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Evidence Summary
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Key messages from scientific research that's ready to be acted on
Got It, Hide thisCounseling with activity monitors improves physical activity and health outcomes in patients with type 2 diabetes
Vaes AW, Cheung A, Atakhorrami M, et al Effect of 'activity monitor-based' counseling on physical activity and health-related outcomes in patients with chronic diseases: A systematic review and meta-analysis. Annals of Medicine, 2013. Volume 45, Issue 5-6, pages 397-412.
Review question
How effective is activity monitor-based counseling for patients with chronic diseases including type-2 diabetes, chronic obstructive pulmonary disease (COPD), or chronic heart failure?
Background
People with chronic disease are less likely to be physically active than healthy people, even though physical activity is beneficial for preventing the progression of various chronic diseases.
Activity monitors, such as pedometers, have become for tracking physical activity. Health care practitioners can use feedback from these devices to encourage patients to be more active.
How the review was done
This summary is based on a meta-analysis of 24 randomized controlled trials. Twenty-one trials with 2763 participants assessed outcomes related to type-2 diabetes (T2D). The average age of participants ranged from 47 to 70 years old. Three trials with 145 participants also examined outcomes related to chronic-obstructive pulmonary disease (COPD). The average age ranged from 61 to 66 years old. No studies looked at chronic heart failure.
The interventions involved one-on-one counseling and activity goal setting, followed by the use of an activity-monitor device. The participants in the intervention were compared with participants receiving usual care, education, or encouragement to engage in physical activity. Program length was 5 weeks to 5 years, with an average of 31 weeks. Physical activity was measured immediately before and after the intervention period.
What the researchers found
As is illustrated in the table below, activity monitor-based counseling improves the following outcomes in patients with type-2 diabetes when compared with usual care or physical activity advice/education. The results for COPD could not be combined due to important differences in the outcomes measured.
This was a well-done review. The included studies varied in quality, but only three were classified by the authors as low quality.
Conclusion
Activity monitor-based counseling improves type-2 diabetes outcomes when compared with usual care or physical activity advice/education. The effects on patients with COPD were not conclusive.
Table header
| Outcome | Effect (SMD) |
| Physical Activity | 0.8 |
| Hemoglobin A1c | -0.23 |
| Body Mass Index | -0.24 |
| Systolic Blood Pressure | -0.18 |
| Diastolic Blood Pressure | Not significant |
| Health-related quality of life | Not significant |
Glossary
Indicates whether someone’s height and weight puts them at an increased risk of a number of chronic diseases.
The lower number in a blood pressure reading. It is the pressure when the heart rests between beats.
Advanced statistical methods contrasting and combining results from different studies.
Studies where people are assigned to one of the treatments purely by chance.
The higher number in a blood pressure reading. It is the pressure in the arteries when the heart beats.
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