Personal Activity Intelligence (PAI) is a physical activity monitoring approach invented by researchers at the Norwegian University of Science and Technology around five years ago. It uses heart rate data (e.g., from a wrist-worn monitor) to provide the user with a single metric. This number reflects the amount and intensity of aerobic exercise a person has completed in the previous seven days. For most people, the goal should be to keep their PAI score at or above 100, as there is now considerable evidence that 100 PAI leads to improved health outcomes. The app to record and monitor PAI is freely available for smartphones and allows heart rate data from all major activity trackers or watches to be synced. Some watches also allow PAI to be displayed.
Our group has researched the use of PAI since it became available. Our previous studies have shown that you need to do more than just give people a heart rate watch and tell them to download the app. Therefore, we designed the PAI e-Health Program that also has them attend a two-hour session per week for four weeks. These group sessions cover technical issues (e.g., downloading, syncing, troubleshooting) and also include PAI playtime. Here, exercise physiologists allow participants to see how they can gain PAI in different ways. A clinical psychologist also has allocated time with the patients to implement individual behavior change strategies.
In the January 2022 issue of Medicine & Science in Sports & Exercise® we published our randomized controlled trial using the PAI e-Health Program in people with type 2 diabetes who were sedentary. Our main findings were that patients achieved and maintained 100 PAI. This led to improvements in exercise capacity and sleep and reduced body fat. Four out of five also stated that they intended to continue to use PAI monitoring after the 12-week trial was finished.
I believe the success of PAI is related to its simplicity. Many of us have tried explaining the difference between moderate- and vigorous-intensity aerobic exercise to a client. Then, we tried adding that if you do vigorous-intensity exercise, you only need to do it for half as long as if you do it at moderate intensity. It confuses even the most astute novice. Having one number that considers exercise intensity and duration is the most important aspect of this approach. Based on our experience and given the widespread use of wrist-worn heart rate watches, I would encourage you to try PAI for yourself and see if it might be appropriate for your clients.
Our trial lasted 12 weeks. The sustainability of this approach needs investigating as it is well known that many tech-based approaches to physical activity promotion and monitoring tend to have short life spans. In our studies, technical issues (e.g., syncing problems) are the major reason why people stop using PAI. Hopefully, advancements in technology will slowly lead to these issues being less of a barrier and if so, we may see more people knowing if they are active enough by looking at one number.
Jeff Coombes, PhD, FACSM, earned his Ph.D. from the University of Florida under the supervision of ACSM Fellow Dr. Scott Powers. Dr. Coombes is a professor of clinical exercise physiology in the School of Human Movement and Nutrition Sciences at The University of Queensland. His research focuses on determining the optimal exercise prescription for improving health and investigating novel approaches to assist people to maintain their fitness. His findings have emphasized the importance of cardiorespiratory fitness for health benefits and many of his current projects are using high-intensity interval training and m-health approaches to improve and sustain fitness.
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