Effect of WeChat Intervention on Physical Activity in Patients with Glaucoma

Objective: To study the effect of WeChat reminder intervention for increasing physical activity (PA) in glaucoma patients. Methods: In this prospective, randomized, controlled study, 102 glaucoma patients were enrolled from the outpatient department of the Eye Hospital, Wenzhou Medical University from June 2018 to December 2018. Participants were randomly divided into a control group and an intervention group using random numbers generated by Excel. All the participants were taught the benefit of exercise and were advised to increase their daily steps when they were enrolled in the outpatient department. Only patients in the intervention group were invited to join the WeChat group for a reminder of exercise intervention. The PA of all patients was monitored by ActiGraph (WGT3X-BT) for a 1-week baseline and 1-month follow-up during the intervention period. Statistical analyses were performed using a Chi-square test, independent samples t test, Mann-Whitney U test, paired samples t test and Wilcoxon signed-rank test. Results: Thirty patients with high daily exercise levels at baseline (>12 000 steps/day), poor compliance or other reasons during the follow-up were excluded. Seventy-two patients finally met all requirements, including 42 patients in the control group and 30 patients in the intervention group. For the intervention group, the mean amount of PA during the 1-month follow-up was significantly higher than that at the 1-week baseline, in which the mean daily steps (t=4.94, P<0.001), calories consumed during exercise (Z=-2.87, P=0.004), metabolism equivalents (METs) (Z=-3.30, P=0.001), moderate physical activity (MPA) (Z=-2.89, P=0.004), vigorous physical activity (VPA) (t=2.57, P=0.016) and moderate-to-vigorous physical activity (MVPA) times (Z=-3.01, P=0.003) had significant differences. Light physical activity (LPA) and the number of sedentary breaks were reduced compared with those before intervention (t=-2.14, P=0.041; t=-2.76, P=0.022). For the control group, the average daily steps in the 1-month follow-up were also higher after intervention than the average at baseline (t=3.29, P<0.001). LPA time was also reduced compared to baseline (t=-2.57, P=0.014). In addition, in the intervention group, the increase in VPA time (follow-up-baseline) (Z=-3.04, P=0.002) and very vigorous physical activity (VVPA) time (Z=-2.06, P=0.040) were significantly higher than those in the control group. Conclusions: WeChat intervention can increase the daily steps and MVPA time of glaucoma patients and decrease the LPA time and the number of sedentary breaks. Key words: glaucoma; WeChat; physical activity