Effectiveness of physical activity monitors in adults: systematic review and meta-analysis

Abstract

Objective To estimate the effectiveness of physical activity monitor (PAM) based interventions among adults and explore reasons for the heterogeneity. Design Systematic review and meta-analysis. Study selection The electronic databases MEDLINE, Embase, SPORTDiscus, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched on 4 June 2021. Eligible randomised controlled trials compared interventions in which adults received feedback from PAMs with control interventions in which no feedback was provided. No restrictions on type of outcome measurement, publication date, or language were applied. Data extraction and synthesis Two reviewers independently extracted data and assessed risk of bias. Random effects meta-analyses were used to synthesise the results. The certainty of evidence was rated by the Grading of Recommendations Assessment and Evaluation (GRADE) approach. Main outcome measures The three primary outcomes of interest were physical activity, moderate to vigorous physical activity, and sedentary time. Results 121 randomised controlled trials with 141 study comparisons, including 16 743 participants, were included. The PAM based interventions showed a moderate effect (standardised mean difference 0.42, 95% confidence interval 0.28 to 0.55) on physical activity, equivalent to 1235 daily steps; a small effect (0.23, 0.16 to 0.30) on moderate to vigorous physical activity, equivalent to 48.5 weekly minutes; and a small insignificant effect (−0.12, −0.25 to 0.01) on sedentary time, equal to 9.9 daily minutes. All outcomes favoured the PAM interventions. Conclusions The certainty of evidence was low for the effect of PAM based interventions on physical activity and moderate for moderate to vigorous physical activity and sedentary time. PAM based interventions are safe and effectively increase physical activity and moderate to vigorous physical activity. The effect on physical activity and moderate to vigorous physical activity is well established but might be overestimated owing to publication bias. Study registration PROSPERO CRD42018102719.

Lack of physical activity is a global problem

“…Time spent sitting (sedentary time) is an independent risk factor for all cause mortality, cardiovascular disease, cancer, and type 2 diabetes 4. Kettle and colleagues reported no significant effect of primary care interventions on sedentary time, while Larsen and colleagues found that physical activity monitor based interventions were associated with a mean decrease of 9.9 min/day 79…”

“…Trials measuring physical activity with objective devices, such as accelerometers or wearable activity trackers, found no significant difference in MVPA between groups, while trials relying on self-reported activity showed an increase of 24 min/week in intervention groups 7. In a previous meta-analysis, Larsen and colleagues found that interventions using physical activity monitors increased MVPA by 48.5 min/week 9. But they judged this evidence to be ‘low certainty’ due to publication and small study biases.…”

“… 7 In a previous meta-analysis, Larsen and colleagues found that interventions using physical activity monitors increased MVPA by 48.5 min/week. 9 But they judged this evidence to be ‘low certainty’ due to publication and small study biases.…”

Implementation of Back At work After Surgery (BAAS): a feasibility study of an intergrated pathway for improved return to work after knee arthroplasty

“…A week later, the CCM called the patient to discuss the current physical activity assessed by the accelerometer and gave advice on the preferred physical preoperative preparation. For example, patients were advised to train functional movements required after surgery, such as walking with a walking aid, or is advised to maintain or increase the current physical tness level by adhering to the World Health Organization's (WHO) latest physical activity guideline [13,25].…”

“…To enhance patients' participation in the BAAS clinical pathway, the patient, together with the physical therapist, sets realistic therapy goals using Goal Attainment Scaling, based on activities needed to RTW after surgery [12]. Also, a patient is equipped with an accelerometer before surgery until full RTW, which provides the patient and physical therapist insight in movement behavior and progression of activity levels during rehabilitation [13].…”