Increasing Physical Activity in Belgian Type 2 Diabetes Patients: a Three-Arm Randomized Controlled Trial Outcomes of a multifaceted physical activity regimen as part of a diabetes self-management intervention Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care Comparative Effectiveness of a 12-Week Physical Activity Intervention for Overweight and Obese Youth: Exergaming with "Dance Dance Revolution". The diabetes network internet-based physical activity intervention: a randomized pilot study. Understanding physical activity in adults with type 2 diabetes after completing an exercise intervention trial: A mediation model of self-efficacy and autonomous motivation Can Exergaming Contribute to Improving Physical Activity Levels and Health Outcomes in Children? Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: A randomized clinical trial. Diabetes NetPLAY: A physical activity website and linked email counselling randomized intervention for individuals with type 2 diabetes Exergaming for Health Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study Changes in enjoyment, self-efficacy, and motivation during a randomized trial to promote habitual physical activity adoption in bariatric surgery patients. In-class Active Video Game Supplementation and Adherence to Cardiac Rehabilitation Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial A randomized trial of an intervention to improve self-care behaviors of African-American women with type 2 diabetes: impact on physical activity. A cognitive-behavioural pedometer-based group intervention on physical activity and sedentary behaviour in individuals with type 2 diabetes
Background Pedometer-based physical activity programs have been typically delivered in a group format by a behavioral expert . An alternative strategy that builds on existing interactions is delivery through individual consultation by a general practitioner ( GP ) . These two delivery strategies have not been directly compared . Purpose To compare effectiveness of a 12-week physical activity ( PA ) intervention for type 2 diabetes patients delivered by a trained GP via an individual consultation or as group delivery by a behavioral expert . MethodS ixty-seven primary care participants ( mean age = 67.4 years , 70 % male ) from three Belgian general practice s were r and omized into three different treatment arms : ( 1 ) individual consultation ( n = 22 ) with three PA contacts with the patient 's GP ; ( 2 ) group counseling ( n = 21 ) with three PA group sessions delivered by a behavioral expert ; and ( 3 ) a control arm ( n = 24 ) receiving no intervention .  Participant inclusion criteria were ≤80 years ; 25–35 kg/m² ; ≤12 % HbA1c and reporting no PA limitations . Outcome measures were pedometer-determined steps/day , self-reported PA , and health parameters ( weight , body mass index , waist circumference , total cholesterol , fasting glucose , and HbA1c ) . Results Group counseling participants increased 1,706 steps/day over baseline significantly ( p ≤ 0.05 ) more than other treatment arms . Moreover , they increased their self-reported PA ( + 82 min/day ) , while control arm participants showed a decrease in PA ( p ≤ 0.05 ) . Participants of the individual consultation had a decrease in waist circumference ( −1.4 cm ) and HbA1c ( −0.32 % ) and a lower increase in total cholesterol ( + 7.2 mg/dl ) compared to the other treatment arms ( all p ≤ 0.05 ) . Conclusion Group counseling in type 2 diabetes patients improved PA , whereas individual consultations had an impact on some health outcomes on the short-term Background :  Physical activity ( PA )  is important for management of diabetes , yet practical interventions that achieve sustained behavior change are rare . Purpose : The goals of this research were to evaluate the effectiveness of a multifaceted PA intervention for people with type 2 diabetes that emphasized participant choice in activity selection . Baseline activity patterns were examined to determine whether they predicted changes in PA at 2 months . Methods : Three hundred thirty-five participants were recruited from 42 primary care physicians and then r and omized to either a computer-assisted , tailored self-management intervention ( N = 174 ) or health risk appraisal with feedback control ( N = 161 ) . Primary outcome measures included the Community Healthy Activities Model Program for Seniors Question naire , diet , and psychosocial assessment s at baseline and 2 months . Results : For 301 participants who completed the 2-month follow-up , the intervention significantly improved all PA ( p < .01 ) and moderate PA ( metabolic equivalents > 3.0 , p < .01 ) relative to controls . Baseline cluster analyses grouped participant activity patterns into three categories . At 2 months , cluster assignment differentially predicted change in calories expended in moderate , rote , sport , and lifestyle PA . Conclusions : A computer-assisted , multifaceted approach to PA demonstrated improvement after 2 months . The results suggest that individuals are capable of adjusting their activity patterns to maximize their PA Background Physical activity ( PA ) and nutrition are the cornerstones of diabetes management . Several review s and meta-analyses report that PA independently produces clinical ly important improvements in glucose control in people with Type 2 diabetes . However , it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care . Methods This study will determine whether an evidence -informed multifaceted behaviour change intervention ( Movement as Medicine for Type 2 Diabetes ) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting . An open pilot study conducted in two primary care practice s ( phase one ) will assess acceptability , feasibility and fidelity . Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures . A two-arm parallel group clustered pilot r and omised controlled trial with patients from participating primary care practice s in North East Engl and will assess acceptability , feasibility , and fidelity of the intervention ( versus usual clinical care ) and trial processes over a 12-month period . Consultation behaviour involving fidelity of intervention delivery , diabetes and PA related knowledge , attitudes/beliefs , intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals . We will rehearse the collection of outcome data ( with the focus on data yield and quality ) for a future definitive trial , through outcome assessment at baseline , one , six and twelve months . An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care . Discussion Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence -base , that is , the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes . The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents , to the best of our knowledge , the first of its kind in the United Kingdom . This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care . Trial registration Movement as Medicine for Type 2 Diabetes ( MaMT2D ) was registered with Current Controlled Trials on the 14th January 2012 : IS RCT N67997502 . The first primary care practice was r and omised on the 5th October 2012 OBJECTIVE Experts recommend that children engage in 60 minutes of daily moderate to vigorous PA ( PA ) , but few meet these goals . Exergames like " Dance Dance Revolution " ( DDR ) ( Konami of America , Redwood City , CA ) have the potential to provide PA . We sought to determine if DDR would boost PA among overweight or obese children . SUBJECTS AND METHODS Children over the 85th percentile for body mass index ( BMI ) and between 9 and 17 years old were r and omly assigned to receive DDR+pedometers ( treatment group ) or pedometers only ( comparison group ) .  PA levels were tracked for 12 weeks by self-report , pedometer , and accelerometer data . RESULTS Sixty-five families completed the study . The average  BMI percentile of the participant was over 96 percent . Despite r and omization , participants in the treatment ( DDR )  group were more often male , older , and heavier than participants in the comparison group . Self-reported frequency of moderate to vigorous PA increased significantly from baseline to 12 weeks for the treatment group and declined for the comparison group . Accelerometer results indicated a significant decline in moderate activity over time for the comparison group . However , there were no significant between-group differences based on the accelerometer or pedometer data . CONCLUSION Based on self-report measures , DDR may have increased PA levels in obese and overweight children . However , we are led to question the validity of these results because analyses based on objective measures do not confirm them . Accelerometer results indicate that although DDR did not boost PA , it may have helped to slow the decline in moderate to vigorous PA over time OBJECTIVE Because of other competing priorities ,  physical activity ( PA ) is seldom addressed in a consistent way in either primary care or diabetes education . This 8-week pilot study evaluated the short-term benefits of an Internet-based supplement to usual care that focused on providing support for sedentary patients with type 2 diabetes to increase their PA levels . RESEARCH DESIGN AND METHODS A total of 78 type 2 diabetic patients ( 53 % female , average age 52.3 years ) were r and omized to the Diabetes Network ( D-Net ) Active Lives PA Intervention or an Internet information-only condition .  The intervention condition received goal - setting and personalized feedback , identified and developed strategies to overcome barriers , received and could post messages to an on-line " personal coach , " and were invited to participate in peer group support areas . Key outcomes included minutes of PA per week and depressive symptomatology . RESULTS There was an overall moderate improvement in PA levels within both intervention and control conditions , but there was no significant improvement in regard to condition effects . There was substantial variability in both site use and outcomes within the intervention and control conditions . Internal analyses revealed that among intervention participants , those who used the site more regularly derived significantly greater benefits , whereas those in the control condition derived no similar benefits with increased program use . CONCLUSIONS Internet-based self-management interventions for  PA and other regimen areas have great potential to enhance the care of diabetes and other chronic conditions . We conclude that greater attention should be focused on methods to sustain involvement with Internet-based intervention health promotion programs over time This study was set out to test if autonomous motivation mediated the relationship between self-efficacy and 12-month physical activity ( PA )  in adults with type 2 diabetes involved in a r and omized exercise trial . Participants ( n = 234 ) completed question naires measuring  barrier self-efficacy at 3 months , autonomous motivation at 6 months , and  PA  at 12 months . A mediational analysis of longitudinal data revealed that autonomous motivation mediated the relationship between barrier-self-efficacy and PA .  High barrier self-efficacy can therefore help predict 12-month PA  in adults with type 2 diabetes , although this effect is attenuated by autonomous motivation . Hence , participating in PA for autonomous reasons such as by choice and /or for fun further explains  PA  at 12 months in this population . Results of this study extend our underst and ing of the motivational constructs involved in  PA  in the maintenance phase . This study has important theoretical implication s in that it helps to organize and consoli date well-known correlates of  PA  by proposing a temporal relationship between them that could be tailored in interventions Physical inactivity among children is a serious public health problem . It has been suggested that high levels of screen time are contributory factors that encourage sedentary lifestyles in young people . As physical inactivity and obesity levels continue to rise in young people , it has been proposed that new-generation active computer- and video-console games ( otherwise known as “ exergaming ” ) may offer the opportunity to contribute to young people 's energy expenditure during their free time . Although studies have produced some encouraging results regarding the energy costs involved in playing active video-console games , the energy costs of playing the authentic versions of activity-based video games are substantially larger , highlighting that active gaming is no substitute for real sports and activities . A small number of exergaming activities engage children in moderate-intensity activity , but most do not . Only 3 very small trials have considered the effects of exergaming on physical activity levels and /or other health outcomes in children . Evidence from these trials has been mixed ; positive trends for improvements in some health outcomes in the intervention groups were noted in 2 trials . No adequately powered r and omized , controlled trial has been published to date , and no trial has assessed the long-term impact of exergaming on children 's health . We now need high- quality r and omized , controlled trials to evaluate the effectiveness and sustainability of exergaming  , as well as its clinical relevance ; until such studies take place , we should remain cautious about its ability to positively affect children 's health AIMS Despite the known benefits , 60 % of individuals with diabetes do not engage in regular physical activity ( PA ) . This pilot study tested the effects of a counseling intervention using continuous glucose monitoring system ( CGMS ) feedback on PA self-efficacy , PA levels , and physiological variables . METHODS Adults ( N=52 ) with type 2 diabetes ( non-insulin requiring , inactive ) were r and omized to intervention ( n=27 ) or control ( n=25 ) groups . Both groups received 90min of diabetes education with a follow-up phone call 4 weeks later . The intervention group also received counseling derived from self-efficacy theory . This intervention included feedback on each participant 's CGMS graph and used role model CGMS graphs to clearly depict glucose reductions in response to PA . Outcomes were assessed at baseline and 8 weeks . RESULTS Participants receiving the intervention had higher self-efficacy scores than the control group for sticking to activity/resisting relapse at 8 weeks ( p<0.05 ) , indicating more confidence in maintaining a PA program . Intervention group participants light/sedentary activity minutes decreased significantly ( p<0.05 ) , moderate activity minutes increased significantly ( p<0.05 ) , and , HbA1c and BMI decreased significantly ( p<0.05 ) . CONCLUSIONS These data suggest that PA counseling interventions using CGMS feedback for individuals with type 2 diabetes may improve PA levels and reduce risk factors for diabetes-related complications Background -This pilot study evaluated the feasibility ( recruitment , retention , adherence and satisfaction ) and preliminary efficacy of a 12-week website and email-linked counselling intervention on physical activity behaviour change in individuals with type 2 diabetes . Methods -A total of 49 individuals with type 2 diabetes ( 59 % female , average age 54.1 years ) were r and omized to the Diabetes NetPLAY intervention or control condition . The intervention condition received information grounded in the Social Cognitive Theory ( SCT ) , personalized weekly emails , an on-line logbook and message board . Key outcomes included physical activity behaviour and related cognition changes . The control condition was provided links to the Canadian Diabetes Association 's Clinical Practice Guidelines for Physical Activity and Canada 's Guide to Physical Activity . Results -Intervention participants indicated high levels of satisfaction for this mode of delivery and study results demonstrated the feasibility of web-based mediums for the delivery of physical activity information in this population . The intervention group demonstrated a significant improvement in total vigorous and moderate minutes of physical activity ( p = 0.05 ) compared to the control group over the 12-week study . Among the SCT variables , behavioural capacity , showed a significant increase ( p < 0.001 ) among intervention participants . Conclusion -Web-based interventions for individuals with type 2 diabetes are feasible and show promise for improving positive physical activity outcomes Objective . To evaluate the efficacy and feasibility of a multifaceted , community-based weight intervention program for children using exergaming technology ( activity-promoting video gaming ) .  Design and Methods . This is a prospect i ve observational pilot study . Forty-eight children , between the ages of 8 and 16 years , who are overweight or obese , enrolled in Exergaming for Health , a multidisciplinary weight management program , which used active video gaming . Primary outcome measures were change in body mass index ( BMI ) z scores . Results . Most children ( n = 40 , 83 % ) completed the program and participated in outcome evaluations . The average BMI change was −0.48 kg/m2 ( SD = 0.93 ) , P < .002 ( BMI z-score change was −0.072 , SD = 0.14 , P < .0001 ) . The average Global Self-Worth score improved , screen time and soda intake reduced , and exercise hours per week increased . Conclusions . The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates . A larger r and omized controlled trial is needed to confirm these results OBJECTIVE : To conduct a r and omised trial of a physical activity ( PA ) intervention , The First Step Program ( FSP ) for adults with type II diabetes . DESIGN : A 16-week intervention study and 24-week follow-up assessment . PARTICIPANTS : A total of 47 overweight/obese , sedentary individuals ( age=52.7±5.2 y ; BMI = 33.3±5.6 kg/m2 ) recruited through a diabetes education centre . MEASUREMENTS : Primary outcome :  daily PA assessed by pedometer ( steps/day ) . Secondary outcomes : anthropometric measures ( weight , BMI , waist girth , hip girth ) ; indicators of cardiovascular health ( resting heart rate and blood pressure ) ; glycemic control ( fasting glucose , insulin , HbA1c , glucose concentration 120 min postglucose load ) ; plasma lipid status ( total cholesterol , HDL cholesterol , LDL cholesterol , and triglycerides ) . RESULTS : Relative to the CONTROL group , FSP participants increased  their PA > 3000 steps/day ( approximately 30 min/day ) during the intervention ( P<0.0001 ) . Waist and hip girth decreased ( approximately 2–3 cm ) , but did not differ significantly between groups . Significant changes did not emerge for any of the other variables . CONCLUSIONS : The FSP is a practical intervention that elicits an immediate and profound change in walking behaviour . Such change is an important ‘ first step ’ towards increasing the volume and /or intensity of PA necessary to improve long-term health outcomes in this largely sedentary and overweight or obese population . Relapse by 24 weeks indicates that other strategies such as booster sessions are needed to maintain lifestyle change . Further research must determine realistic and responsive health outcomes for this population that are achievable through practical , real-world programming Background Childhood obesity has reached epidemic proportions in developed countries . Sedentary screen-based activities such as video gaming are thought to displace active behaviors and are independently associated with obesity . Active video games , where players physically interact with images onscreen , may have utility as a novel intervention to increase physical activity and improve body composition in children . The aim of the Electronic Games to Aid Motivation to Exercise ( eGAME ) study is to determine the effects of an active video game intervention over 6 months on : body mass index ( BMI ) , percent body fat , waist circumference , cardio-respiratory fitness , and physical activity levels in overweight children . Methods / Design Three hundred and thirty participants aged 10–14 years will be r and omized to receive either an  active video game up grade package  or to a control group ( no intervention ) .  Discussion An overview of the eGAME study is presented , providing an example of a large , pragmatic r and omized controlled trial in a community setting . Reflection is offered on key issues encountered during the course of the study . In particular , investigation into the feasibility of the proposed intervention , as well as robust testing of proposed study procedures is a critical step prior to implementation of a large-scale trial . Trial registration Australian New Zeal and Clinical Trials Registry BACKGROUND The Bari-Active trial found that a physical activity ( PA ) intervention ( PAI ) , versus st and ard presurgical care control ( SC ) , produced significant increases in daily bout-related moderate-to-vigorous PA ( MVPA , in≥10-min bouts ) preoperatively . The present study examined whether PAI also produces superior improvements in psychological and /or motivational processes that may be important for PA adoption . OBJECTIVES Compare PAI and SC on baseline to postintervention changes in PA-related enjoyment , self-efficacy , and motivations , and examine whether greater bout-related MVPA changes are associated with greater improvements in these variables . SETTING University hospital , United States . METHODS Participants ( 87 % female ; body mass index = 45.0±6.5 kg/m(2 ) ) were r and omly assigned to 6 weeks of PAI ( n = 40 ) or SC ( n = 35 ) . PAI received weekly counseling sessions to increase daily walking exercise . At baseline and postintervention , both groups completed 7-day objective PA monitoring and question naires to evaluate changes in bout-related MVPA and PA enjoyment , self-efficacy , and motivation . RESULTS Retention was 84 % at postintervention . Intent-to-treat analyses showed that PAI on average reported more favorable changes than SC in PA enjoyment , self-efficacy , amotivation ( i.e. , lack of PA motivation ) , and identified and intrinsic regulations ( i.e. , more autonomous PA motivations ; P<.01 ) . In PAI completers ( n = 33 ) , changes in bout-related MVPA and psychological/motivational variables were unrelated . CONCLUSION PAI produced greater improvements in PA-related enjoyment , self-efficacy , and motivations  than SC . The lack of association between objective ly measured PA changes and psychological/motivational processes highlights the need for future research to identify which processes are most important for PA adoption and maintenance in bariatric surgery patients , and to determine whether the method used to measure PA affects the pattern of association Purpose : The application of active video games ( AVGs ) during cardiac rehabilitation ( CR ) sessions could potentially facilitate patient adherence . The feasibility , safety , and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated . Methods : A pilot , evaluator-blinded , intention-to-treat , r and omized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise . Both groups experienced equal exercise loads for 6 weeks . Patients were assessed at baseline , end of the program , and after an 8-week followup . Adherence and safety-related outcomes were the primary endpoints . Secondary outcomes included change in exercise capacity , daily physical activity ( PA ) , energy expenditure ( EE ) , and psychometric profiling . Results : Patients ( males 81 % ; 60 ± 10 years ) presented with typical cardiovascular risk factors and similar baseline characteristics . Participants did not perceive an increased risk of injury and were more interactive . At the end of the program , there was a lower tendency for dropping out ( 6 % vs 19 % , P > .05 ) , a significant improvement in PA ( 322 vs 247 arbitrary acceleration units/min , P = .047 ) and related EE per body weight ( 13 vs 11 kcal/kg/d , P = .04 ) among AVG participants compared with controls . No significant differences between groups for adverse medical events , exercise capacity , affect toward exercise , anxiety , depression , or quality -of-life changes were reported . Conclusions : The additional use of AVGs during CR sessions is feasible , safe , and significantly improved daily PA and EE . A dropout reduction trend among its users , which needs to be confirmed in a larger trial , raises awareness to AVG supplementation as a promising strategy to increase CR adherence Background Improving mobility in elderly persons is a primary goal in geriatric rehabilitation . Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low . Exergames may improve adherence . This study therefore compared exergames with self-regulated exercise using instruction leaflets . The primary outcome was adherence . Secondary outcomes were enjoyment , motivation and balance during walking . Methods Design : single center parallel group non-blinded r and omized controlled trial with central stratified r and omization . Setting : center for geriatric inpatient rehabilitation . Included were patients over 65 with mobility restrictions who were able to perform self-regulated exercise . Patients were assigned to self-regulated exercise using a ) exergames on Windows Kinect ® ( exergame group EG ) or b ) instruction leaflets ( conventional group CG ) . During two 30 min sessions physical therapists instructed self-regulated exercise to be conducted twice daily during thirty minutes during ten working days . Patients reported adherence ( primary outcome ) , enjoyment and motivation daily . Balance during walking was measured blind before and after the treatment phase with an accelerometer . Analysis was by intention to treat . Repeated measures mixed models and Cohen ’s d effect sizes ( ES , moderate if > 0.5 , large if > 0.8 ) with 95 % CIs were used to evaluate between-group effects over time . Alpha was set at 0.05 . Results From June 2014 to December 2015 217 patients were evaluated and 54 included , 26 in the EG and 28 in the CG . Adverse effects were observed in two patients in the EG who stopped because of pain during exercising . Adherence was comparable at day one ( 38 min . in the EG and 42 min . in the CG ) and significantly higher in the CG at day 10 ( 54 min . in the CG while decreasing to 28 min . in the EG , p = 0.007 , ES 0.94 , 0.39–0.151 ) . Benefits favoring the CG were also observed for enjoyment ( p = 0.001 , ES 0.88 , 0.32 – 1.44 ) and motivation ( p = 0.046 , ES 0.59 , 0.05–1.14 ) ) . There was no between-group effect in balance during walking . Conclusions Self-regulated exercise using instruction leaflets is superior to exergames  regarding adherence , enjoyment and motivation in a geriatric inpatient rehabilitation setting . Effects were moderate to large . There was no between group difference in balance during walking . Trial registration Clinical Trials.gov , NCT02077049 , 6 February 2014 OBJECTIVE To determine whether a culturally appropriate clinic- and community-based intervention for African-American women with type 2 diabetes will increase  moderate-intensity physical activity ( PA ) . RESEARCH DESIGN AND METHODS In this r and omized controlled trial conducted at seven practice s in central North Carolina , 200 African-American women , > or = 40 years of age with type 2 diabetes , were r and omized to one of three treatment conditions : clinic and community ( group A ) , clinic only ( group B ) , or minimal intervention ( group C ) . The clinic-based intervention ( groups A and B ) consisted of four monthly visits with a nutritionist who provided counseling to enhance PA and dietary intake that was tailored to baseline practice s and attitudes ; the community-based intervention ( group A ) consisted of three group sessions and 12 monthly phone calls from a peer counselor and was design ed to provide social support and reinforce behavior change goals ; and the minimal intervention ( group C ) consisted of educational pamphlets mailed to participants . The primary study outcome was the comparison of PA levels between groups assessed at 6 and 12 months by accelerometer , which was worn while awake for 7 days . RESULTS Totals of 175 ( 88 % ) and 167 ( 84 % ) participants completed PA assessment at 6 and 12 months , respectively . For comparison of PA , the P value for overall group effect was 0.014 . Comparing group A with C , the difference in the average adjusted mean for PA was 44.1 kcal/day ( 95 % CI 13.1 - 75.1 , P = 0.0055 ) . Comparing group B with C , the difference in the average adjusted mean was 33.1 kcal/day ( 95 % CI 3.3 - 62.8 , P = 0.029 ) . The intervention was acceptable to participants : 88 % were very satisfied with clinic-based counseling to enhance PA , and 86 % indicated that the peer counselor 's role in the program was important . CONCLUSIONS The intervention was associated with a modest enhancement of PA and was acceptable to participants The purpose of this study was to investigate the benefits of a pedometer and a cognitive-behavioural group intervention for promoting physical activity ( PA ) in type 2 diabetes patients . We recruited 41 participants and r and omized them into an intervention group ( IG ) ( n = 20 ) and a control group ( CG ) ( n = 21 ) . The intervention consisted of five sessions within 12 weeks , a booster session after 22 weeks and a pedometer . Primary outcome was PA assessed by accelerometer ( minutes per day ) and pedometer ( steps per day ) . Secondary outcomes were weight , body mass index , blood pressure , haemoglobin A1c and total cholesterol . After 12 weeks , the IG increased with more than 2000 steps day−1 compared with the CG , whereas sedentary behaviour decreased more than 1 hour day−1 in the IG and showed no change in the CG . There was no intervention effect on the accelerometer-based PA nor on health measurements . After 1 year , the increase in steps per day remained significant in the IG , but sedentary activity increased again to baseline levels . This pilot study showed that the combination of a 12-week cognitive-behavioura intervention and a pedometer has a significant short-term impact on daily steps and sedentary behaviour but that the effects on total PA and long-term effects were limited
However , effects of exergaming in terms of changes in these intensity parameters varied significantly between game modes and consoles as well as because of the vastly differing duration s of exergame activity between studies .
Conclusion This review suggests that exergames are able to increase PA among overweight individuals .
However , the inconsistent results and the overall poor or moderate method ological quality do not permit judgment on whether exergames are suitable to meet PA guidelines in this target group .
Background The majority of patients with overweight and type 2 diabetes show insufficient levels of daily physical activity ( PA ) and usually are among the least likely to engage in or adhere to any form of generic PA .
Active video games ( exergames ) may be a solution to motivate these individuals to overcome their sedentary lifestyle .
Objectives This systematic review was conducted to review the current evidence for the effectiveness of exergaming in overweight and type 2 diabetes mellitus and thus to evaluate the suitability of these games to be used as tools for exercise promotion that meet current PA guidelines .