Accelerometer- and Pedometer-Based Physical Activity Interventions Among Adults With Cardiometabolic Conditions

Hodkinson, Alexander; Kontopantelis, Evangelos; Adeniji, Charles; Marwijk, Harm van; McMillan, Brian; Bower, Peter; Panagioti, Maria

doi:10.1001/jamanetworkopen.2019.12895

Cited by 37 publications

(59 citation statements)

References 62 publications

(93 reference statements)

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“…Some studies provided only graphical presentation of step-count results, which prevented their inclusion in meta-analyses. We were also unable to analyse the importance of both number and length of intervention sessions, due to reporting inconsistencies, which others have also highlighted [96]. Moving forward, therefore, when interventions are being investigated, it is important for study reports to provide clear information about the exact nature of the intervention, the number and length of contacts included within it and the reporting of outcomes, to provide further robust evidence to inform policy.…”

Section: Implications For Public Health Research Practice and Policymentioning

confidence: 99%

The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults

Chaudhry

Wahlich

Fortescue

et al. 2020

Int J Behav Nutr Phys Act

109

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Background Step-count monitors (pedometers, body-worn trackers and smartphone applications) can increase walking, helping to tackle physical inactivity. We aimed to assess the effect of step-count monitors on physical activity (PA) in randomised controlled trials (RCTs) amongst community-dwelling adults; including longer-term effects, differences between step-count monitors, and between intervention components. Methods Systematic literature searches in seven databases identified RCTs in healthy adults, or those at risk of disease, published between January 2000–April 2020. Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcome was mean differences (MD) with 95% confidence intervals (CI) in steps at follow-up between treatment and control groups. Our preferred outcome measure was from studies with follow-up steps adjusted for baseline steps (change studies); but we also included studies reporting follow-up differences only (end-point studies). Multivariate-meta-analysis used random-effect estimates at different time-points for change studies only. Meta-regression compared effects of different step-count monitors and intervention components amongst all studies at ≤4 months. Results Of 12,491 records identified, 70 RCTs (at generally low risk of bias) were included, with 57 trials (16,355 participants) included in meta-analyses: 32 provided change from baseline data; 25 provided end-point only. Multivariate meta-analysis of the 32 change studies demonstrated step-counts favoured intervention groups: MD of 1126 steps/day 95%CI [787, 1466] at ≤4 months, 1050 steps/day [602, 1498] at 6 months, 464 steps/day [301, 626] at 1 year, 121 steps/day [− 64, 306] at 2 years and 434 steps/day [191, 676] at 3–4 years. Meta-regression of the 57 trials at ≤4 months demonstrated in mutually-adjusted analyses that: end-point were similar to change studies (+ 257 steps/day [− 417, 931]); body-worn trackers/smartphone applications were less effective than pedometers (− 834 steps/day [− 1542, − 126]); and interventions providing additional counselling/incentives were not better than those without (− 812 steps/day [− 1503, − 122]). Conclusions Step-count monitoring leads to short and long-term step-count increases, with no evidence that either body-worn trackers/smartphone applications, or additional counselling/incentives offer further benefit over simpler pedometer-based interventions. Simple step-count monitoring interventions should be prioritised to address the public health physical inactivity challenge. Systematic review registration PROSPERO number CRD42017075810.

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Section: Implications For Public Health Research Practice and Policymentioning

confidence: 99%

The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults

Chaudhry

Wahlich

Fortescue

et al. 2020

Int J Behav Nutr Phys Act

109

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“…Application of accelerometers and pedometers was analysed in different cardiometabolic conditions (e.g., diabetes and cardiac disease) in a systematic review [26], which reported increased moderate to vigorous physical activity (MVPA) levels with either pedometers or accelerometers specifically when face to face consultation with the health professionals was executed. Regular advice and guidance on exercise or physical activity regime to patients were provided with pedometers and accelerometers separately or in combination yielded higher PA levels with a standardized mean difference of 0.30 (accelerometers) and 0.52 (1703 steps using pedometers).…”

Section: Cardiology Research and Practicementioning

confidence: 99%

Impact of Cardiac Rehabilitation on Functional Capacity and Physical Activity after Coronary Revascularization: A Scientific Review

Prabhu

Maiya

2020

Cardiology Research and Practice

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Background. Coronary revascularization procedures often cause lowered exercise capacity and declining physical activity levels. These outcomes are paramount in predicting morbidity and mortality after these procedures. Cardiac rehabilitation (CR) focuses on incrementing cardiovascular endurance, exercise capacity, muscle strength, levels of physical activity, and quality of life through health education and lifestyle modification in post-coronary revascularization patients. Objective. To review the impact of cardiac rehabilitation on functional capacity, levels of physical activity, and health related quality of life in patients following coronary revascularization. Methods. A structured literature search in PubMed, Scopus, CINAHL, and ProQuest for studies focused on CR and its effects on functional capacity, physical activity, and quality of life after coronary revascularization. Results. A total of 2,010 studies were retrieved. Deduplication and eligibility screening included 190 studies after the application of filters. A sum of 21 studies were considered for this review. Most studies reported that exercise and physical activity programs were centre-based and home-based and via telerehabilitation. Treadmill and cycle ergometry training with callisthenics and flexibility exercises in phase 2 CR exhibited significant improvement in functional capacity and physical activity levels in patients after coronary revascularization procedures. Conclusion. Although centre-based supervised CR programs do improve functional capacity after coronary revascularization, home-based or telerehabilitation-based CR programs are feasible, improve patient compliance in improving physical activity, and thereby increase functional capacity. Patient education improves levels of physical activity, health related quality of life, and adherence to home- and centre-based CR programs.

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“…In comparison, in the HEALD trial, the group receiving pedometers without any counseling (similar to our group B) increased daily steps to a lower extent than the group receiving counseling (30). Meta-analyses provide con icting results regarding the e cacy of counseling as a complement to self-monitoring (8,9). The speci c content of the intervention components may in uence both the implementation and the outcomes of an intervention.…”

Section: The Hypothesis Of Sophiamentioning

confidence: 78%

“…Diabetes care givers are encouraged to give advice on physical activity and such advice may be combined with using a pedometer or a comparable self-monitoring device (4, 5). Pedometers have shown positive effects on increased physical activity in short term in populations with type 2 diabetes (3,(6)(7)(8)(9) and are recommended for use to increase motivation to be physically active (10,11). Yet, it is unclear whether self-monitoring alone, or in combination with counseling is the most feasible and effective alternative (8,9,12).…”

Section: Introductionmentioning

confidence: 99%

“…Pedometers have shown positive effects on increased physical activity in short term in populations with type 2 diabetes (3,(6)(7)(8)(9) and are recommended for use to increase motivation to be physically active (10,11). Yet, it is unclear whether self-monitoring alone, or in combination with counseling is the most feasible and effective alternative (8,9,12). Comparison of available studies is di cult due to heterogeneous intervention setups and the limited reporting of context and implementation of interventions (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes

Rossen

Hagströmer

Yngve

et al. 2020

Preprint

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Background Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health. Methods The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry. Results From April 2013 to January 2018 188 participants were randomized. Response rate was 49% and drop out was 10%. The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and -506 (-1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(-507, 570) steps/day for the multicomponent intervention group, 144 (-566, 853) step/day for the single component group and -890 (-1485, -294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.Conclusions Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support. While physical activity levels increased after 6 months, maintenance of physical activity is a more realistic expectation in the long term. Physical activity behavior varies among individuals and support for physical activity should be tailored to the person. Trial registration ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788

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Accelerometer- and Pedometer-Based Physical Activity Interventions Among Adults With Cardiometabolic Conditions

Cited by 37 publications

References 62 publications

The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults

The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults

Impact of Cardiac Rehabilitation on Functional Capacity and Physical Activity after Coronary Revascularization: A Scientific Review

Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes

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