Pedometers, Activity Trackers Linked to Greater Improvements in Physical Activity in Randomized Trials

Maria Panagioti, PhD

Research from a team at the National Institute for Health Research at the University of Manchester provides evidence suggesting wearable physical activity trackers could significantly improve physical activity levels in patients with cardiometabolic conditions.

A systematic review and meta-analysis of more than 3 dozen randomized clinical trials, results of the investigators' study indicate use of wearable physical activity trackers combined with consultations with health professionals was associated with significant improvements in physical activity levels among patients with cardiometabolic conditions.

“In this systematic review and meta-analysis of individuals with cardiometabolic conditions, interventions that combined activity trackers (especially pedometers) with complementary intervention components, such as consultations with health care professionals, were significantly associated with increased levels of PA,” wrote study investigators. “Understanding how to improve these interventions further for greater PA improvements in the longer term may have implications in the care of people with cardiometabolic conditions.”

While physical activity has been a pillar of risk management in the management of most, if not all, disease states, the advent of wearable technology to monitor physical activity is a more recent revelation. Led by Maria Panagioti, PhD, Senior Lecturer at the Center for Primary Care at the University of Manchester, the current study was designed with the intent of exploring whether interventions using wearable trackers were associated with increased physical activity.

Investigators designed their study as a systematic review and meta-analysis of randomized clinical trials published within the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO from 2000-2020. For the purpose of analysis, search and text words of interest used by Investigators included diabetes, obesity, cardiovascular disease, pedometers, accelerometers, and Fitbits.

For inclusion in the systematic review and meta-analysis, trials needed to include a patient population aged 18 years or older with a diagnosis of type 1 diabetes, obesity or overweight, and cardiovascular disease. The primary outcome of the investigators’ analyses was association of use of an activity tracker with physical activity levels and secondary outcomes included changes in body weight or BMI, blood glucose level, blood pressure, and cholesterol levels.

The investigators’ initial search returned 5670 references. After screening and application of inclusion criteria, 38 studies with 4203 participants were identified for inclusion. Of these 38, 29 evaluated pedometers and 9 evaluated accelerometers or fitness trackers. Most of these studies were conducted in the US (12) or in the UK (6). Investigators noted 4 studies did not have amendable outcome data and 34 trials with 3793 participants were included in the meta-analysis.

Upon analysis, results indicated use of a physical ac5ivity tracker was associated with increased physical activity levels overall in studies with a short to medium follow-up for median of 15 (12-52) weeks. Using multivariable meta-regression, investigators observed an association between increased levels of activity and intervention when they included face-to-face consultations (23 studies; β = -0.04; 95% CI, -0.11 to -0.01), included men (23 studies; β = 0.48; 95% CI, 0.01 to 0.96), and assessed pedometer-based interventions (26 studies; β = 0.20; 95% CI, 0.02 to 0.32).

“The findings of the present study suggest that interventions that combine the use of monitoring devices (particularly pedometers) with regular consultations with health care professionals predominantly among male participants are associated with the greatest PA improvements and that these interventions may help reach the recommendations of governments and agencies for people with cardiometabolic conditions,” wrote investigators.

This study, “Interventions Using Wearable Physical Activity Trackers Among Adults With Cardiometabolic Conditions: A Systematic Review and Meta-analysis,” was published in JAMA Network Open.