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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):953-67

DOI: 10.23736/S1973-9087.17.04585-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Effectiveness of physical activity promoting technology-based distance interventions compared to usual care. Systematic review, meta-analysis and meta-regression

Sanna HAKALA 1 , Aki RINTALA 1, 2, Jaakko IMMONEN 3, Juha KARVANEN 3, Ari HEINONEN 1, Tuulikki SJÖGREN 1

1 Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland; 2 Department of Neurosciences, Center for Contextual Psychiatry, University of Leuven, Leuven, Belgium; 3 Department of Mathematics and Statistics, Faculty of Mathematics and Science, University of Jyvaskyla, Jyvaskyla, Finland


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INTRODUCTION: Technology has been thought to have strong potential for promoting physical activity, but the evidence has remained unclear. The aim of this study was to examine whether a technology-based distance intervention promoting physical activity is more effective than a physical activity intervention without the use of technology. This systematic review is registered in Prospero (CRD42016035831).
EVIDENCE ACQUISITION: A systematic literature search of studies published between January 2000 to December 2015 was conducted in CENTRAL, EMBASE, Ovid MEDLINE, CINAHL, PsycINFO, OT-Seeker, WOS and PEDro. Studies were selected by two independent authors applying the following PICOS criteria P) adults, I) technology-based distance intervention promoting physical activity, C) distance intervention promoting physical activity without technology, O) physical activity, S) RCT. Quality was assessed following the guidelines of Cochrane Back Review Group. Meta-analysis and meta-regression were performed using R.
EVIDENCE SYNTHESIS: From 3 031 studies, 23 randomized controlled trials with a total of 4 645 participants were included in the meta-analysis. The quality of the studies was moderate (mean 6 out of the maximum 12, with range of 4-9). Technology-based interventions were 12% more effective than similar or minimal control interventions in increasing physical activity (RR: 1.12; 95% CI: 1.01 to 1.25, P=0.03). Compared to minimal control interventions, technology-based interventions were 19% more effective (RR: 1.19; 95% CI 1.05 to 1.35, P=0.0096). In the interventions targeting patients, use of technology was 25% more effective than non-use (P=0.027). No differences were observed in physical activity between the effectiveness of interactive, non-interactive and self-monitoring technologies. Study quality, intervention duration and whether the measures used were subjective or objective were not significantly related to the amount of physical activity engaged in.
CONCLUSIONS: Technology-based delivery of interventions seems to be more effective than usual care in promoting physical activity, particularly in the interventions targeting patients. Future research should investigate the cost-effectiveness of the use of distance technology for this purpose. Technology benefits rehabilitation, and can be considered for use in clinical practice, may adequately replace face-to-face meetings and stimulate more intensive rehabilitation in daily life.


KEY WORDS: Technology - Health promotion - Rehabilitation - Clinical trial - Meta-analysis

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Publication History

Issue published online: December 12, 2017
Article first published online: May 2, 2017
Manuscript accepted: April 21, 2017
Manuscript revised: March 28, 2017
Manuscript received: November 28, 2016

Cite this article as

Hakala S, Rintala A, Immonen J, Karvanen J, Heinonen A, Sjögren T. Effectiveness of physical activity promoting technology-based distance interventions compared to usual care. Systematic review, meta-analysis and meta-regression. Eur J Phys Rehabil Med 2017;53:953-67. DOI: 10.23736/S1973-9087.17.04585-3

Corresponding author e-mail

sanna.m.h.hakala@jyu.fi