Introduction:
The prevalence of obesity is lower amongst those meeting physical activity guidelines. However, global estimates by the World Health Organisation suggest that 37% of people in high-income countries (and 46% in Wales) do not meet recommended levels of physical activity. The COVID-19 pandemic, along with increased waiting lists within the NHS, highlights the need for digitalisation and remote access to health resources. Therefore, this study examined the effect of a digitally delivered exercise programme in increasing habitual physical activity in people on an NHS weight management programme.

Methods:
In a randomised-control trial, people with obesity (BMI ≥ 30 kg/m2) were recruited from the KindEating programme, an NHS weight management programme delivered by Betsi Cadwaladr University Health Board (BCUHB). Participants were randomised to either intervention (12-weeks of digitally delivered, individualised exercise training facilitated by an online digital therapy platform (Salaso Health Solutions Ltd, Tralee, Co. Kerry, Ireland)), or to control (standard routine care). To assess the primary outcome of habitual physical activity (intervention vs. control at post-test timepoint), the Global Physical Activity Questionnaire (GPAQ) was used to calculate minutes of moderate vigorous physical activity (MVPA) per week, with an additional question to determine the number of days completing muscle strengthening activity per week. Non-parametric ANCOVAs (Quade’s analysis) were used to examine the difference in intervention vs. control at post-test, when accounting for pre-test values.

Results:
Out of the sixty-seven participants randomised, 48% in intervention and 50% in control groups were lost to follow up. Thus thirty-four participants provided baseline and follow up data in intervention (N = 17) and control (N = 17) groups. For the primary outcome of habitual physical activity, at post-test, intervention reported a greater amount of MVPA than control (260 ± 655 vs. 60 ± 255 minutes per week, respectively; P = 0.02) and tended to report a greater number of days of muscle strengthening activity per week than control (1 ± 2 vs. 0 ± 1 days per week, respectively; P = 0.08).

Conclusion:
A digitally delivered exercise programme increased habitual physical activity compared to normal routine care in people with obesity. However, nearly half of participants were lost to follow up, suggesting benefits may only be applicable to a subset of patients. Further analyses will look at impacts upon secondary outcomes including habitual physical activity assessed by wearables, training load, exercise and functional capacity, self-reported health status, pain, patient activation, risk of type 2 diabetes, weight loss, and physical activity self-efficacy.