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Longhini J, Marzaro C, Bargeri S, Palese A, Dell'Isola A, Turolla A, Pillastrini P, Battista S, Castellini G, Cook C, Gianola S, Rossettini G. Wearable Devices to Improve Physical Activity and Reduce Sedentary Behaviour: An Umbrella Review. SPORTS MEDICINE - OPEN 2024; 10:9. [PMID: 38219269 PMCID: PMC10788327 DOI: 10.1186/s40798-024-00678-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Several systematic reviews (SRs), with and without meta-analyses, have investigated the use of wearable devices to improve physical activity, and there is a need for frequent and updated syntheses on the topic. OBJECTIVE We aimed to evaluate whether using wearable devices increased physical activity and reduced sedentary behaviour in adults. METHODS We conducted an umbrella review searching PubMed, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, MedRxiv, Rxiv and bioRxiv databases up to February 5th, 2023. We included all SRs that evaluated the efficacy of interventions when wearable devices were used to measure physical activity in adults aged over 18 years. The primary outcomes were physical activity and sedentary behaviour measured as the number of steps per day, minutes of moderate to vigorous physical activity (MVPA) per week, and minutes of sedentary behaviour (SB) per day. We assessed the methodological quality of each SR using the Assessment of Multiple Systematic Reviews, version 2 (AMSTAR 2) and the certainty of evidence of each outcome measure using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations). We interpreted the results using a decision-making framework examining the clinical relevance and the concordances or discordances of the SR effect size. RESULTS Fifty-one SRs were included, of which 38 included meta-analyses (302 unique primary studies). Of the included SRs, 72.5% were rated as 'critically low methodological quality'. Overall, with a slight overlap of primary studies (corrected cover area: 3.87% for steps per day, 3.12% for MVPA, 4.06% for SB) and low-to-moderate certainty of the evidence, the use of WDs may increase PA by a median of 1,312.23 (IQR 627-1854) steps per day and 57.8 (IQR 37.7 to 107.3) minutes per week of MVPA. Uncertainty is present for PA in pathologies and older adults subgroups and for SB in mixed and older adults subgroups (large confidence intervals). CONCLUSIONS Our findings suggest that the use of WDs may increase physical activity in middle-aged adults. Further studies are needed to investigate the effects of using WDs on specific subgroups (such as pathologies and older adults) in different follow-up lengths, and the role of other intervention components.
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Affiliation(s)
- Jessica Longhini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Silvia Bargeri
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alvisa Palese
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Andrea Dell'Isola
- Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Simone Battista
- Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Savona, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Chad Cook
- Department of Orthopaedics, Division of Physical Therapy, Duke University, Durham, NC, USA
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| | - Giacomo Rossettini
- School of Physiotherapy, University of Verona, Verona, Italy
- Department of Human Neurosciences, University of Roma "Sapienza Roma", Rome, Italy
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón 28670, Spain
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Ferguson T, Olds T, Curtis R, Blake H, Crozier AJ, Dankiw K, Dumuid D, Kasai D, O'Connor E, Virgara R, Maher C. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. Lancet Digit Health 2022; 4:e615-e626. [PMID: 35868813 DOI: 10.1016/s2589-7500(22)00111-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/22/2022] [Accepted: 05/27/2022] [Indexed: 05/27/2023]
Abstract
Wearable activity trackers offer an appealing, low-cost tool to address physical inactivity. This systematic review of systematic reviews and meta-analyses (umbrella review) aimed to examine the effectiveness of activity trackers for improving physical activity and related physiological and psychosocial outcomes in clinical and non-clinical populations. Seven databases (Embase, MEDLINE, Ovid Emcare, Scopus, SPORTDiscus, the Cochrane Library, and Web of Science) were searched from database inception to April 8, 2021. Systematic reviews of primary studies using activity trackers as interventions and reporting physical activity, physiological, or psychosocial outcomes were eligible for inclusion. In total, 39 systematic reviews and meta-analyses were identified, reporting results from 163 992 participants spanning all age groups, from both healthy and clinical populations. Taken together, the meta-analyses suggested activity trackers improved physical activity (standardised mean difference [SMD] 0·3-0·6), body composition (SMD 0·7-2·0), and fitness (SMD 0·3), equating to approximately 1800 extra steps per day, 40 min per day more walking, and reductions of approximately 1 kg in bodyweight. Effects for other physiological (blood pressure, cholesterol, and glycosylated haemoglobin) and psychosocial (quality of life and pain) outcomes were typically small and often non-significant. Activity trackers appear to be effective at increasing physical activity in a variety of age groups and clinical and non-clinical populations. The benefit is clinically important and is sustained over time. Based on the studies evaluated, there is sufficient evidence to recommend the use of activity trackers.
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Affiliation(s)
- Ty Ferguson
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Rachel Curtis
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Henry Blake
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Alyson J Crozier
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Kylie Dankiw
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Daiki Kasai
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Edward O'Connor
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Rosa Virgara
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, SA, Australia.
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Motahari-Nezhad H, Fgaier M, Mahdi Abid M, Péntek M, Gulácsi L, Zrubka Z. Scoping review of systematic reviews of digital biomarker-based studies (Preprint). JMIR Mhealth Uhealth 2021; 10:e35722. [DOI: 10.2196/35722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/20/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
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Wong SH, Tan ZYA, Cheng LJ, Lau ST. Wearable technology-delivered lifestyle intervention amongst adults with overweight and obese: A systematic review and meta-regression. Int J Nurs Stud 2021; 127:104163. [DOI: 10.1016/j.ijnurstu.2021.104163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 02/08/2023]
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Hutchesson MJ, Gough C, Müller AM, Short CE, Whatnall MC, Ahmed M, Pearson N, Yin Z, Ashton LM, Maher C, Staiano AE, Mauch CE, DeSmet A, Vandelanotte C. eHealth interventions targeting nutrition, physical activity, sedentary behavior, or obesity in adults: A scoping review of systematic reviews. Obes Rev 2021; 22:e13295. [PMID: 34159684 DOI: 10.1111/obr.13295] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022]
Abstract
A vast body of evidence regarding eHealth interventions for nutrition, physical activity, sedentary behavior, and obesity exists. This scoping review of systematic reviews aimed to evaluate the current level of evidence in this growing field. Seven electronic databases were searched for systematic reviews published until October 27, 2019. The systematic reviews must have included adult participants only and have evaluated eHealth behavioral interventions with the primary aim of changing nutrition, physical activity, and sedentary behavior or treating or preventing overweight and obesity. One hundred and six systematic reviews, published from 2006 to 2019, were included. Almost all (n = 98) reviews evaluated the efficacy of interventions. Over half (n = 61) included interventions focused on physical activity, followed by treatment of obesity (n = 28), nutrition (n = 22), prevention of obesity (n = 18), and sedentary behavior (n = 6). Many reviews (n = 46) evaluated one type of eHealth intervention only, while 60 included two or more types. Most reviews (n = 67) were rated as being of critically low methodological quality. This scoping review identified an increasing volume of systematic reviews evaluating eHealth interventions. It highlights several evidence gaps (e.g., evaluation of other outcomes, such as reach, engagement, or cost effectiveness), guiding future research efforts in this area.
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Affiliation(s)
- Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Claire Gough
- Flinders Digital Health Research Centre, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Camille E Short
- Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, Faculty of Dentistry, Medicine and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Megan C Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mavra Ahmed
- Department of Nutritional Sciences and Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Pearson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Zenong Yin
- UT Health San Antonio Graduate School of Biomedical Sciences, University of Texas, San Antonio, Texas, USA
| | - Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Amanda E Staiano
- Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Chelsea E Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Nutrition and Health Program, Health & Biosecurity Business Unit, CSIRO, Canberra, ACT, Australia
| | - Ann DeSmet
- Faculty of Psychology and Educational Sciences, Université Libre de Bruxelles, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, Queensland, Australia
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Nutrition and physical activity interventions for the general population with and without cardiometabolic risk: a scoping review. Public Health Nutr 2021; 24:4718-4736. [PMID: 34030758 DOI: 10.1017/s1368980021002184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this scoping review was to examine the research question: In the adults with or without cardiometabolic risk, what is the availability of literature examining interventions to improve or maintain nutrition and physical activity-related outcomes? Sub-topics included: (1) behaviour counseling or coaching from a dietitian/nutritionist or exercise practitioner, (2) mobile applications to improve nutrition and physical activity and (3) nutritional ergogenic aids. DESIGN The current study is a scoping review. A literature search of the Medline Complete, CINAHL Complete, Cochrane Database of Systematic Reviews and other databases was conducted to identify articles published in the English language from January 2005 until May 2020. Data were synthesised using bubble charts and heat maps. SETTING Out-patient, community and workplace. PARTICIPANTS Adults with or without cardiometabolic risk factors living in economically developed countries. RESULTS Searches resulted in 19 474 unique articles and 170 articles were included in this scoping review, including one guideline, thirty systematic reviews (SR), 134 randomised controlled trials and five non-randomised trials. Mobile applications (n 37) as well as ergogenic aids (n 87) have been addressed in several recent studies, including SR. While primary research has examined the effect of individual-level nutrition and physical activity counseling or coaching from a dietitian/nutritionist and/or exercise practitioner (n 48), interventions provided by these practitioners have not been recently synthesised in SR. CONCLUSION SR of behaviour counseling or coaching provided by a dietitian/nutritionist and/or exercise practitioner are needed and can inform practice for practitioners working with individuals who are healthy or have cardiometabolic risk.
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Analysis of the Behavioral Change and Utility Features of Electronic Activity Monitors. TECHNOLOGIES 2020. [DOI: 10.3390/technologies8040075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to perform a content analysis of electronic activity monitors that also evaluates utility features, code behavior change techniques included in the monitoring systems, and align the results with intervention functions of the Behaviour Change Wheel program planning model to facilitate informed device selection. Devices were coded for the implemented behavior change techniques and device features. Three trained coders each wore a monitor for at least 1 week from December 2019–April 2020. Apple Watch Nike, Fitbit Versa 2, Fitbit Charge 3, Fitbit Ionic—Adidas Edition, Garmin Vivomove HR, Garmin Vivosmart 4, Amazfit Bip, Galaxy Watch Active, and Withings Steel HR were reviewed. The monitors all paired with a phone/tablet, tracked exercise sessions, and were wrist-worn. On average, the monitors implemented 27 behavior change techniques each. Fitbit devices implemented the most behavior change techniques, including techniques related to the intervention functions: education, enablement, environmental restructuring, coercion, incentivization, modeling, and persuasion. Garmin devices implemented the second highest number of behavior change techniques, including techniques related to enablement, environmental restructuring, and training. Researchers can use these results to guide selection of electronic activity monitors based on their research needs.
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Hahn L, Rathbun SL, Schmidt MD, Johnsen K, Annesi JJ, Ahn SJG. Using Virtual Agents and Activity Monitors to Autonomously Track and Assess Self-Determined Physical Activity Among Young Children: A 6-Week Feasibility Field Study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:471-478. [PMID: 32379498 DOI: 10.1089/cyber.2019.0491] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The majority of youth fail to get the recommended amount of physical activity (PA), and there is a precipitous decline in PA among children as they get older. Guided by self-determination theory and social cognitive theory, we designed an interactive, mixed reality PA intervention for 6-10-year-old children. Capitalizing on the features of consumer-grade interactive communication technologies, the intervention features a kiosk-based system that houses a virtual agent programmed to encourage children to set self-determined PA goals. This intervention aims to resolve many practical challenges in designing and administering a personalized, intrinsically motivated PA intervention for this age group. We pilot tested the feasibility of this kiosk across 6 weeks with n = 42 child/parent dyads. The kiosk tracked and logged children's daily PA and engagement with the intervention without having to rely on human reporting, provided tailored evaluation and feedback whenever children requested it, informed parents about their child's PA progress, and employed a virtual agent (a dog) to offer social support to children. The virtual agent prompted users to set PA goals, and as children met these goals over time, their personalized dog became happier, more fit, and better at tricks. Each time a child engaged with the kiosk the system automatically sent a text message to his/her parent with details about the child's PA progress. The current study demonstrated the kiosk's feasibility in the field over 6 weeks, illustrating the potential of using interactive technologies as tools for disseminating self-sufficient, and truly self-determined health interventions for children at scale.
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Affiliation(s)
- Lindsay Hahn
- Department of Communication, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Stephen L Rathbun
- Department of Kinesiology, College of Public Health, University of Georgia, Athens, Georgia, USA
| | | | - Kyle Johnsen
- College of Engineering, University of Georgia, Athens, Georgia, USA
| | | | - Sun Joo Grace Ahn
- Grady College of Journalism and Mass Communication, University of Georgia, Athens, Georgia, USA
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Lewis ZH, Pritting L, Picazo AL, JeanMarie-Tucker M. The utility of wearable fitness trackers and implications for increased engagement: An exploratory, mixed methods observational study. Digit Health 2020; 6:2055207619900059. [PMID: 31976079 PMCID: PMC6958644 DOI: 10.1177/2055207619900059] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/18/2019] [Indexed: 12/28/2022] Open
Abstract
Objective To explore which features of wearable fitness trackers are used and deemed helpful. Methods Forty-seven participants took part in an online survey. All participants were over 18 years of age and owned a wearable device that objectively measured physical activity and provided feedback. The survey included questions related to the acceptance of different features of wearables, and exercise information, self-efficacy, exercise identity, motivation, and general demographics of the wearer. Seven participants took part in focus groups in an effort to gain further insight into the acceptability and utilization of wearables. Data were examined using means and frequencies. Results Participants were mostly young adults (18–24 years, 48.9%), White (63.8%), female (80.9%), overweight (body mass index 26.0±6.2), students (42.6%) and generally healthy. Fitbit was the most commonly owned wearable device (42.6%). Most participants had owned their device for 6–12 months (27.7%) and they wore their device daily (80.9%). The most commonly used features were rewards/badges (59.6%), notifications (52.2%), and challenges (42.6%). The features that were reportedly the most helpful, however, were motivational cues (83.3%), general health information (82.4%), and challenges (75.0%). Conclusions The reported use and helpfulness ratings of various features of wearables appeared to vary based on the wearer’s gender, race/ethnicity, exercise goal, exercise proficiency, preferred type of exercise, and psychosocial metrics but the results are inconclusive. Future research should evaluate whether engagement with certain features is strongly associated with improved outcomes and whether the use of these features is significantly associated with wearer characteristics.
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Affiliation(s)
- Zakkoyya H Lewis
- Health and Human Sciences, Loyola Marymount University, USA.,Kinesiology and Health Promotion, Cal Poly Pomona, USA
| | - Lauren Pritting
- Health and Human Sciences, Loyola Marymount University, USA.,Physical Therapy, Washington University in St. Louis, USA
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