A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: a systematic review and meta-analysis of controlled trials

Abstract

The objective of this study was to systematically review the literature and compare the effectiveness of controlled interventions with a focus on physical activity (PA) and/or sedentary behaviours (SBs) for reducing sedentary time in adults. Six electronic databases were searched to identify all studies that examined the effects of interventions that targeted PA and/or SBs and that reported on changes in SBs (sedentary, sitting or television time). A qualitative synthesis was performed for all studies, and meta-analyses conducted among studies with mean differences (min/d) of sedentary time.

Prospero: CRD42014006535. Sixty-five controlled studies met inclusion criteria; 33 were used in the meta-analyses. Interventions with a focus on PA or that included a PA and SB component produced less consistent findings and generally resulted in modest reductions in sedentary time (PA: standardized mean differences [SMD] = -0.22 [95% confidence interval {CI}: -0.35, -0.10], PA+SB: SMD= -0.37 [95% CI: -0.69, -0.05]). Moderate quality evidence from the randomized controlled trial meta-analysis coupled with the qualitative synthesis provides consistent evidence that large and clinically meaningful reductions in sedentary time can be expected from interventions with a focus on reducing SBs (SMD= -1.28 [95% CI: -1.68, -0.87] ). There is evidence to support the need for interventions to include a component focused on reducing SBs in order to generate clinically meaningful reductions in sedentary time.

Keywords: Intervention; physical activity; sedentary behaviour; systematic review.

Figure 1

Flow diagram for literature search. PA, physical activity; SB, sedentary behaviour.

Figure 2

Risk of bias for studies included in meta-analyses (n = 33).

Figure 3

Forest plot of standardized mean differences of sedentary time (min/d) from physical activity interventions. APE, activities-based education courses; CI, confidence interval; CPE, conceptually based courses; df, degrees of freedom; SD, standard deviation; SMD, standardized mean differences.

Figure 4

Forest plot of standardized mean differences of sedentary time (min/d) from combined physical activity and sedentary behaviour interventions. CI, confidence interval; df, degrees of freedom; SD, standard deviation; SMD, standardized mean differences.

Figure 5

Forest plot of standardized mean differences of sedentary time (min/d) from sedentary behaviour focused interventions. CI, confidence interval; df, degrees of freedom; SD, standard deviation; SMD, standardized mean differences.