Step Counting In A Virtual Whole Health Program For Veterans With Chronic Multi-symptom Illness

Approximately 25-35% (175,000 to 250,000) of the 700,000 US troops deployed during the Gulf War in 1990-91 still suffer from chronic multisymptom illnesses also known as Gulf War Illness (GWI). Veterans evaluated at the War-Related Illness and Injury Study Center (WRIISC) in VA New Jersey Health Care System were invited to participate in a virtual multi-component program centered on Whole Health and functional medicine health coaching. PURPOSE: To assess the feasibility and efficacy of an activity monitoring program for veterans with GWI. METHODS: The 24-week program included functional medicine assessments, personalized and group nutrition coaching, adaptive exercise coaching (individual and group), mindfulness meditation and yoga sessions, and provision of nutritional supplements. Participants were each given a Fitbit Sense 2 to track step counts during the intervention. We analyzed Fitbit data over the first 16 weeks for feasibility quantified as A) wear time, and B) step count changes from Week 0 to Week 16 among consistent Fitbit wearers (t-test). RESULTS: Eleven participants enrolled in the program (4 female, age range: 39-59, 2 non-white). Three participants stopped wearing the device in week 7, 9, and 13, respectively, and three others did not consistently wear it during the intervention. Among the five consistent wearers of the device, there was no significant difference between W0 and W16 (6,188 ± 3,580 vs 7,349 ± 4,161 steps per day, p = 0.218, d = 0.30). Among these five participants, three increased their daily step count by 1,800-5,200, while two showed no change or a decrease. CONCLUSION: Preliminary data show feasibility of an activity monitoring program as a complement to a virtual multi-component treatment program for veterans with GWI. Several veterans increased their step count, but variability in gains suggests a need for greater participant support to encourage physical activity. Considering other factors that may influence physical activity, such as the severity of medical symptoms, pain, stress, health-related quality of life, and mindfulness, may provide additional data to tailor efforts to increase physical activity in this population of veterans.