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Meta-Analysis
. 2023 Jan 25;32(167):220109.
doi: 10.1183/16000617.0109-2022. Print 2023 Mar 31.

Physical activity promotion interventions in chronic airways disease: a systematic review and meta-analysis

Caroline Reilly  1 , Joe Sails  1 , Antonios Stavropoulos-Kalinoglou  1 , Rebecca J Birch  2 , Jim McKenna  1 , Ian J Clifton  2   3 , Daniel Peckham  2   3 , Karen M Birch  4 , Oliver J Price  5   3   4
Affiliations
Meta-Analysis

Physical activity promotion interventions in chronic airways disease: a systematic review and meta-analysis

Caroline Reilly et al. Eur Respir Rev. .

Abstract

Physical inactivity is common in people with chronic airways disease (pwCAD) and associated with worse clinical outcomes and impaired quality of life. We conducted a systematic review and meta-analysis to characterise and evaluate the effectiveness of interventions promoting step-based physical activity (PA) in pwCAD. We searched for studies that included a form of PA promotion and step-count outcome measure. A random-effects model was used to determine the overall effect size using post-intervention values. 38 studies (n=32 COPD; n=5 asthma; n=1 bronchiectasis; study population: n=3777) were included. Overall, implementing a form of PA promotion resulted in a significant increase in step-count: median (IQR) 705 (183-1210) when compared with usual standard care: -64 (-597-229), standardised mean difference (SMD) 0.24 (95% CI: 0.12-0.36), p<0.01. To explore the impact of specific interventions, studies were stratified into subgroups: PA promotion+wearable activity monitor-based interventions (n=17) (SMD 0.37, p<0.01); PA promotion+step-count as an outcome measure (n=9) (SMD 0.18, p=0.09); technology-based interventions (n=12) (SMD 0.16, p=0.01). Interventions promoting PA, particularly those that incorporate wearable activity monitors, result in a significant and clinically meaningful improvement in daily step-count in pwCAD.

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Conflict of interest statement

Conflict of interest: I.J. Clifton reports personal fees from GlaxoSmithKline, outside the submitted work. The remaining authors have no conflicts to declare.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart representing search results.
FIGURE 2
FIGURE 2
Standard mean difference (SMD) in daily step-count according to intervention duration (pre-to-post intervention). REML: restricted maximum likelihood.
FIGURE 3
FIGURE 3
Standard mean difference (SMD) in daily step-count according to primary method of physical activity promotion (pre-to-post intervention). PA: physical activity; REML: restricted maximum likelihood.
FIGURE 4
FIGURE 4
Daily step-count stratified according to subgroups pre-to-post intervention (closed and open circles denote intervention and controls, respectively). PA: physical activity.
See this image and copyright information in PMC

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