Objectively measured physical activity levels and adherence to physical activity guidelines in people with multimorbidity—A systematic review and meta-analysis

Abstract

Objective To determine levels of objectively measured physical activity (PA) and the proportion of adults with multimorbidity that adheres to PA guidelines. Methods All studies, where PA was measured at baseline using an activity monitor in an adult (≥18 years) multimorbid (≥80% of the population had ≥2 chronic conditions) population. A systematic literature search was performed in Medline, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, opengrey.eu and google.com from inception up until 18th of January 2022. Risk of bias was assessed with a modified version of the Quality Assessment Tool for Quantitative Studies. A random-effects meta-analyses was performed to estimate daily minutes of sedentary behavior (SB), light PA (LPA), moderate PA (MPA), moderate to vigorous PA (MVPA) and steps. Proportions adhering to PA guidelines was narratively synthesized. Certainty of evidence was determined using The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Fifteen studies (2,172 participants) were included. The most frequent combination of conditions were type 2 diabetes and hypertension (six studies). Participants spent a daily average of 500.5 (95% CI: 407.1 to 593.9) minutes in SB, 325.6 (95% CI: 246.4 to 404.7 minutes in LPA and 32.7 (95% CI: 20.2 to 45.3) minutes in MVPA. The mean daily number of steps was 5,145 (95% CI: 4264 to 6026) for people in free-living conditions. The proportion adhering to PA guidelines ranged widely (7.4% to 43%). All studies were rated as at high risk of bias and the certainty of evidence was very low. Conclusions PA levels and adherence varied from low to above guideline recommended levels for adults with chronic conditions, depending on PA intensity. The very low certainty of evidence calls for high quality studies focusing on detailed descriptions of PA behavior in people with multimorbidity. PROSPERO registration number CRD42020172456.

Impact of a wearable-based physical activity andsleep intervention in multimorbidity patients:protocol for a randomized controlled trial

“…A recent systematic review showed strong evidence of the positive impact of wearables on increasing physical activity among the general population, although effect on physiological and psychosocial measures was not clear [15]. Despite these findings, limited evidence exists on elderly patients with multimorbidity, both on objectively measured PA as well as on the efficacy of using activity trackers to improve PA [16]. Commercial offthe-shelf activity trackers allow users to self-monitor their daily PA, including the number of steps, type of PA, and amount of sleep.…”

“…Commercial offthe-shelf activity trackers allow users to self-monitor their daily PA, including the number of steps, type of PA, and amount of sleep. Fitbit (Fitbit Inc, San Francisco, CA, USA) activity trackers have previously been utilized as both measurement and intervention tools, however, it is unclear how they are being integrated into PA intervention studies, and their use in MM patients remains limited [16,17]. Moreover, in order to access the impact of the PA the patient's view must be considered.…”

Gender Differences in University Students’ Levels of Physical Activity and Motivations to Engage in Physical Activity

“…One of society's greatest challenges is to combat sedentary lifestyles in order to prevent the onset of cardiovascular diseases and problems associated with physical inactivity [1], since physical inactivity is considered the fourth leading risk factor for mortality worldwide [2]. Research has associated low or non-existent levels of physical activity with an increased risk of developing diseases such as diabetes, cardiovascular diseases, hypertension, breast or colon cancer, as well as mental illness [3][4][5][6][7].…”

Impact of a wearable-based physical activity and sleep intervention in multimorbidity patients: protocol for a randomized controlled trial

“…A recent systematic review showed strong evidence of the positive impact of wearables on increasing physical activity among the general population, although effect on physiological and psychosocial measures was not clear [ 15 ]. Despite these findings, limited evidence exists on older adult patients with multimorbidity, both on objectively measured PA as well as on the efficacy of using activity trackers to improve PA [ 16 ]. Commercial off-the-shelf activity trackers allow users to self-monitor their daily PA, including the number of steps, type of PA, and amount of sleep.…”

“…Commercial off-the-shelf activity trackers allow users to self-monitor their daily PA, including the number of steps, type of PA, and amount of sleep. Fitbit (Fitbit Inc, San Francisco, CA, USA) activity trackers have previously been utilized as both measurement and intervention tools, however, it is unclear how they are being integrated into PA intervention studies, and their use in Multimorbidity (MM) patients remains limited [ 16 , 17 ]. Moreover, in order to access the impact of the PA the patient’s view must be considered.…”