title: Feasibility of a dynamic web guidance approach for personalized physical activity prescription based on daily information from wearable technology.
abstract: BACKGROUND
  Computer tailored, Web-based interventions have emerged as an effective approach to promote physical activity. Existing programs, however, do not adjust activities according to the participant's compliance or physiologic adaptations, which may increase risk of injury and program attrition in sedentary adults. To address this limitation, objective activity monitor (AM) and heart rate data could be used to guide personalization of physical activity, but improved Web-based frameworks are needed to test such interventions.
  
  
  OBJECTIVE
  The objective of this study is to (1) develop a personalized physical activity prescription (PPAP) app that combines dynamic Web-based guidance with multi-sensor AM data to promote physical activity and (2) to assess the feasibility of using this system in the field.
  
  
  METHODS
  The PPAP app was constructed using an open-source software platform and a custom, multi-sensor AM capable of accurately measuring heart rate and physical activity. A novel algorithm was written to use a participant's compliance and physiologic response to aerobic training (ie, changes in daily resting heart rate) recorded by the AM to create daily, personalized physical activity prescriptions. In addition, the PPAP app was designed to (1) manage the transfer of files from the AM to data processing software and a relational database, (2) provide interactive visualization features such as calendars and training tables to encourage physical activity, and (3) enable remote administrative monitoring of data quality and participant compliance. A 12-week feasibility study was performed to assess the utility and limitations of the PPAP app used by sedentary adults in the field. Changes in physical activity level and resting heart rate were monitored throughout the intervention.
  
  
  RESULTS
  The PPAP app successfully created daily, personalized physical activity prescriptions and an interactive Web environment to guide and promote physical activity by the participants. The varied compliance of the participants enabled evaluation of administrative features of the app including the generation of automated email reminders, participation surveys, and daily AM file upload logs.
  
  
  CONCLUSIONS
  This study describes the development of the PPAP app, a closed-loop technology framework that enables personalized physical activity prescription and remote monitoring of an individual's compliance and health response to the intervention. Data obtained during a 12-week feasibility study demonstrated the ability of the PPAP app to use objective AM data to create daily, personalized physical activity guidance, provide interactive feedback to users, and enable remote administrative monitoring of data quality and subject compliance. Using this approach, public health professionals, clinicians, and researchers can adapt the PPAP app to facilitate a range of personalized physical activity interventions to improve health outcomes, assess injury risk, and achieve fitness performance goals in diverse populations.
authors.affiliation: University of California - Davis, Biomedical Engineering Graduate Group, One Shields Avenue, Davis, CA, United States.
authors.forename: Crystal L
authors.identifier: http://orcid.org/0000-0002-1825-598X
authors.initials: CL
authors.lastname: Coolbaugh
authors.forename: Stephen C
authors.identifier: http://orcid.org/0000-0001-5699-1569
authors.initials: SC
authors.lastname: Raymond
authors.forename: David A
authors.identifier: http://orcid.org/0000-0002-8425-482X
authors.initials: DA
authors.lastname: Hawkins
keywords: Web-based interventions; activity monitoring; algorithms; exercise; physical fitness