How to combat the pandemic of physical inactivity?

This blog provides an overview of a recent systematic review (1) which aimed to determine the effect of different physical activity intervention components on step counts in addition to self-monitoring. Our study was a collaboration between Charles University, Prague, St. George’s University of London and the National Institute of Cardiology, Warsaw. We analysed the added value of different interventions aimed at increasing physical activity beyond self-monitoring of physical activity. Additional interventions included goal setting, different forms of counselling, keeping a diary, printed materials, mobile apps and websites, text messaging, or providing incentives. 

 

Why is this study important?

Despite knowing about the many established physical and mental health benefits of regular physical activity, many people lead sedentary lives and find it hard to increase their physical activity levels. Most clinical interventions in daily life are limited to a single message on the importance of regular physical activity for health and the need for its implementation in daily routines, which has limited efficacy. More successful means to combat physical inactivity are desperately needed.

Various interventions to promote physical activity have been tested in clinical trials, most compared interventions to  usual care. In recent years different self-monitoring devices such as pedometers, fitness trackers or smartphone apps (collectively known as activity monitors) have become widely available. Several systematic reviews have demonstrated that self-monitoring using different activity monitors can lead to substantial physical activity increases. However, until now, none of the systematic reviews have analysed the added value of complex physical activity interventions beyond self-monitoring. 

 

How did the study go about this?

We searched five databases to look for randomized controlled trials using different interventions to promote physical activity, but with self-monitoring in both treatment arms. The studied arms were therefore different only in terms of the additional intervention beyond physical activity self-monitoring. Eighty five eligible studies were found (including 12,057 participants) and 75 of those studies were included in the meta-analysis. We analysed the effect of any physical activity increase directly post intervention and for some studies we were also able to examine effects up to 24 months later. 

 

What did the study find?

We found that adding interventions to physical activity self-monitoring led to an initial increase on average of an extra 926 steps/day.  This positive initial effect of interventions was decreasing with time: each additional week decreased the step-count on average by approximately 10 steps/day. Interventions with a prescribed goal such as a number of steps daily and those involving human counselling, particularly via phone/video calls, were associated with a greater increase in the daily step-count than interventions with added print materials, websites, smartphone apps or incentives. In the long-term, there was a less evident but still positive effect, leading on average to an additional 413 steps/day up to 2 years post-intervention.

 

What are the key take-home points?

Based on available evidence, those who are physically inactive should be encouraged to use pedometers, fitness trackers or smartphone apps to monitor their daily step-count and to set goals to increase this by a specific number of steps. Other interventions can also be considered; however, these should provide additional benefit beyond simple self-monitoring. Remote phone/video counselling is another potentially highly effective and convenient component of physical activity interventions. Our findings should be further explored as a promising way of combatting the pandemic of physical inactivity, both at a population level and within individual clinician and patient encounters.

 

Author and Affiliations:

Tomas Vetrovsky, Tess Harris, Łukasz Małek 

Dr Tomas Vetrovsky, Faculty of Physical Education and Sport, Charles University, Prague, 16252, Czech Republic; tomas.vetrovsky@gmail.com

 

References 

1. Vetrovsky T, Borowiec A, Juřík R, et al Do physical activity interventions combining self-monitoring with other components provide an additional benefit compared with self-monitoring alone? A systematic review and meta-analysis British Journal of Sports Medicine  Published Online First: 07 September 2022. doi: 10.1136/bjsports-2021-105198

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