Sustainability of the Effects of an Adapted Physical Activity Program on Physical Fitness and Psycho-behavioral Factors in Patients With Chronic Diseases

Sustainability of the Effects of an Adapted Physical Activity Program on Physical Fitness and Psycho-behavioral Factors in Patients With Chronic Diseases: the Influence of Program Duration and the Use of a Smartwatch

This study aims to determine the extent to which different approaches to adapted physical activity coaching influence physical fitness, psycho-behavioral, and anthropometric parameters in patients with stabilized chronic conditions who have been referred to a Sport-Health Center by their physician. The trial includes four parallel groups, distinguishing between two program durations (3 months or 6 months) and the use or non-use of a smartwatch as a tool for monitoring activity. All participants complete 24 sessions of adapted physical activity (APA), in accordance with the standard practices of the La Musse Sport-Health Center, where the study is entirely conducted. However, the distribution of sessions differs by group: two sessions per week over three months or one session per week over six months. Randomization is stratified by age, sex, and baseline fitness level. Assessments are conducted at the following five time points: enrollment (T0), end of the 3-month program (T1), end of the 6-month program (T2), followed by follow-up at 12 months (T3) and 18 months (T4), to observe the durability of the effects after the supervised phase. The primary outcome measure is improvement in physical fitness and anthropometric parameters, objectively measured using tests recognized for their reliability (TDM6, Sit-to-Stand 30s, Timed Up and Go, Sit and Reach, grip strength, BMI, waist circumference). The secondary outcomes focus on changes in motivation toward health-related physical activity (EMAPS), perceived self-efficacy to engage in physical activity (ECS), and self-reported physical activity (IPAQ-SF), which will be collected regularly throughout the program, more frequently than in standard care. A total of 280 patients will be enrolled to ensure sufficient statistical power, taking into account an anticipated loss-to-follow-up rate over 18 months. Data collection and processing will be pseudonymized and conducted on the secure network of La Musse Hospital.

Inclusion Criteria:

• Patients over the age of 18
• French-speaking patients
• Patients with a chronic condition diagnosed by a doctor
• Patients with a doctor's prescription for APA
• Patients capable of understanding instructions
• Patients enrolled in the Social Security system
• Patients referred to Maison Sport Santé La Musse by a doctor for the first time

Non inclusion Criteria :

• Medical contraindications to physical exertion
• Pregnant women
• Individuals under legal guardianship, conservatorship, or judicial protection.
• Severe cognitive or motor impairment
• Lack of proficiency in French
• Patients in the acute phase requiring specialized care
• Patients simultaneously participating in another interventional research study
• Inability to attend sessions regularly or adhere to the schedule of evaluations.
• Patients who have already completed a program at the Maison Sport Santé

Exclusion Criteria:

• Completion of fewer than 16 APA sessions (less than 70% of sessions)
• Acute exacerbation of a chronic condition during follow-up
• For groups without smartwatches, the use of a digital tool such as a physical activity tracker by participants would constitute an exclusion criterion
• Completion of a patient therapeutic education program