Impact of wearable device-based interventions with feedback for increasing daily walking activity and physical capacities in cardiovascular patients: a systematic review and meta-analysis of randomised controlled trials

Abstract

Objective: To systematically review randomised controlled trials (RCTs) using a wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in patients with cardiovascular disease (CVD).

Design: Systematic review and meta-analysis of RCTs.

Data sources: PubMed, Embase and Web of Science from inception to June 2022.

Eligibility criteria: Randomised controlled studies including patients with CVD over 18 years of age at the end of a cardiac rehabilitation programme comparing an intervention group using a wearable physical activity monitoring device with feedback with usual care or with a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walk test (6-MWT) or a change in peak oxygen uptake (V̇O2_peak) as endpoints.

Results: Sixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardised mean difference (SMD) 0.85; 95% CI (0.42; 1.27); p<0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI (0.18; 1.82); p<0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI (0.27; 1.16); p<0.01), but no significant interaction was found between subgroups (p=0.55). 6-MWT distance and V̇O2_peak showed only small effects (SMD 0.34; 95% CI (-0.11; 0.80); p=0.02 and SMD 0.54; 95% CI (0.03; 1.03); p=0.07, respectively).

Conclusion: The use of wearable physical activity monitoring devices appears to help patients with CVD to increase their daily walking activity and thus their physical activity, particularly in the short term.

Prospero registration number: CRD42022300423.

Keywords: cardiology; public health; rehabilitation medicine; sports medicine; telemedicine; vascular medicine.

Figure 1

Preferred Reporting Items for Systematic Reviews and Meta-Analysis diagram for the search and selection process.

Figure 2

Forest plot of daily steps outcome. SD, standardised difference; SMD, standardised mean difference.

Figure 3

Forest plot of 6-minute walk test outcome. SD, standardised difference; SMD, standardised mean difference.

Figure 4

Forest plot of peak oxygen uptake outcome. SD, standardised difference; SMD, standardised mean difference.