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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
280
Common Practices at MSS In the standard setting of MSS La Musse, participants are referred by their primary care physician, a specialist involved in prescribing physical activity programs. Each participant undergoes an individual pre-test guided by the protocols of the National Observatory of Physical and Sports Activities (ONAPS), which assesses various parameters of physical fitness as well as certain psychological aspects (see Appendix - ONAPS protocol). These assessments serve as the basis for referral to a personalized physical activity plan (PPAP), developed jointly with a physical activity instructor. These assessments serve as the basis for referral to a personalized physical activity plan (PPAP), developed jointly with a physical activity instructor. This PPAP defines weekly goals centered on independent physical activity (gentle mobility, self-directed exercises at home), combating a sedentary lifestyle (reducing time spent resting), and participation in supervised sessions (
Improvements in physical fitness and anthropometric parameters
Several tests will be conducted: The TDM6, which assesses cardiorespiratory fitness by measuring the distance (in meters) covered while walking at a brisk pace for six minutes; The 30-second "Sit to Stand" test, which measures quadriceps muscle endurance as well as physical capacity; The handgrip test, which assesses upper limb muscle strength; The "Sit and Reach" test, which assesses lower limb flexibility and the range of motion of the posterior chain; The "Timed Up and Go" test, which assesses overall functional mobility through a sequence of movements (standing up from a chair, walking three meters, turning around, returning, and sitting down); Body Mass Index (BMI) will be calculated using body weight (in kilograms) divided by height squared (in meters); Body weight will be measured using a calibrated electronic scale, with the participant fully clothed and barefoot; Waist circumference will be measured using a non-stretchable anthropometric tape measuring tape, placed midway bet
Time frame: At the start of the program, 3 months after the first assessment, and then 6 months, 12 months, and 18 months
The Health-Related Physical Activity Motivation Scale
The Health-Related Physical Activity Motivation Scale (EMAPS) measures the various forms of motivation described by self-determination theory. It consists of 18 items rated on a seven-point scale and includes six dimensions (intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation).
Time frame: At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment
The Exercise Confidence Survey (ECS)
The Exercise Confidence Survey (ECS) is a questionnaire designed to measure perceived self-efficacy in the regular practice of physical activity. It consists of 12 items organized into two dimensions: adherence to PA, which assesses confidence in maintaining physical activity despite various obstacles (fatigue, stress, lack of support, obligations), and time management, which focuses on the ability to organize one's schedule to incorporate PA. Responses are rated on a five-point scale ranging from "I know I can't" to "I know I can."
Time frame: At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment.
The International Physical Activity Questionnaire
The International Physical Activity Questionnaire - Short Form (IPAQ-SF, 7-day) is used to assess self-reported physical activity over the previous week. It includes questions on the frequency and duration of vigorous and moderate-intensity activities, walking, as well as time spent sitting. Responses are converted into MET-minutes per week, allowing individuals to be classified into three levels of physical activity: low, moderate, or high. An official French version is available and widely used, although psychometric validation of the short form remains limited.
Time frame: At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment.
The meCUE
The meCUE (Modular Evaluation of Key Components of the User Experience) scale is a standardized questionnaire used to evaluate the key components of the user experience, whether instrumental (utility, usability) or non-instrumental (aesthetics, status, engagement).
Time frame: At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment.
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