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Original research
Web-based physical activity promotion in young people with CF: a randomised controlled trial
  1. Narelle S Cox1,2,
  2. Beverley Eldridge3,4,
  3. Sarah Rawlings1,5,
  4. Julianna Dreger1,
  5. Jennifer Corda6,
  6. Jennifer Hauser7,
  7. Brenda M Button8,9,10,
  8. Jennifer R Bishop11,
  9. Amanda Nichols5,
  10. Anna Middleton12,
  11. Nathan Ward13,
  12. Tiffany Dwyer14,15,
  13. Ruth Dentice16,
  14. Raynuka Lazarus11,
  15. Paul O'Halloran3,
  16. Joanna Y T Lee1,
  17. Christie Mellerick1,
  18. Kelly Mackintosh17,
  19. Melitta McNarry17,
  20. Craig Anthony Williams18,
  21. Anne E Holland1,2,8
  22. On behalf of Youth Activity Unlimited – A Strategic Research Centre of the UK Cystic Fibrosis Trust
  1. 1Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia
  2. 2Institute for Breathing and Sleep, Melbourne, Victoria, Australia
  3. 3College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
  4. 4Children’s Medical Research Institute, Melbourne, Victoria, Australia
  5. 5Monash Health, Melbourne, Victoria, Australia
  6. 6Physiotherapy, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
  7. 7Tasmanian Adult CF Service, Royal Hobart Hospital, Hobart, Tasmania, Australia
  8. 8Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
  9. 9Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
  10. 10Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
  11. 11Respiratory Medicine, Westmead Hospital, Sydney, New South Wales, Australia
  12. 12Physiotherapy, Sydney Children’s Hospital Network Westmead, Sydney, New South Wales, Australia
  13. 13Physiotherapy, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  14. 14Discipline of Physiotherapy, Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
  15. 15Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  16. 16Physiotherapy, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  17. 17College of Engineering, Swansea University, Swansea, UK
  18. 18Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK
  1. Correspondence to Dr Narelle S Cox, Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne 3004, Victoria, Australia; narelle.cox{at}monash.edu

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.

  • Cystic Fibrosis
  • Exercise
  • Pulmonary Rehabilitation

Data availability statement

Data are available on reasonable request. Data requests should, in the first instance, be addressed to Professor Anne Holland (anne.holland@monash.edu). Access to data will be subject to approval by the coordinating principal investigator and relevant Human Research Ethics Committee.

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Data availability statement

Data are available on reasonable request. Data requests should, in the first instance, be addressed to Professor Anne Holland (anne.holland@monash.edu). Access to data will be subject to approval by the coordinating principal investigator and relevant Human Research Ethics Committee.

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Footnotes

  • Twitter @kelmackintosh

  • Contributors Procured funding: CAW, AEH, KM, MM, NSC and PO’H. Conceptualisation and design: NSC, AEH and PO’H. Data acquisition: NSC, JD, BE, SR, JC, AN, BMB, JH, JRB, RL, RD, TD, AM, NW, JYTL and CM. Data analysis: NSC, AEH, KM and MM. Drafting manuscript: NSC and AEH. Critical review of manuscript: JD, BE, SR, JC, AN, BMB, JH, JRB, RL, RD, TD, AM, NW, P’OH, JYTL, CM, KM, MM and CAW. NSC and AEH are guarantors of this work.

  • Funding Funding for this trial was from a competitive UK Cystic Fibrosis Trust Strategic Research Centre grant award No: 008.

  • Competing interests NSC, AEH, KM, MM, PO’H and CAW were all named investigators on the grant which provided funding for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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