Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: A randomized clinical trial (EMID Study)

Alonso-Domínguez, Rosario; Patino-Alonso, María C; Sánchez-Aguadero, Natalia; García-Ortiz, Luis; Recio-Rodríguez, Jose I; Gómez-Marcos, Manuel A

doi:10.1177/1474515119835048

Cited by 38Physical Activity and HealthDiabetes Management and EducationMobile Health and mHealth Applications

Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: A randomized clinical trial (EMID Study)

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Alonso-Domínguez, Rosario, Patino-Alonso, María C, Sánchez-Aguadero, Natalia, García-Ortiz, Luis, Recio-Rodríguez, Jose I, Gómez-Marcos, Manuel A·2019·European Journal of Cardiovascular Nursing

DOI 10.1177/1474515119835048

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Abstract

BACKGROUND: Regular physical activity is essential for metabolic control in type 2 diabetes mellitus. AIMS: The aim of this study was to assess the short and long-term impact of a multifactorial intervention on physical activity and clinically relevant biochemical parameters in patients with type 2 diabetes mellitus. METHODS: This randomised, controlled clinical trial (NCT02991079) included two parallel groups aged 25-70 years from a primary care health centre in Salamanca, Spain. The subjects were assigned randomly (1:1) to control and intervention groups, using Epidat 4.0 software. Both were counselled on the importance of physical activity and maintaining a healthy diet. The intervention group also took five low-moderate intensity 4 km nurse-guided walks, received a smartphone application to promote healthy habits and attended a diet workshop. Physical activity was measured objectively using a pedometer and subjectively using a shortened international physical activity questionnaire (at baseline, 3 and 12 months). RESULTS: In total, 204 subjects were included (mean age 60.6 years, 45.6% were women). After 3 months, relative to the control group, the intervention group increased their daily number of steps by 1852, aerobic steps by 1623, distance walked by 994 m, and total metabolic equivalent minutes per week by 1297 and decreased sedentary time by 34.3 minutes per day. Differences from baseline persisted at 12 months, including mean increases of 1141 daily steps, 917 aerobic steps, and 1065 total metabolic equivalent minutes per week in the intervention group relative to the control group ( P<0.05 for all). CONCLUSIONS: The success of this multifactorial intervention should help inform future clinical approaches and application designs towards managing type 2 diabetes mellitus and improving patient outcomes.

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The effectiveness of wearable devices appears to depend largely on how they are integrated into the overall intervention, particularly in relation to the level of structure, the consistency and nature of behavioural support, and the presence of clearly defined, measurable objectives.
“Their effectiveness appears to depend largely on how they are integrated into the overall intervention, particularly in relation to the level of structure, the consistency and nature of behavioural support, and the presence of clearly defined, measurable objectives [17,20,21,22,23,26,28].”
From Effectiveness of wearable technologies in supporting physical activity and metabolic health in adults with type 2 diabetes: a systematic-narrative hybrid review (2025) · cites this paper as [22]

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Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial
Alonso‐Domínguez, R., Gómez-Marcos, M. Á., Patino-Alonso, M. C., Sánchez‐Aguadero, N., Agudo-Conde, C., Castaño-Sánchez, C., García‐Ortiz, L., & Recio-Rodriguez, J. I. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016191 · Cited by 21 · see citing works
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The effectiveness of a brief intervention using a pedometer and step-recording diary in promoting physical activity in people diagnosed with type 2 diabetes or impaired glucose tolerance
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Authors: Alonso-Domínguez, R., Patino-Alonso, M. C., Sánchez-Aguadero, N., García-Ortiz, L., Recio-Rodríguez, J. I., & Gómez-Marcos, M. A.
Affiliations: Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, Spain
Universidad de Salamanca (ES)
ORCID: Patino-Alonso, María C
Venue: European Journal of Cardiovascular Nursing
Publisher: Oxford University Press (OUP)
Published: 2019-02-26
Volume: 18
Issue: 5
Pages: 399-409
ISSN: 1474-5151 (ISSN-L)
1873-1953
DOI: 10.1177/1474515119835048
OpenAlex: W2915772093
Cited by: 38
References: 36
Citations by year: 2026: 4 · 2025: 4 · 2024: 7 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 2 · 2019: 1
FWCI: 3.26
Type: journal article
Language: en
Open access: green
doi.org
Licence: cc-by-nc-nd
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: European Journal of Cardiovascular Nursing (publishedVersion)
PubMed (publishedVersion)
Gredos (University of Salamanca) (publishedVersion, cc-by-nc-nd)
Hispana (publishedVersion, cc-by-nc-nd)
Funders: Regional Health Management
instituto de salud carlos iii
european regional development fund
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: type 2 diabetes, physical activity, multifactorial intervention, mobile application, healthy eating, pedometers, sedentary behavior, metabolic equivalent minutes, primary care, metabolic control
MeSH terms: Aged, Behavior Therapy, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Primary Health Care, Spain, Exercise, Walking

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Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: A randomized clinical trial (EMID Study)

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