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Meenamkuzhy-Hariharan P, Tew KF, Cranwell EJ, Birkinshaw LM, Eleuteri A, Fisher M. Effect of Adding a Program of Contextualized, Personalized, Remote Physical Activity Support to Conventional Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2024; 44:174-179. [PMID: 38488136 DOI: 10.1097/hcr.0000000000000859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
PURPOSE The objective of this investigation was to conduct a randomized controlled trial to evaluate whether KiActiv Heart alongside usual care (UC) promotes positive physical activity (PA) change versus UC alone. METHODS Patients in cardiac rehabilitation (n = 130) undertook an 8-wk intervention with follow-up at wk 8. Both groups attended UC and wore a PA monitor during the intervention. The intervention group accessed the digital service and received weekly one-to-one remote mentor sessions. The primary outcome was change in PA to achieve the Association of Certified Physiotherapists in Cardiac Rehabilitation (ACPICR) recommendations. The secondary outcome was cardiorespiratory fitness (CRF) change, measured using incremental shuttle walk test (ISWT). RESULTS The probability of meeting ACPICR "Daily Activity" recommendation was statistically significantly greater in the intervention group versus control at wk 8 ( P < .05). No statistically significant differences between groups were found for mean ISWT change (intervention 89 ± 116 m; control 44 ± 124 m). CONCLUSION Participation in KiActiv Heart alongside UC was associated with statistically significant improvement in probability of meeting ACPICR recommendation and non-statistically significant but potentially clinically important increases in CRF versus UC alone. This builds on existing evidence for effectiveness.
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Affiliation(s)
- Priyanka Meenamkuzhy-Hariharan
- Author Affiliations: Liverpool University Hospitals NHS Foundation Trust, Liverpool, England, United Kingdom (Drs Meenamkuzhy-Hariharan, Eleuteri, and Fisher and Ms Birkinshaw); KiActiv, London, United Kingdom (Ms Tew and Mr Cranwell); and University of Liverpool, Liverpool, England, United Kingdom (Drs Eleuteri and Fisher)
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du Plessis J, Jordaan J. The impact of virtual reality on the psychological well-being of hospitalised patients: A critical review. Heliyon 2024; 10:e24831. [PMID: 38312552 PMCID: PMC10835256 DOI: 10.1016/j.heliyon.2024.e24831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background and objectives Improving hospitalised patients' psychological well-being (PWB) is relevant to their recovery and overall quality of life. Virtual Reality (VR) holds the potential to emerge as a novel tool for increasing the PWB of hospitalised patients. This study critically reviewed existing research concerning the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The primary aim of this study was to evaluate the efficacy and practical applicability of VR in enhancing the PWB for hospitalised patients dealing with serious illnesses. Methodology In the initial search, the authors identified 106 sources that provided valuable insights into the broader field of VR, PWB, and the influence of VR on the psychological functioning of hospitalised patients. However, only eight articles were selected for the critical review, following the SALSA method. The SALSA method comprises the following steps: (S) Search, (AL) Appraisal, (S) Synthesis and (A) Analysis. Data extracted from these eight articles were subjected to reflexive thematic analysis, through which patterns were identified to examine the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The thematic analysis process involves data gathering and familiarisation, code identification, and formulating and refining various themes to produce a thematic analysis report. Results The themes that emerged from the analysis were (i) positive psychological effects (with sub-themes including the effectiveness of VR in improving psychological symptoms, its role as an equivalent or adjunctive treatment, and symptom reduction), (ii) perceptions and the adoption of novel technology, (iii) characteristics that influence the effectiveness of VR, and (iv) statistical and practical applicability and diversity of VR. Conclusion and recommendation The use of VR to increase the PWB of hospitalised patients is a relatively recent innovation. Nevertheless, the themes identified in this study indicate that the use of VR within the context of hospitalised patients can benefit their psychological functioning, ultimately contributing to an improvement in their overall PWB. Further in-depth studies are needed to provide a comprehensive conclusion on the potential benefits of VR on the PWB of hospitalised patients dealing with serious illnesses.
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Affiliation(s)
- Jolize du Plessis
- Department of Psychology, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 9301, South Africa
| | - Jacques Jordaan
- Department of Psychology, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 9301, South Africa
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Hao L, Goetze S, Alessa T, Hawley MS. Effectiveness of Computer-Tailored Health Communication in Increasing Physical Activity in People With or at Risk of Long-Term Conditions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e46622. [PMID: 37792469 PMCID: PMC10585448 DOI: 10.2196/46622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Regular physical activity (PA) is beneficial for enhancing and sustaining both physical and mental well-being as well as for the management of preexisting conditions. Computer-tailored health communication (CTHC) has been shown to be effective in increasing PA and many other health behavior changes in the general population. However, individuals with or at risk of long-term conditions face unique barriers that may limit the applicability of CTHC interventions to this population. Few studies have focused on this cohort, providing limited evidence for the effectiveness of CTHC in promoting PA. OBJECTIVE This systematic review and meta-analysis aims to assess the effectiveness of CTHC in increasing PA in individuals with or at risk of long-term conditions. METHODS A systematic review and meta-analysis were conducted to evaluate the effect of CTHC in increasing PA in people with or at risk of long-term conditions. Hedges g was used to calculate the mean effect size. The total effect size was pooled and weighted using inverse variance. When possible, potential moderator variables were synthesized, and their effectiveness was evaluated by subgroups analysis with Q test for between-group heterogeneity Qb. Potential moderator variables included behavior change theories and models providing the fundamental logic for CTHC design, behavior change techniques and tailoring strategies to compose messages, and computer algorithms to achieve tailoring. Several methods were used to examine potential publication bias in the results, including the funnel plot, Egger test, Begg test, fail-safe N test, and trim-and-fill method. RESULTS In total, 24 studies were included in the systematic review for qualitative analysis and 18 studies were included in the meta-analysis. Significant small to medium effect size values were found when comparing CTHC to general health information (Hedges g=0.16; P<.001) and to no information sent to participants (Hedges g=0.29; P<.001). Half of the included studies had a low to moderate risk of bias, and the remaining studies had a moderate to high risk of bias. Although the results of the meta-analysis indicated no evidence of publication bias, caution is required when drawing definitive conclusions due to the limited number of studies in each subgroup (N≤10). Message-tailoring strategies, implementation strategies, behavior change theories and models, and behavior change techniques were synthesized from the 24 studies. No strong evidence was found from subgroup analyses on the effectiveness of using particular behavior change theories and models or from using particular message-tailoring and implementation strategies. CONCLUSIONS This study demonstrates that CTHC is effective in increasing PA for people with or at risk of long-term conditions, with significant small to medium effects compared with general health information or no information. Further studies are needed to guide design decisions for maximizing the effectiveness of CTHC.
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Affiliation(s)
- Longdan Hao
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Stefan Goetze
- Department of Computer Science, University of Sheffield, Sheffield, United Kingdom
| | - Tourkiah Alessa
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mark S Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Natalucci V, Marmondi F, Biraghi M, Bonato M. The Effectiveness of Wearable Devices in Non-Communicable Diseases to Manage Physical Activity and Nutrition: Where We Are? Nutrients 2023; 15:nu15040913. [PMID: 36839271 PMCID: PMC9966298 DOI: 10.3390/nu15040913] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/28/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Wearable devices are increasingly popular in clinical and non-clinical populations as a tool for exercise prescription, monitoring of daily physical activity and nutrition, and health-related parameters management. In this regard, smart devices not only assist people in pursuing a healthier lifestyle, but also provide a constant stream of physiological and metabolic data for management of non-communicable diseases (NCDs). Although the benefits of lifestyle-based interventions (exercise and nutrition) for NCDs are well known, the potential of wearable devices to promote healthy behaviors in clinical populations is still controversial. In this narrative review, we aimed to discuss the current application of wearable devices in NCDs, highlighting their role in prescribing and monitoring daily physical activity and dietary habits in the population living with chronic diseases. None of the studies considered specifically addressed the efficacy of the use of wearable devices, and limited are those that incorporate monitoring of both physical activity and nutrition for NCDs. However, there is evidence that such devices have helped improve physical activity levels, physical fitness, body composition, and metabolic and psychological parameters. Therefore, the authors believe that the benefits obtained from the use of wearable devices are likely to translate to public health and represent one of the important tools for the development of prevention plans in everyday life and clinical practice for optimal patient management.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
- Correspondence:
| | - Federica Marmondi
- Department of Infection Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Michele Biraghi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Matteo Bonato
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20122 Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
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McNamara R, Davy K, Niranjan V, O'Regan A. Recruitment and characteristics of participants in trials of physical activity for adults aged 45 years and above in general practice: a systematic review. Fam Pract 2022; 40:387-397. [PMID: 36472583 PMCID: PMC10047612 DOI: 10.1093/fampra/cmac128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND General practice is well situated to promote physical activity (PA), but with PA levels declining after 45 years of age, often those who are most likely to benefit from interventions tend to be the least likely recruited to participate in research. AIMS AND RATIONALE The aim of this study was to investigate recruitment and reporting of participant demographics in PA trials for adults aged 45 years and above. Specific objectives were: (i) to examine the reporting of demographics of participants; (ii) to investigate the strategies used to recruit these participants; and, (iii) to examine the efficiency of recruitment strategies. METHODS Seven databases were searched, including: PubMed, CINAHL, the Cochrane Library Register of Controlled Trials, Embase, Scopus, PsycINFO, and Web of Science. Only randomized control trials involving adults 45 years old or older recruited through primary care were included. The PRISMA framework for systematic review was followed, which involved 2 researchers independently conducting title, abstract, and full article screening. Tools for data extraction and synthesis were adapted from previous work on inclusivity in recruitment. RESULTS The searches retrieved 3,491 studies of which 12 were included for review. Sample size of the studies ranged from 31 to 1,366, with a total of 6,042 participants of which 57% were female. Of 101 participating practices, 1 was reported as rural. Reporting of recruitment lacked detail-only 6 studies outlined how practices were recruited. 11/12 studies involved a database or chart review to identify participants that met the inclusion criteria, followed by a letter of invitation sent to those people. The studies with higher recruitment efficiency ratios each employed more than 1 recruitment strategy, e.g. opportunistic invitations and telephone calls. CONCLUSION This systematic review has presented deficits in the reporting of both demographics and recruitment. Future research should aim for a standardized approach to reporting.
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Affiliation(s)
- Richard McNamara
- University of Limerick, Health Research Institute, School of Medicine, Limerick, Ireland
| | - Kimberly Davy
- University of Limerick, Health Research Institute, School of Medicine, Limerick, Ireland
| | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Andrew O'Regan
- University of Limerick, Health Research Institute, School of Medicine, Limerick, Ireland
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Dlima SD, Shevade S, Menezes SR, Ganju A. Digital Phenotyping in Health Using Machine Learning Approaches: Scoping Review. JMIR BIOINFORMATICS AND BIOTECHNOLOGY 2022; 3:e39618. [PMID: 38935947 PMCID: PMC11135220 DOI: 10.2196/39618] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 06/29/2024]
Abstract
BACKGROUND Digital phenotyping is the real-time collection of individual-level active and passive data from users in naturalistic and free-living settings via personal digital devices, such as mobile phones and wearable devices. Given the novelty of research in this field, there is heterogeneity in the clinical use cases, types of data collected, modes of data collection, data analysis methods, and outcomes measured. OBJECTIVE The primary aim of this scoping review was to map the published research on digital phenotyping and to outline study characteristics, data collection and analysis methods, machine learning approaches, and future implications. METHODS We utilized an a priori approach for the literature search and data extraction and charting process, guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews). We identified relevant studies published in 2020, 2021, and 2022 on PubMed and Google Scholar using search terms related to digital phenotyping. The titles, abstracts, and keywords were screened during the first stage of the screening process, and the second stage involved screening the full texts of the shortlisted articles. We extracted and charted the descriptive characteristics of the final studies, which were countries of origin, study design, clinical areas, active and/or passive data collected, modes of data collection, data analysis approaches, and limitations. RESULTS A total of 454 articles on PubMed and Google Scholar were identified through search terms associated with digital phenotyping, and 46 articles were deemed eligible for inclusion in this scoping review. Most studies evaluated wearable data and originated from North America. The most dominant study design was observational, followed by randomized trials, and most studies focused on psychiatric disorders, mental health disorders, and neurological diseases. A total of 7 studies used machine learning approaches for data analysis, with random forest, logistic regression, and support vector machines being the most common. CONCLUSIONS Our review provides foundational as well as application-oriented approaches toward digital phenotyping in health. Future work should focus on more prospective, longitudinal studies that include larger data sets from diverse populations, address privacy and ethical concerns around data collection from consumer technologies, and build "digital phenotypes" to personalize digital health interventions and treatment plans.
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Lin H, Yu P, Yang M, Wu D, Wang Z, An J, Duan H, Deng N. Making Specific Plan Improves Physical Activity and Healthy Eating for Community-Dwelling Patients With Chronic Conditions: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:721223. [PMID: 35664117 PMCID: PMC9160833 DOI: 10.3389/fpubh.2022.721223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Implementation intention formed by making a specific action plan has been proved effective in improving physical activity (PA) and dietary behavior (DB) for the general, healthy population, but there has been no meta-analysis of their effectiveness for patients with chronic conditions. This research aims to analyze several explanatory factors and overall effect of implementation intention on behavioral and health-related outcomes among community-dwelling patients. Methods We searched CIHNAL (EBSCO), PUBMED, Web of Science, Science Direct, SAGE Online, Springer Link, Taylor & Francis, Scopus, Wiley Online Library, CNKI, and five other databases for eligible studies. Random-effects meta-analysis was conducted to estimate effect sizes of implementation intention on outcomes, including PA, DB, weight, and body mass index. And the eligible studies were assessed by the Cochrane Collaboration's tool for risk of bias assessment. Sensitivity analysis adopted sequential algorithm and the p-curve analysis method. Results A total of 54 studies were identified. Significant small effect sizes of the intervention were found for PA [standard mean difference (SMD) 0.24, 95% confidence interval (CI) (0.10, 0.39)] and for the DB outcome [SMD -0.25, 95% CI (-0.34, -0.15)]. In moderation analysis, the intervention was more effective in improving PA for men (p < 0.001), older adults (p = 0.006), and obese/overweight patients with complications (p = 0.048) and when the intervention was delivered by a healthcare provider (p = 0.01). Conclusion Implementation intentions are effective in improving PA and DB for community dwelling patients with chronic conditions. The review provides evidence to support the future application of implementation intention intervention. Besides, the findings from this review offer different directions to enhance the effectiveness of this brief and potential intervention in improving patients' PA and DB. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=160491.
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Affiliation(s)
- Hui Lin
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Hangzhou, China
| | - Ping Yu
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Min Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Chronic Disease Research Institute, Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Wu
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Hangzhou, China
| | - Zhen Wang
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Hangzhou, China
| | - Jiye An
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Hangzhou, China
| | - Huilong Duan
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Hangzhou, China
| | - Ning Deng
- Ministry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Hangzhou, China
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Strategies to improve uptake and adherence of non-pharmacologic interventions for orthostatic hypotension in older people: a qualitative study. Eur Geriatr Med 2022; 13:685-692. [PMID: 35286620 PMCID: PMC9151510 DOI: 10.1007/s41999-022-00632-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/17/2022] [Indexed: 12/02/2022]
Abstract
Aim To identify specific behavioural change techniques to promote uptake and adherence with non-pharmacologic interventions for older adults with OH. Findings Specific behaviour change strategies, derived from older people with orthostatic hypotension, include biofeedback, rehearsal, embedding into daily routine and patient education. Message Evidence-based behaviour change strategies may be used to improve uptake and adherence to non-drug therapies for older people with orthostatic hypotension. Purpose Non-pharmacologic therapies are a safe and effective treatment for orthostatic hypotension (OH) in older adults. However, adherence to non-drug therapies is challenging and may require specific behaviour change approaches to promote uptake and adherence. The study aim is to identify specific behavioural change techniques to promote uptake and adherence with non-pharmacologic interventions for older adults with OH. Methods Forty semi-structured, qualitative interviews were performed in 25 older adults with OH. Each participant experienced bolus-water drinking, physical counter-manoeuvres and compression garments during two efficacy studies. Emergent themes were identified through framework analysis, based on The Behaviour Change Technique Taxonomy. Results Several themes to encourage uptake and adherence arose. Motivation to adhere with an intervention may be improved by demonstrating its effectiveness, either through symptom monitoring or biofeedback. Practising or rehearsing how to use an intervention may improve self-efficacy and promote habit formation. Embedding therapies into daily life so that they become second nature was felt to be a useful strategy. Educating older adults about why they are being asked to use a therapy and demonstrating how to use it is important. More specific barriers may be overcome by encouraging a personal problem-solving approach. Conclusion These specific behaviour change techniques, derived by older people with OH and based on evidence-based approaches, provide useful strategies to improve the uptake and adherence of non-drug therapies in the treatment of OH. Trial registration ISRCTN15084870.
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Western MJ, Standage M, Peacock OJ, Nightingale T, Thompson D. Supporting Behavior Change in Sedentary Adults via Real-time Multidimensional Physical Activity Feedback: Mixed Methods Randomized Controlled Trial. JMIR Form Res 2022; 6:e26525. [PMID: 35234658 PMCID: PMC8928046 DOI: 10.2196/26525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/18/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increasing physical activity (PA) behavior remains a public health priority, and wearable technology is increasingly being used to support behavior change efforts. Using wearables to capture and provide comprehensive, visually persuasive, multidimensional feedback with real-time support may be a promising way of increasing PA in inactive individuals. OBJECTIVE This study aims to explore whether a 6-week self-monitoring intervention using composite web-based multidimensional PA feedback with real-time daily feedback supports increased PA in adults. METHODS A 6-week, mixed methods, 2-armed exploratory randomized controlled trial with 6-week follow-up was used, whereby low to moderately active (PA level [PAL] <2.0) adults (mean age 51.3 years, SD 8.4 years; women 28/51, 55%) were randomly assigned to receive the self-monitoring intervention (36/51, 71%) or waiting list control (15/51, 29%). Assessment of PA across multiple health-harnessing PA dimensions (eg, PAL, weekly moderate to vigorous intensity PA, sedentary time, and steps), psychosocial cognitions (eg, behavioral regulation, barrier self-efficacy, and habit strength), and health were made at the prerandomization baseline at 6 and 12 weeks. An exploratory analysis of the mean difference and CIs was conducted using the analysis of covariance model. After the 12-week assessment, intervention participants were interviewed to explore their views on the program. RESULTS There were no notable differences in any PA outcome immediately after the intervention; however, at 12 weeks, moderate-to-large effects were observed with a mean difference in PAL of 0.09 (95% CI 0.02-0.15; effect size [Hedges g] 0.8), daily moderate-intensity PA of 24 (95% CI 0-45; Hedges g=0.6) minutes, weekly moderate-to-vigorous intensity PA of 195 (95% CI 58-331; Hedges g=0.8) minutes, and steps of 1545 (95% CI 581-2553; Hedges g=0.7). Descriptive analyses suggested that the differences in PA at 12 weeks were more pronounced in women and participants with lower baseline PA levels. Immediately after the intervention, there were favorable differences in autonomous motivation, controlled motivation, perceived competence for PA, and barrier self-efficacy, with the latter sustained at follow-up. Qualitative data implied that the intervention was highly informative for participants and that the real-time feedback element was particularly useful in providing tangible, day-to-day behavioral support. CONCLUSIONS Using wearable trackers to capture and present sophisticated multidimensional PA feedback combined with discrete real-time support may be a useful way of facilitating changes in behavior. Further investigation into the ways of optimizing the use of wearables in inactive participants and testing the efficacy of this approach via a robust study design is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT02432924; https://clinicaltrials.gov/ct2/show/NCT02432924.
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Affiliation(s)
| | - Martyn Standage
- Department for Health, University of Bath, Bath, United Kingdom
| | | | - Tom Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, United Kingdom
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Larsen RT, Wagner V, Korfitsen CB, Keller C, Juhl CB, Langberg H, Christensen J. Effectiveness of physical activity monitors in adults: systematic review and meta-analysis. BMJ 2022; 376:e068047. [PMID: 35082116 PMCID: PMC8791066 DOI: 10.1136/bmj-2021-068047] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 12/16/2022]
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.
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Affiliation(s)
- Rasmus Tolstrup Larsen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark
| | - Vibeke Wagner
- Department of Brain Injury Rehabilitation, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Christoffer Bruun Korfitsen
- Parker Institute, Bispebjerg and Frederiksberg Hospital, Capital Region, Frederiksberg, Denmark
- Danish Health Authority, Copenhagen, Denmark
| | - Camilla Keller
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Carsten Bogh Juhl
- Research Unit of Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Henning Langberg
- Section of Health Services Research, Department of Public Health, University of Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark
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Rockette-Wagner B, Cheng J, Bizhanova Z, Kriska AM, Sereika SM, Kline CE, Imes CC, Kariuki JK, Mendez DD, Burke LE. Change in Objectively Measured Activity Levels Resulting from the EMPOWER Study Lifestyle Intervention. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7:e000184. [PMID: 35391998 PMCID: PMC8982931 DOI: 10.1249/tjx.0000000000000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose To examine changes in physical activity (PA) during a behavioral weight-loss intervention and determine baseline factors associated with PA goal achievement. Methods Overweight/obese community-dwelling adults with valid PA accelerometer data (N=116; mean age 51.7 years; 89% female; 83% non-Hispanic White) were recruited into a single-arm prospective cohort study examining the effects of a 12-month intervention that included 24 in-person group sessions, weight-loss, calorie, fat gram, and PA goals, self-monitoring, and feedback. Minutes of moderate-to-vigorous (MV) PA and steps were measured using a waist-worn accelerometer (ActiGraph GT3x) at baseline, 6 months, and 12 months. Achievement of the 150 minute/week MVPA goal was examined using total minutes and bout minutes (i.e., counting only PA occurring in bouts ≥10 minutes in length). Change in PA was analyzed using non-parametric tests for multiple comparisons. Associations of factors with meeting the PA goal were modeled using binary logistic regression. Results At 6 months, there were increases from baseline in MVPA (median [p25, p75]: 5.3 [-0.9, 17.6] minutes/day) and steps (863 [-145, 2790] steps/day), both p<0.001. At 12 months, improvements were attenuated (MVPA: 2.4 [-2.0, 11.4] minutes/day, p=0.047; steps: 374[-570, 1804] p=0.14). At 6 months, 33.6% of individuals met the PA goal (using total or bout minutes). At 12 months, the percent meeting the goal using total MVPA [31%] differed from bout MVPA [22.4%]. Male gender (OR=4.14, p=0.027) and an autumn program start (versus winter; OR=3.39, p=0.011) were associated with greater odds of goal achievement at 6 months. Conclusions The intervention increased PA goal achievement at 6 and 12 months with many making clinically meaningful improvements. Our results suggest female participants may require extra support toward improving PA levels.
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Affiliation(s)
| | - J Cheng
- University of Pittsburgh, School of Public Health
| | - Z Bizhanova
- University of Pittsburgh, School of Public Health
| | - AM Kriska
- University of Pittsburgh, School of Public Health
| | - SM Sereika
- University of Pittsburgh, School of Nursing
| | - CE Kline
- University of Pittsburgh, School of Education
| | - CC Imes
- University of Pittsburgh, School of Nursing
| | - JK Kariuki
- University of Pittsburgh, School of Nursing
| | - DD Mendez
- University of Pittsburgh, School of Public Health
| | - LE Burke
- University of Pittsburgh, School of Nursing
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