. Trial Registration ClinicalTrials.gov NCT03396666; http://clinicaltrials.gov/ct2/show/NCT03396666

Beyond the Calorie Paradigm: Taking into Account in Practice the Balance of Fat and Carbohydrate Oxidation during Exercise?

“…Follow-up of a cohort of 12 obese patients regularly followed over 96 months (results partially presented in [33] and further updated in January 2022). This is the continuation of previously presented shorter follow-up studies [17,18,231,256]. Results show that the weight-lowering effect of LIPOXmax training persists over more than 8 years.…”

“…Various help such as connected devices can be used, but clearly, regular outpatient consultations are the simplest and most efficient procedure to date to obtain good results in the long term [302]. In a recent study, Bughin and coworkers [231] found in 49 LIPOXmax-trained patients, randomized to conventional follow-up vs. a mobile telerehabilitation solution on a smartphone, that telerehabilitation was not superior to the usual care for improving body composition.…”

Behavior Change Effectiveness Using Nutrition Apps in People With Chronic Diseases: Scoping Review

“…The studies focused on obesity prevention and treatment in many diverse populations that ranged in age, socioeconomic background, and physical status (ie, pregnancy and post partum). App features included physical activity tracking [ 69 - 78 ], food tracking [ 70 , 72 - 83 ], knowledge, education, or recommendations [ 70 , 72 - 76 , 78 , 79 , 82 - 86 ], push notifications or scheduled reminders [ 74 - 76 , 78 , 79 , 81 - 84 , 86 ], weight monitoring [ 75 , 76 , 78 , 81 , 85 , 86 ], behavior demonstration [ 69 , 75 , 83 ], motivational challenges [ 69 , 75 - 78 , 83 ], goal setting [ 69 , 73 - 75 , 78 , 81 , 84 , 85 ], feedback [ 69 , 70 , 73 , 75 , 76 , 81 - 83 , 86 ], community support [ 70 , 75 , 78 , 85 ], connectivity to digital health devices [ 70 , 72 , 81 , 86 ], clinician portals [ 72 , 73 , 82 ], and access to a health coach [ 76 - 78 ...…”

Acceptability of Telerehabilitation for Magnification Devices for the Visually Impaired Using Various Approaches to Facilitate Accessibility

“…Our findings for high levels of patient satisfaction are similar to those reported from other studies of telerehabilitation for disabilities other than visual impairment. Other types of disabilities or chronic conditions that reported high satisfaction with telerehabilitation included Parkinson disease, 20 , 21 chronic heart failure, 22 esophageal cancer, 23 chronic obstructive pulmonary disease, 24 , 25 neurorehabilitation, 26 speech therapy, 27 dysphagia, 28 obesity, 29 stroke, 30 , 31 and physical therapy following knee or hip replacement 32 – 34 or wheelchair use or mobility. 35 , 36 In response to the COVID-19 pandemic in 2020–2022, several studies have continued to report good patient satisfaction with telerehabilitation for various disabilities.…”