A sedentary lifestyle can increase one’s risk for a variety of mental and physical health problems, including depression, obesity, diabetes and cardiovascular disease. Unfortunately, this is the way of life for a majority of Americans.
So, how do you motivate people to become active? Researchers at the University of Iowa (UI) developed a potential solution: Turn everyday exercise into a game. UI faculty and students designed a web-based game that can be played by anyone with a smartphone and a Fitbit.
“We essentially found that people who received the game right out of the gates increased their steps by about 2,200 per day, which is close to walking one mile,” says researcher Lucas Carr, associate professor in the department of health and human physiology (HHP). “Statistically, that’s significant. It’s also clinically significant.”
The game, called MapTrek, was designed by the Computational Epidemiology Research (CompEpi) Group, a collaborative group of students and faculty in the UI computer science, internal medicine, and HHP departments. Computer science professors James Cremer and Alberto Segre played a large role in the project as well.
Initially, the CompEpi group had been awarded a pilot grant to develop and test a platform that could monitor activity levels of pre-diabetic and diabetic patients. The platform also sent text messages to patients encouraging them to set daily activity goals.
“Our results suggested that goal-setting alone was not enough,” says researcher Philip Polgreen, professor in the Department of Internal Medicine. “So, we decided to design a game with challenges and to make the game social: the result is MapTrek.”
To begin, users sync data from accelerometers — in the case of this study, Fitbits — to the web-based MapTrek game. Using Google Maps, MapTrek then moves a virtual avatar along a map in correlation to the number of steps the participant takes. Participants of the study were grouped together and competed against one another in weekly walking challenges.
“You can see what place you’re in and see where you’re at on this map,” Carr says. “Every week, the race changes to a different place in the world — the Appalachian Trail, the Grand Canyon.”
Using Google’s street view function, users can click and see where they are in real time, effectively turning the game into a virtual walk or race through different locations. In addition, MapTrek sends users text messages each day to remind them to wear their Fitbit and also to provide encouragement. Users also can take part in daily challenges to earn bonus steps.
“We tried to make it as enjoyable as possible,” Carr says. “We want people to wear their Fitbit and we want them to participate in these games.”
The study involved 146 sedentary office workers (aged 21-65) who had reported sitting at least 75 percent of their workday. Participants were divided into two groups and given Fitbits, but only one group used their Fitbit along with the MapTrek game. Participants’ activity levels were monitored with the Fitbit’s activity monitor.
During the 10-week study, the Fitbit and MapTrek group walked 2,092 more steps per day and completed 11 more active minutes per day compared with the Fitbit-only group. Active minutes are defined as those in which the participant took more than 100 steps.
“If a person can maintain a daily 2,000-step increase, that could result in a clinically significant improvement in their overall health,” Carr says. “It’s associated with about a 10 percent relative reduction in long-term incidence of cardiovascular disease.”
Ultimately, the Fitbit and MapTrek group did not maintain the spike in overall activity throughout the 10-week study. Though the Fitbit and MapTrek users regressed, they were still averaging more steps than the Fitbit-only group by the end of the study. However, the MapTrek group returned to their pre-study fitness levels, Carr says.
“Over 10 weeks, the gains in activity declined and the two groups looked similar by the end of the study,” Polgreen says. “But, we are encouraged by the big initial increase in daily steps and are now looking to improve the game in ways that result in longer changes in behavior.”
Carr says they will continue to conduct studies with sedentary office workers, but they’re also looking at clinical populations, including cardiac rehab patients and those suffering from chronic obstructive pulmonary disease.
“The value of this kind of approach is virtually anyone can play it with minimal risk,” Carr says. “Nearly everyone can benefit from increased levels of activity.”
The findings are published in the Journal of the American Heart Association.
Source: University of Iowa
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