The effectiveness of physical activity interventions using activity trackers during or after inpatient care: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background Promoting physical activity (PA) in patients during and/or after an inpatient stay appears important but challenging. Interventions using activity trackers seem promising to increase PA and enhance recovery of physical functioning. Objective To review the effectiveness of physical activity interventions using activity trackers on improving PA and physical functioning, compared to usual care in patients during and/or after inpatient care. In addition, it was determined whether the following intervention characteristics increase the effectiveness of these interventions: the number of behaviour change techniques (BCTs) used, the use of a theoretical model or the addition of coaching by a health professional. Design Systematic review and meta-analysis. Data Sources PubMed, EMBASE, Cinahl, SportDiscus and Web of Science databases were searched in March 2020 and updated in March 2021. Eligibility criteria for selecting studies Randomized controlled trials (RCTs) including interventions using activity trackers and feedback on PA in adult patients during, or less than 3 months after, hospitalization or inpatient rehabilitation. Methods Following database search and title and abstract screening, articles were screened on full text for eligibility and then assessed for risk of bias by using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses, including subgroup analysis on intervention characteristics, were conducted for the outcomes PA and physical functioning. Results Overall, 21 RCTs totalling 2355 patients were included. The trials covered a variety of clinical areas. There was considerable heterogeneity between studies. For the 13 studies that measured PA as an outcome variable(N = 1435), a significant small positive effect in favour of the intervention was found (standardized mean difference (SMD) = 0.34; 95%CI 0.12–0.56). For the 13 studies that measured physical functioning as an outcome variable (N = 1415) no significant effect was found (SMD = 0.09; 95%CI -0.02 - 0.19). Effectiveness on PA seems to improve by providing the intervention both during and after the inpatient period and by using a theoretical model, multiple BCTs and coaching by a health professional. Conclusion Interventions using activity trackers during and/or after inpatient care can be effective in increasing the level of PA. However, these improvements did not necessarily translate into improvements in physical functioning. Several intervention characteristics were found to increase the effectiveness of PA interventions. Trial registration Registered in PROSPERO (CRD42020175977) on March 23th, 2020.

Improving physical activity in hospitalized patients: The preliminary effectiveness of a goal-directed movement intervention

“…9 Previous studies evaluating the effect of interventions using activity trackers mainly focused on the minimal clinically important change of step counts in patients with a chronic disease. 16,17 Only few studies evaluated interventions with an activity tracker during hospital stay, whereby step count significantly increased. 28,29 Another study evaluated a smartphone application with an activity tracker in hospitalized patients on standing and walking time.…”

Development of a goal-directed movement intervention (GOAL) using a movement sensor for hospitalized patients: An intervention mapping approach

“…25 Goal setting is stated to be effective in improving physical activity in both hospitalized and nonhospitalized populations. 11 A previous review stated that the use of a movement sensor with a step goal is associated with a significant increase in physical activity. 26 In our study, patients received a movement sensor with a predefined movement goal based on preimplementation measurements of activity levels.…”

“…10 Interventions using movement sensors during or after an inpatient period have the potential to increase the level of physical activity across a wide range of surgical and nonsurgical populations on nursing wards. 11 Previous research looked into barriers and facilitators of patients' physical activity, from patients' and healthcare professionals' perspective. 12,13 They suggested that physical activity is influenced by patients' knowledge, awareness and attitudes.…”

Die Wirksamkeit von Maßnahmen zur Förderung der körperlichen Aktivität unter Verwendung von Aktivitätsmessgeräten während oder nach einer stationären Behandlung: eine systematische Überprüfung und Meta-Analyse von randomisierten kontrollierten Studien

“…Die Ergebnisse von de Leeuwerk et al 2 müssen aufgrund der hohen Heterogenität der Studien mit Vorsicht interpretiert werden. Die Übersichtsarbeit deckt eine breite Population von Patient*innen ab, es kann jedoch aufgrund der heterogenen Studien kein spezifischer Schluss oder keine Handlungsempfehlung zur Dauer oder Intensität der Intervention gemacht werden.…”