WEARABLE ACTIVITY TRACKERS ARE EFFECTIVE TO IMPROVE PHYSICAL ACTIVITY BEHAVIOR IN RHEUMATIC AND MUSCULOSKELETAL DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS

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Davergne T1, Pallot A2,3, Dechartres A1, Fautrel B1,4, Gossec L1,4
1Sorbonne University, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S 1136, Paris, France, 2Institut de Formation en Masso-Kinésithérapie CEERRF, Saint-Denis, France, 3Institut d’Ingénierie de la Santé, Université de Picardie Jules Verne, Amiens, France, 4Pitié-Salpêtrière Hospital, Rheumatology, Paris, France

Background: Wearable activity trackers could be a promising strategy to improve physical activity (PA) in patients with rheumatic and musculoskeletal diseases.

Purpose: The aim was to assess the adherence and effectiveness of wearable activity trackers to increase PA levels in rheumatic and musculoskeletal diseases.

Methods: This review was conducted in accordance with the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. PROSPERO CRD42018083532. A systematic review was performed to identify all cohorts and controlled trials evaluating WATs in rheumatic and musculoskeletal diseases, published between 2000 and 2018, by searching MEDLINE, EMBASE, PsycINFO and Cochrane. Data collected pertained to (a) adherence, (b) effectiveness on PA or (c) effectiveness on symptoms (pain, function, quality of life or fatigue). Meta-analyses were performed with a random effect model.

Results: Of 2378 references, 17 studies were included with a total of 1588 patients; 8 studies (47%) in osteoarthritis, 5 (29%) in low back pain and 3 (18%) in inflammatory arthritis. Adherence assessed in 4 studies was high (weighted mean time worn: 92.7% (standard deviation 4.6%). A significant increase in PA was noted (mean difference 1520 steps, 95% confidence interval [580 - 2460], I2=77% or 16 minutes [2 - 29] of moderate to vigorous PA, I2=0%). A significant increase in pain was found for long interventions (>8 weeks) (standardized mean difference 0.25 [0.07, 0.43], I2= 0%).

Conclusion(s): Wearable activity trackers in rheumatic and musculoskeletal diseases had a high short- term adherence with a significant increase in number of steps and time spent in moderate to vigorous PA though pain should be monitored. Wearable activity trackers may be an interesting option to increase PA in this at risk population.

Implications:
• Short-term adherence to wearable activity trackers was high in people with rheumatic and musculoskeletal diseases.
• Interventions using wearable activity trackers were effective to increase physical activity levels in rheumatic and musculoskeletal diseases, with a mean difference of 1520 steps per day and 16 daily minutes spent in moderate to vigorous physical activity.
• Symptoms did not worsen with short term use of wearable activity trackers though pain increased in long-term interventions.

Keywords: Wearable activity tracker, rheumatic and musculoskeletal diseases, physical activity

Funding acknowledgements: This study was partly funded by an educational grant from the French society of rheumatology (patient education working group).

Topic: Musculoskeletal; Information management, technology & big data; Health promotion & wellbeing/healthy ageing

Ethics approval required: No
Institution: None
Ethics committee: None
Reason not required: Systematic reviews are based on published data and require no ethics approval


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