Impact of a mobile telerehabilitation solution on metabolic health outcomes and rehabilitation adherence in obese patients: a randomised controlled trial (Preprint)

BACKGROUND Obesity is a challenge for public health. Combining exercise training, nutrition and therapeutic education in a metabolic rehabilitation (MR) is recommended for obesity management. Yet, randomized controlled study-based evidences are lacking. In addition MR is associated with poor patient’s adherence. Mobile Health (mHealth) devices improve the access to the MR components. OBJECTIVE Thus, a telerehabilitation (TR) solution could deliver a feasible multidisciplinary MR in obese patients and improve fat mass (FM), metabolic parameters and quality of life versus usual care. METHODS This was a randomised, controlled, parallel-design study. Fifty obese (body mass index BMI > 30 kg/m²) patients were included in a telerehabilitation group (TRG) or a usual care group (UCG) for 12 weeks. Patients underwent biometric impedance analyses, metabolic exercise tests, actimetry, QOL and satisfaction questionnaires. The primary outcome was the changes in body composition. Secondary outcomes were BW, metabolic parameters, exercise capacity, QOL, patient’s adhesion and satisfaction. RESULTS Forty-nine patients completed the study. No significant group*time interaction was found for FM. Compared to UCG, TRG patients significantly improved waist to hip ratio and EQVOD’s physical impact. Significant time effects occurred for body composition, 6MWT distance, exercise metabolism, sedentary time and QOL (p<0,05). Adherence (95%) and satisfaction in the TRG were good. CONCLUSIONS In obese adults, TR was able to deliver a full multidisciplinary rehabilitation in obese patients and improved their health outcomes. Given the patient’s adherence and satisfaction, pragmatic programs should consider mHealth devices to improve the access to MR. Further studies are warranted to establish the additional TR benefits versus usual care. CLINICALTRIAL Mobile Tele-rehabilitation Solution for Obese Patients NCT03396666 https://clinicaltrials.gov/ct2/show/NCT03396666?term=03396666&draw=2&rank=1