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Diabetes Research and Clinical Practice Jun 2023To conduct a meta-analysis of differences in physical activity, sedentary behaviour, and physical fitness between children and adolescents with type 1 diabetes and their... (Meta-Analysis)
Meta-Analysis Review
AIMS
To conduct a meta-analysis of differences in physical activity, sedentary behaviour, and physical fitness between children and adolescents with type 1 diabetes and their healthy peers.
METHODS
The databases EMBASE, PubMed and SportsDiscus were searched for studies. Pooled effects were calculated using random effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman adjustment.
RESULTS
Thirty-five studies were included, comprising a total of 4,751 youths (53% girls, 2,452 with type 1 diabetes). Youth with type 1 diabetes were less physically active (Cohen's d = -0.23, 95%CI - 0.42 to -0.04), more sedentary (Cohen's d = 0.33, 95%CI 0.06 to 0.61), and had lower cardiorespiratory fitness (Cohen's d = -0.52, 95%CI - 0.73 to -0.31) than their healthy peers. This corresponds to -12.72 min/day of moderate-to-vigorous physical activity, 63.3 min/day of sedentary time (accelerometry) and -4.07 ml/kg/min of maximum/peak oxygen consumption. In addition, young people with type 1 diabetes were less likely to meet the international physical activity recommendations than their healthy peers (odds ratio = 0.44, 95%CI 0.31 to 0.62).
CONCLUSIONS
Keeping in mind the heterogeneity between studies in the design, population and assessment, our findings show that children and adolescents with type 1 diabetes seem to be less active, more sedentary, and have lower cardiorespiratory fitness levels than their healthy peers.
Topics: Female; Child; Humans; Adolescent; Male; Sedentary Behavior; Diabetes Mellitus, Type 1; Exercise; Physical Fitness; Cardiorespiratory Fitness
PubMed: 37169308
DOI: 10.1016/j.diabres.2023.110697 -
JMIR MHealth and UHealth May 2023Mobile health (mHealth) apps can promote physical activity; however, the pragmatic nature (ie, how well research translates into real-world settings) of these studies is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mobile health (mHealth) apps can promote physical activity; however, the pragmatic nature (ie, how well research translates into real-world settings) of these studies is unknown. The impact of study design choices, for example, intervention duration, on intervention effect sizes is also understudied.
OBJECTIVE
This review and meta-analysis aims to describe the pragmatic nature of recent mHealth interventions for promoting physical activity and examine the associations between study effect size and pragmatic study design choices.
METHODS
The PubMed, Scopus, Web of Science, and PsycINFO databases were searched until April 2020. Studies were eligible if they incorporated apps as the primary intervention, were conducted in health promotion or preventive care settings, included a device-based physical activity outcome, and used randomized study designs. Studies were assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) and Pragmatic-Explanatory Continuum Indicator Summary-2 (PRECIS-2) frameworks. Study effect sizes were summarized using random effect models, and meta-regression was used to examine treatment effect heterogeneity by study characteristics.
RESULTS
Overall, 3555 participants were included across 22 interventions, with sample sizes ranging from 27 to 833 (mean 161.6, SD 193.9, median 93) participants. The study populations' mean age ranged from 10.6 to 61.5 (mean 39.6, SD 6.5) years, and the proportion of males included across all studies was 42.8% (1521/3555). Additionally, intervention lengths varied from 2 weeks to 6 months (mean 60.9, SD 34.9 days). The primary app- or device-based physical activity outcome differed among interventions: most interventions (17/22, 77%) used activity monitors or fitness trackers, whereas the rest (5/22, 23%) used app-based accelerometry measures. Data reporting across the RE-AIM framework was low (5.64/31, 18%) and varied within specific dimensions (Reach=44%; Effectiveness=52%; Adoption=3%; Implementation=10%; Maintenance=12.4%). PRECIS-2 results indicated that most study designs (14/22, 63%) were equally explanatory and pragmatic, with an overall PRECIS-2 score across all interventions of 2.93/5 (SD 0.54). The most pragmatic dimension was flexibility (adherence), with an average score of 3.73 (SD 0.92), whereas follow-up, organization, and flexibility (delivery) appeared more explanatory with means of 2.18 (SD 0.75), 2.36 (SD 1.07), and 2.41 (SD 0.72), respectively. An overall positive treatment effect was observed (Cohen d=0.29, 95% CI 0.13-0.46). Meta-regression analyses revealed that more pragmatic studies (-0.81, 95% CI -1.36 to -0.25) were associated with smaller increases in physical activity. Treatment effect sizes were homogenous across study duration, participants' age and gender, and RE-AIM scores.
CONCLUSIONS
App-based mHealth physical activity studies continue to underreport several key study characteristics and have limited pragmatic use and generalizability. In addition, more pragmatic interventions observe smaller treatment effects, whereas study duration appears to be unrelated to the effect size. Future app-based studies should more comprehensively report real-world applicability, and more pragmatic approaches are needed for maximal population health impacts.
TRIAL REGISTRATION
PROSPERO CRD42020169102; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=169102.
Topics: Male; Humans; Child; Adolescent; Young Adult; Adult; Middle Aged; Exercise; Mobile Applications; Health Promotion; Telemedicine; Research Design
PubMed: 37140972
DOI: 10.2196/43162 -
The International Journal of Behavioral... Apr 2023The World Health Organization (WHO) recommend that preschool-aged children should engage in 180 min of total physical activity (TPA) including 60 min of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The World Health Organization (WHO) recommend that preschool-aged children should engage in 180 min of total physical activity (TPA) including 60 min of moderate-to-vigorous physical activity (MVPA) each day. No systematic reviews or meta-analyses have pooled adherence to the recommendation across multiple studies. This study aimed to estimate the prevalence of preschool-aged children achieving the WHO's physical activity recommendation for young children, and determine if the prevalence differed between boys and girls.
METHODS
Primary literature searches were conducted on six online databases and a machine learning assisted systematic review was used to identify relevant studies. Studies written in English reporting on the prevalence of children aged 3-5 years achieving overall WHO physical activity recommendation or the individual TPA or MVPA aspects of the recommendation measured using accelerometers were eligible for inclusion. Random effects meta-analysis was used to determine the prevalence of preschools achieving the overall WHO recommendation and the individual TPA and MVPA aspect of the recommendation, and to determine difference in prevalence between boys and girls.
RESULTS
Forty-eight studies reporting on 20,078 preschool-aged children met the inclusion criteria. Based on the most commonly employed accelerometer cut-points across all aspects of the recommendation, 60% (95% Confidence Interval [CI] = 37%, 79%) of preschool-aged children adhered to the overall physical activity recommendation, 78% (95% CI = 38%, 95%) adhered to the TPA aspect of the recommendation, and 90% (95% CI = 81%, 95%) adhered to the MVPA aspect of the recommendation. There was substantial variability is prevalence estimates between different accelerometer cut-points. Girls were significantly less likely to achieve the overall recommendation and the MVPA aspect of the recommendation than boys were.
CONCLUSIONS
Although there was substantial variability in estimated prevalence of preschool-aged children adhering the WHO physical activity recommendation between various accelerometer cut-points, the weight of available evidence suggests that the majority of young children are adhering to the overall recommendation and the individual TPA and MVPA aspects of the recommendation. Large-scale, intercontinental surveillance studies are needed to further strengthen the evidence regarding the prevalence of preschool-aged children achieving physical activity recommendation globally.
Topics: Male; Female; Humans; Child; Child, Preschool; Accelerometry; Exercise; Motor Activity; Prevalence; World Health Organization
PubMed: 37101226
DOI: 10.1186/s12966-023-01450-0 -
Clinical Rehabilitation Nov 2023The aim of this systematic review was to determine if the diagnostic capabilities of wearable accelerometers enhanced, provided earlier detection, or improved fall risk...
OBJECTIVE
The aim of this systematic review was to determine if the diagnostic capabilities of wearable accelerometers enhanced, provided earlier detection, or improved fall risk assessment when evaluating individuals with chronic stroke.
DATA SOURCES
CINAHL and PubMed databases were searched for articles from 2015 to 2023 utilizing key terms.
REVIEW METHODS
A team of researchers reviewed articles for bias via the Quality in Prognostic Studies tool, and further analyzed the data to answer the research question.
RESULTS
Four studies were included in the systematic review. When utilizing an accelerometer, the vertical axis was most predictive of falls, followed by the medio-lateral axis and the anterior-posterior axis. L2-3 was the most common accelerometer placement for fall risk assessment, however no uniformity existed in the literature on placement, number of accelerometers, or type. It was determined that gait symmetry, the Timed Up and Go, Berg Balance Scale, and Longitudinal Aging Study Amsterdam best predicted falls risk.
CONCLUSION
Based on limited available evidence, clinicians should continue to perform a comprehensive examination and evaluation for fall risk, that includes the use of a combination of evidence-based outcome measures and gait characteristics to develop an individualized plan of care for individuals post-stroke. However, further research is necessary to determine the added value of accelerometers as well as type, applicability of data, and placement.
Topics: Humans; Accidental Falls; Stroke; Gait; Risk Assessment; Accelerometry; Postural Balance
PubMed: 37067051
DOI: 10.1177/02692155231168303 -
Animals : An Open Access Journal From... Mar 2023Lameness within the dairy industry is a concern because of its associated costs and welfare implications. Visual locomotion scoring has been commonly used for assessing... (Review)
Review
Lameness within the dairy industry is a concern because of its associated costs and welfare implications. Visual locomotion scoring has been commonly used for assessing cows' locomotion quality, but it can have low reliability and is relatively subjective compared to automated methods of assessing locomotion. Kinematic, kinetic, and accelerometric technologies can provide a greater number of more detailed outcome measurements than visual scoring. The objective of this systematic review was to determine outcome measurements, and the relationships between them, that have been recorded using kinematic, kinetic, and accelerometric technologies, as well as other approaches to evaluating cow locomotion. Following PRISMA guidelines, two databases were searched for studies published from January 2000 to June 2022. Thirty-seven articles were retained after undergoing a screening process involving a title and abstract evaluation, followed by a full-text assessment. Locomotion measurements recorded using these technologies often overlapped, but inconsistencies in the types of technology, the arrangement of equipment, the terminology, and the measurement-recording approaches made it difficult to compare locomotion measurements across studies. Additional research would contribute to a better understanding of how factors regarding the health, environment, and management of dairy cows affect aspects of locomotion, as recorded through the detailed, objective outcome measurements provided by these technologies.
PubMed: 36978660
DOI: 10.3390/ani13061121 -
Anesthesia and Analgesia Apr 2023Functional capacity assessment is important for perioperative risk stratification; however, there are currently limited options for objective and economical functional...
Functional capacity assessment is important for perioperative risk stratification; however, there are currently limited options for objective and economical functional capacity evaluation. Pedometer functions are now widely available in mobile devices and offer a nonintrusive and objective approach to measuring patient activity level over time. Therefore, we conducted this systematic review to assess the value of pedometer readings in predicting perioperative outcomes. We systematically searched PubMed, EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science Citation Index for studies, which assessed the correlation between perioperative (30 days before to 30 days after surgery) pedometer data and perioperative outcomes. We identified a total of 18 studies for inclusion. Seven of the studies recorded preoperative pedometer data, and 13 studies recorded postoperative pedometer data. Notably, 10 of the studies covered oncologic surgery patients. The included studies consistently reported that preoperative pedometer readings correlated with postoperative complication rates. In addition, in-hospital postoperative pedometer readings correlated with postdischarge complications and readmissions. Perioperative pedometer data demonstrated consistent and biologically plausible association with perioperative outcomes. Further studies are needed to validate the use of pedometer in the perioperative period and to identify the optimal approach for its use to potentially improve patient outcomes.
Topics: Humans; Actigraphy; Aftercare; Patient Discharge; Postoperative Complications; Wearable Electronic Devices
PubMed: 36928149
DOI: 10.1213/ANE.0000000000006353 -
The International Journal of Behavioral... Mar 2023Accelerometer measures of physical behaviours (physical activity, sedentary behaviour and sleep) in observational studies offer detailed insight into associations with... (Review)
Review
BACKGROUND
Accelerometer measures of physical behaviours (physical activity, sedentary behaviour and sleep) in observational studies offer detailed insight into associations with health and disease. Maximising recruitment and accelerometer wear, and minimising data loss remain key challenges. How varying methods used to collect accelerometer data influence data collection outcomes is poorly understood. We examined the influence of accelerometer placement and other methodological factors on participant recruitment, adherence and data loss in observational studies of adult physical behaviours.
METHODS
The review was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Observational studies of adults including accelerometer measurement of physical behaviours were identified using database (MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus and Cumulative Index to Nursing & Allied Health Literature) and supplementary searches to May 2022. Information regarding study design, accelerometer data collection methods and outcomes were extracted for each accelerometer measurement (study wave). Random effects meta-analyses and narrative syntheses were used to examine associations of methodological factors with participant recruitment, adherence and data loss.
RESULTS
123 accelerometer data collection waves were identified from 95 studies (92.5% from high-income countries). In-person distribution of accelerometers was associated with a greater proportion of invited participants consenting to wear an accelerometer (+ 30% [95% CI 18%, 42%] compared to postal distribution), and adhering to minimum wear criteria (+ 15% [4%, 25%]). The proportion of participants meeting minimum wear criteria was higher when accelerometers were worn at the wrist (+ 14% [ 5%, 23%]) compared to waist. Daily wear-time tended to be higher in studies using wrist-worn accelerometers compared to other wear locations. Reporting of information regarding data collection was inconsistent.
CONCLUSION
Methodological decisions including accelerometer wear-location and method of distribution may influence important data collection outcomes including recruitment and accelerometer wear-time. Consistent and comprehensive reporting of accelerometer data collection methods and outcomes is needed to support development of future studies and international consortia. Review supported by the British Heart Foundation (SP/F/20/150002) and registered (Prospero CRD42020213465).
Topics: Humans; Adult; Accelerometry; Exercise; Data Collection; Sedentary Behavior; Research Design
PubMed: 36890553
DOI: 10.1186/s12966-022-01388-9 -
Applied Ergonomics May 2023The dynamic work environments of tactical athletes are difficult to replicate in a laboratory. Accelerometers and inertial measurement units provide a way to... (Review)
Review
The dynamic work environments of tactical athletes are difficult to replicate in a laboratory. Accelerometers and inertial measurement units provide a way to characterize movement in the field. This systematic review identified how accelerometers and inertial measurement units are currently being used to quantify movement patterns of tactical athletes. Seven research and military databases were searched, producing 26,228 potential articles with 78 articles included in this review. The articles studied military personnel (73.1%), firefighters (19.2%), paramedics (3.8%), and law enforcement officers (3.8%). Accelerometers were the most used type of sensor, and physical activity was the primarily reported outcome variable. Seventy of the studies had fair or poor quality. Research on firefighters, emergency medical services, and law enforcement officers was limited. Future research should strive to make quantified movement data more accessible and user-friendly for non-research personnel, thereby prompting increased use in tactical athlete groups, especially first responder agencies.
Topics: Humans; Accelerometry; Emergency Responders; Firefighters; Military Personnel; Motor Activity; Movement; Paramedics; Police
PubMed: 36841096
DOI: 10.1016/j.apergo.2023.103991 -
Age and Ageing Jan 2023chronic insomnia is a highly prevalent and persistent health concern among older adults, and it has significant adverse effects on cognitive function and physical health. (Meta-Analysis)
Meta-Analysis
BACKGROUND
chronic insomnia is a highly prevalent and persistent health concern among older adults, and it has significant adverse effects on cognitive function and physical health.
OBJECTIVES
the study aimed to evaluate the efficacy of a brief 4-week behavioural therapy for insomnia (BBTi) on insomnia remission in older adults with chronic insomnia.
DESIGN
a systematic review and meta-analysis were conducted.
SUBJECTS
adults aged 60 years or older.
METHODS
eight electronic databases were systematically searched through the end of March 2022. Studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement.
RESULTS
four randomised controlled trials (190 subjects) were included. The mean age of the participants was 69.06 (65.10-71.65), and 29.9% (27.3-32.3%) were male. Older adults who received the BBTi showed a significant insomnia remission (standardised mean differences, -1.07; 95% confidence interval, -1.43 to -0.71; I2, 0%). Sleep parameters measured by actigraphy revealed that in older adults, the BBTi program significantly improved total sleep time, wake after sleep onset (WASO), sleep onset latency (SOL) and sleep efficacy (SE) compared to the controls. For the subjective sleep parameters measured the by sleep diary, older adults who received BBTi obtained a more effective improvement in WASO, SE and SOL. The overall risk of bias was mostly low or of some concern due to the difficulty of blinding participants and assessors.
CONCLUSIONS
a 4-week BBTi program can be considered an effective and nonselective intervention for insomnia remission among older adults with chronic insomnia and thereby has the potential to ameliorate WASO, SE and SOL.
Topics: Humans; Male; Aged; Female; Sleep Initiation and Maintenance Disorders; Behavior Therapy; Sleep; Polysomnography; Actigraphy; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 36702516
DOI: 10.1093/ageing/afac333 -
Psychiatry Research Feb 2023The aim of our study was to investigate if physical activity has a beneficial impact on insomnia. A systematic literature review was conducted in PubMed database using... (Review)
Review
The aim of our study was to investigate if physical activity has a beneficial impact on insomnia. A systematic literature review was conducted in PubMed database using the terms "Physical activity" and "Insomnia" and 591 records were retrieved. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed and fifteen articles were considered eligible for further analysis. Participants were mainly female, between 40 and 60 years; design studies were variable and most studies involved long-term interventions; insomnia definition was mainly based on diagnostic criteria or considered a specific cut-off point of well-known insomnia questionnaires; sleep was mostly assessed with polysomnography (PSG) or actigraphy; physical activity interventions included different methodologies (predominantly treadmill exercise). A beneficial effect of physical activity on insomnia was observed in most studies when sleep was evaluated with PSG or actigraphy. Sleep efficiency was the objective sleep parameter that mainly provided statistically significant results, as expected, followed by sleep onset latency, wake after sleep onset and, less frequently, total sleep time. Using objective methods to assess sleep in insomnia might be useful to support subjective insomnia complaints and to evaluate the efficacy of physical activity interventions in ameliorating sleep of people with insomnia.
Topics: Humans; Female; Male; Sleep; Sleep Initiation and Maintenance Disorders; Polysomnography; Actigraphy; Sleep Latency
PubMed: 36577233
DOI: 10.1016/j.psychres.2022.115019