Table 1.
Characteristics of included RCT’s
| Author (year) | Population | Group characteristics, sample size; n, male; n(%), age; mean ±SD | Setting | Intervention | Control | PA outcome measure(s)a | PF performance-based outcome measure(s)a | PF patient reported outcome measurea | Short conclusion | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Descriptive | duration | Coaching by a health professional | Theory used | Type of activity tracker | |||||||||
|
Atkins (2019) [57] |
Patients with lower initial function independence measure scores and longer anticipated length of stay. |
Intervention: n = 39, 20 (51), 74 ± 17 Control: n = 39, 12 (31), 78 ± 18 |
During inpatient rehabilitation | Usual care + pedometer with feedback on step count | 1 month* | No | NA | Yamax Digiwalker SW200 pedometer | Usual care + pedometer without feedback on step count. |
aSteps/day (D) Daily upright time |
aMorton mobility index (DEMMI) (P) | NA | Pedometers without targets do not improve functional mobility |
|
Brandes (2018) [46] |
Patients after primary, unilateral joint replacement due to knee or hip osteoarthritis |
Intervention: n = 23, 11 (48), 71 ± NA Control: n = 26, 12 (46), 70 ± NA |
During inpatient rehabilitation | Usual care + activity tracker with physical activity counselling with tailored approach by adding +5% in daily steps compared to the previous days | 3 weeks* | Yes (RL) | NA | Step Activity Monitor 3.0 | Usual care |
aSteps/day a(P, FU) Active minutes/day Inactive time |
NA | aOxford hip/knee score (P, FU) | PA counselling during inpatient rehabilitation did not improve PA or functional outcomes |
|
Christiansen (2020) [49] |
Patients after a unilateral total knee replacement |
Intervention: n=20, 12 (60), 66.5 ± 6.9 Control: n=23, 8 (35), 67.5 ± 7.2 |
After hospital discharge | Usual outpatient physiotherapy care + activity tracker with weekly steps/day goal and monthly follow-up calls | 10 weeks outpatient physiotherapy* + 6 months follow up | Yes (RL+OD) | NA | Fitbit Zip | Usual outpatient physiotherapy care |
aSteps/day a(P, FU) Minutes in moderate – vigorous PA |
NA | NA | A PA intervention with supervision is feasible and may increase PA |
|
Creel (2016) [55] |
Patients after bariatric surgery |
Intervention 1: n = 52, 8 (15), 42 ± 11 Intervention 2: n = 48, 8 (17), 44 ± 12 Control: n = 50, 8 (16), 44 ± 11 |
After hospital discharge |
1)Pedometer intervention: Usual care + Pedometer + information sheet to increase PA to 10.000 steps/day 2)Counseling intervention: Usual care + Pedometer + exercise counseling with Motivational Interviewing (MI) |
6 months |
1)No 2)Yes (RL) |
1)NA 2)Self-determination theory |
Omron HJ 113 pedometer | Usual care |
aSteps/day a(D, P) % time spent in sedentary activity |
aSubmaximal graded exercise test (P) | NA | A counselling intervention using pedometers increased PA in the perioperative period |
|
Dorsch (2015) [38] |
Patients with stroke |
Intervention: n = 78, 31 (40), 62 ± 16 Control: n = 73, 28 (38), 65 ± 13 |
During inpatient rehabilitation | Speed feedback + results and feedback on their summary activity graphs with a therapist | 21 days* | Yes (RL) | NA | Tri-axial accelerometer (Gulf Coast Data Concepts) |
Speed feedback only: verbal feedback about walking speed after 10m walking test. |
aTime spent walking (P) |
a3-minute walking test (P) 150m walking speed test |
NA | Augmented feedback did not improve walking outcomes |
|
Frederix (2015) [43] |
Patients with acute coronary syndrome after a percutaneous coronary intervention or coronary artery bypass graft |
Intervention: n = 32, 26 (81), 58 ± 9 Control: n = 34, 29 (85), 63 ± 10 |
During phase II cardiac rehabilitation. | Exercise training at home with telemonitoring support with accelerometers to encourage patients to increase his/her daily amount of steps wit 10% each week from baseline. | 18 weeks | No | NA | Triaxial accelerometer (Yorbody company) | Exercise training in the hospital’s rehabilitation centre | NA | aMaximal cardio-pulmonary exercise test (P) | NA | PA monitoring might be effective to maintain exercise tolerance |
|
Hassett (2020) [42] |
Adults with mobility limitations undertaking aged care and neurological inpatient rehabilitation |
Intervention: n = 149, 77 (52), 70 ± 18 Control: n = 151, 74 (49), 73 ± 15 |
During and after inpatient rehabilitation | Usual care + activity monitor, virtual reality video games and handheld computer devices with support by a physiotherapist | 6 months | Yes (RL+OD) | NA | Fitbit Zip, One and Alta | Usual care |
aSteps/day (D,P) Time spent walking/day % of the day spent upright |
aShort Physical Performance Battery (SPPB) (P) DEMMI Step test |
NA | The use of digitally enabled rehabilitation improved mobility |
|
Hornikx (2015) [54] |
Patients with COPD, hospitalized for an exacerbation of COPD |
Intervention: n = 15, 8 (53), 66 ± 7 Control: n = 15, 9 (60), 68 ± 6 |
After hospital discharge | Pedometer + physical activity counselling with personalized goals | 1 month | Yes (OD) | NA | Fitbit Ultra pedometer | Usual care |
aSteps/day (P) Time spent walking/day |
aSix minutes walking test (P) Quadriceps muscle strength |
NA | PA counselling with pedometer feedback did not improve PA or clinical outcomes |
|
Houle (2011) [44] |
Patients < 80 years hospitalized for an acute coronary syndrome |
Intervention: n = 32, 26 (81), 58 ± 8 Control: n = 33, 25 (76), 59 ± 9 |
After hospital discharge | Home based cardiac rehabilitation program + pedometer + exercise counseling by clinical nurse specialist with a target of 3000 steps per day increment in physical activity | 12 months | Yes (RL+OD) | Social Cognitive theory | Yamax Digiwalker SW-200 | Usual care |
aSteps/day a(D, P) |
NA | NA | A pedometer intervention was useful to improve average steps/day |
|
Izawa (2005) [37] |
Patients after completion of an acute-phase inpatient cardiac rehabilitation program |
Intervention: n = 24, 21 (88), 64 ± 10 Control: n = 21, 17 (81), 65 ± 10 |
After inpatient rehabilitation | Usual care + self-monitoring of physical activity with feedback from a physical therapist | 5 months | Yes (RL) | Bandura’s self-efficacy theory | Kenz Liferecorder pedometer | Usual care | Steps/day (FU) |
aCardio-pulmonary exercise test (P) Hand grip strength Quadriceps muscle strength |
NA | Self-monitoring of PA may effectively increase PA |
|
Izawa (2012) [45] |
Consecutive cardiovascular patients |
Intervention: n = 52, 41 (79), 59 ± 8 Control: n = 51, 42 (82), 59 ± 13 |
During hospitalization until the first outpatient contact with a physician after discharge. | Usual care + self-monitoring of physical activity with feedback from a physical therapist | 7 weeks* | Yes (RL) | Self-efficacy theory of Bandura and Oka | Kenz Lifecorder EX 1-axial accelerometer | Usual care | aSteps/day (P) | NA | NA | Self-monitoring of PA might effectively increase PA |
|
Kanai (2018) [39] |
Patients with acute ischemic stroke |
Intervention: n = 23, 15 (65), 67 ± 10 Control: n = 25, 13 (52), 63 ± 9 |
During hospitalization | Usual care + self-monitoring of physical activity with feedback from a physical therapist | 12 days* | Yes (RL) | Self-efficacy theory of Bandura | Fitbit One | Usual care | aSteps/day (P) | NA | NA | Exercise training with accelerometer-based feedback effectively increased PA |
|
Lawrie (2018) [40] |
Patients with recent stroke during rehabilitation |
Intervention: n = 14, 10 (71), 53 ± 12 Control: n = 16, 13 (81), 62 ± 12 |
During inpatient rehabilitation | Usual care + smartwatch with visual feedback and a set goals based on a 5% increase in the total activity. | 3 weeks* | No | NA | ZGPAX S8 Android smartwatch | Usual care + smartwatch with limited visual feedback without goal setting. | NA |
aBarthel Index (P) 10m walk test Hand grip strength |
NA | No effect was found on functional outcome |
|
Mansfield (2015) [41] |
Patients with sub-acute stroke attending inpatient rehabilitation |
Intervention: n =29, 20 (69), 64 ± 19 Control: n = 28, 16 (57), 62 ± 13 |
During inpatient rehabilitation | Usual care + accelerometer-based daily walking activity reports with feedback from a physical therapist | 2 weeks* | Yes (RL) | NA | Two tri-axial accelerometers (Gulf Data Concepts) | Usual care |
aSteps/day (P) Time spent walking/day |
a6-meter walk test (P) | NA | Feedback did not increase the amount of walking |
|
Mehta (2020) [50] |
Patients after hip or knee arthroplasty |
Intervention: n=118, 38 (24), median age 66 (IQR 60-73) Control: n=124, 25 (20), median age 66 (IQR 57-73) |
After hospital discharge |
1) Intervention A: Usual care + remote monitoring alone 2)Intervention B: Usual care + remote monitoring with gamification and social support |
45 days |
1)No 2)No |
NA | Withings physical activity monitor | Usual care | NA | aTimed up and Go test (P) | NA | PA monitoring did not improve functional outcomes |
|
Moller (2015) [53] |
Inactive patients with breast or colon cancer referred to adjuvant chemotherapy |
Intervention: n = 14, 1 (7), 48 ± 8 Control: n = 16, 2 (13), 47 ± 9 |
After surgery, during adjuvant chemotherapy | Usual care + Home-based individual progressive pedometer intervention with health promotion counselling and symptom management by a clinical nurse specialist | 12 weeks | Yes (RL) | NA | Omron Walking Style Pro pedometer | Usual care | NA |
aCardio-respiratory fitness test (P) Muscle strength (leg press and chest press) |
NA | No effect was found on functional outcomes |
|
Peel (2016) [56] |
Patients admitted to post-acute care rehabilitation (aged 60 years and older) |
Intervention: n = 128, 50 (39), 81 ± 9 Control: n = 127, 57 (45), 82 ± 8 |
During inpatient rehabilitation | Usual care + accelerometer based feedback and goal setting on daily walking time by therapist | 4 weeks | Yes (RL) | NA | Triaxial ALIVE Heart and Activity Monitors and ActivPAL | Usual care |
aNon-therapy walking time a(D, P) |
aShort Physical Performance Battery (SPPB) (P) | NA | Daily feedback on PA using accelerometers increased walking time |
|
Pol (2019) [47] |
Patients > 65 years old after hip fracture |
Intervention: n =76, 11 (14), 84 ± 7 Control: n =87, 21 (24), 83 ± 7 |
During and after institutional-ization in a skilled nursing facility | Usual occupational care + Cognitive Behavioural Treatment (CBT) + sensor monitoring | 4 months | Yes (RL) | Self-efficacy theory of Bandura | PAM AM300 | Usual occupational care + CBT | NA |
aPerformed-Oriented Mobility Assessment (POMA) a(P, FU) Timed up and Go test |
aCanadian Occupational Performance Measure (COPM) – performance scale (P, FU) | Sensor monitoring occupation therapy was more effective in improving patient reported daily functioning than usual care |
|
Van der Meij (2018) [51] |
Adult patients scheduled for laparoscopic adnexal surgery, laparoscopic or open hernia inguinal surgery or laparoscopic cholecystectomy |
Intervention: n = 173, 78 (45), 52 ± NA Control: n = 171, 79 (46), 51 ± NA |
During and after hospitalization | Usual care + Personalized E-health program including self-monitoring on PA | 6 weeks | Yes (OD) | NA | UP MOVE, Jawbone | Usual care | NA | NA |
aPatient Reported Outcomes Measurement Information System (PROMIS) – Physical Functioning a(P) |
A personalised e-health program speeds up the return to normal activities compared to usual care |
|
Van der Walt (2018) [48] |
Adults undergoing primary elective hip or knee arthroplasty |
Intervention: n = 81, 45 (56), 67 ± 9 Control: n = 82, 36 (44), 66 ± 9 |
During and after hospitalization | Usual care + activity tracker with daily step goals | 6 weeks | No | NA | Garmin Vivofit 2 | Usual care + activity tracker with obscured display |
a% of preoperative step count a(D, P, FU) |
NA | Knee Injury and osteoarthritis outcome score (KOOS) (FU) | Patients who received feedback from a activity tracker had significant higher activity levels |
|
Wolk (2019) [52] |
Patients scheduled for elective open and laparoscopic surgery of the colon, rectum, stomach, pancreas or liver. |
Intervention: n = 27, 16 (59), 61 ± 10 Control: n = 27, 19 (70), 56 ± 11.1 |
During the first 5 postoperative days | Usual care + activity trackers with daily step goals | 5 days | No | NA | Polar Loop activity tracker | Usual care + activity tracker with obscured display | aSteps/day (P) | |||
NA not applicable, *dependent on admission time, RL real life, OD on distance, D during the intervention, P post-intervention, FU long term follow up, aBold = included in meta-analysis