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Randomized Controlled Trial
. 2021 Dec 6;9(12):e28242.
doi: 10.2196/28242.

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

François Bughin #  1 , Gaspard Bui #  1 , Bronia Ayoub  1 , Leo Blervaque  1 , Didier Saey  2 , Antoine Avignon  3   4 , Jean Frédéric Brun  1 , Nicolas Molinari  5   6 , Pascal Pomies  1 , Jacques Mercier  1 , Fares Gouzi  1 , Maurice Hayot  1
Affiliations
Randomized Controlled Trial

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

François Bughin et al. JMIR Mhealth Uhealth. .

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.

Keywords: mHealth; mobile phone; obesity; rehabilitation; telerehabilitation.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Telerehabilitation mobile app.
Figure 2
Figure 2
Telerehabilitation website.
Figure 3
Figure 3
Study participant flowchart.
Figure 4
Figure 4
Relative change in fat mass after 12 weeks. TRG: telerehabilitation group; UCG: usual care group.
Figure 5
Figure 5
Waist to hip ratio change after 12 weeks (absolute). TRG: telerehabilitation group; UCG: usual care group.
Figure 6
Figure 6
EQVOD scale scores for physical impact changes after 12 weeks (absolute). EQVOD: echelle qualité de vie, obésité et diététique; TRG: telerehabilitation group; UCG: usual care group.
See this image and copyright information in PMC

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