Effectiveness of healthcare interventions using objective feedback on physical activity: A systematic review and meta-analysis

Abstract

Wearable technology is progressively applied in health care and rehabilitation to provide objective insight into physical activity levels. In addition, feedback on physical activity levels delivered by wearable monitors might be beneficial for optimizing their physical activity. A systematic review and meta-analysis was conducted to evaluate the effectiveness of interventions using feedback on objectively measured physical activity in patient populations. Fourteen studies including 1902 patients were analyzed. Overall, the physical activity levels of the intervention groups receiving objective feedback on physical activity improved, compared to the control groups receiving no objective feedback. Mostly, a variety of other strategies were applied in the interventions next to wearable technology. Together with wearable technology, behavioral change strategies, such as goalsetting and action planning seem to be an important ingredient to promote physical activity in health care and rehabilitation. Objective: To determine the effectiveness of health care interventions promoting physical activity, which use objective feedback on physical activity delivered using wearable activity monitors as part of the in tervention. Intervention groups are compared with control groups receiving usual care or interventions without objective feedback. Data sources: PubMed, EMBASE, MEDLINE and Co chrane Library were searched to identify randomized controlled trials. Study selection: Randomized controlled trials pu blished after 2007 with (former) healthcare patients ≥ 21 years of age were included if physical activity was measured objectively using a wearable moni tor for both feedback and outcome assessment. The main goal of included studies was promoting phy sical activity. Any concurrent strategies were related only to promoting physical activity. Data extraction: Effect sizes were calculated using a fixed-effects model with standardized mean dif ference. Information on study characteristics and interventions strategies were extracted from study descriptions. Data synthesis: Fourteen studies met the inclusion criteria (total n = 1,902), and 2 studies were exclu ded from metaanalysis. The overall effect size was in favour of the intervention groups (0.34, 95% CI 0.23-0.44, p < 0.01). Study characteristics and inter vention strategies varied widely. Conclusion: Healthcare interventions using feedback on objectively monitored physical activity have a moderately positive effect on levels of physical acti vity. Further research is needed to determine which strategies are most effective to promote physical ac tivity in healthcare programmes.

Do smartphone applications and activity trackers increase physical activity in adults? Systematic review, meta-analysis and metaregression

“…14 It has been suggested that reducing user burden and providing features like goal setting, personalisation and game-like functionality (ie, gamification) may facilitate engagement, promote retention and increase intervention effectiveness. [15][16][17] Existing reviews of apps and trackers have not yet focused on seemingly healthy adults [18][19][20][21][22][23] and technology enabling automated and continuous self-monitoring and feedback, with apps often still requiring users to connect an accelerometer to a computer periodically via a hardware connection. 20 22 24-30 These reviews of older apps and trackers have shown non-significant 22 24 26 or small-to-moderate positive results 20 25 28 with high heterogeneity, often mixing very different types of populations apart from healthy adults (eg, children, 26 elderly 22 27 28 and chronic conditions 20 25 27 28 ).…”

Lifestyle Modification Using a Wearable Biometric Ring and Guided Feedback Improve Sleep and Exercise Behaviors: A 12-Month Randomized, Placebo-Controlled Study

“…This pattern of initial and continued improvement with GTF, and maintenance of improved values upon removal of GTF, was also observed in Step Count, % Time Jogging, and VO 2 max. Previous research demonstrates similar improvements in physical activity and cardiovascular fitness resulting from interventions incorporating activity trackers and personalized feedback (Braakhuis et al, 2019;Brickwood et al, 2019Brickwood et al, , 2021Ellingson et al, 2019). Furthermore, there is a dose-response relationship between physical activity and major health outcomes, where simply increasing daily step count has a positive impact on mortality and morbidity risk.…”

Detection of body postures and movements in ambulatory adults with cerebral palsy: a novel and valid measure of physical behaviour

“…Compared to these systems the Activ8 is inexpensive, easy-to-use, and can provide direct feedback. A recent systematic review and meta-analysis has reported that AMs that provide users with ongoing feedback have moderately positive effects on levels of PA [36]. This suggests AMs like the Activ8 would be valuable components of PA promoting programs in the field of rehabilitation.…”