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      The Effect of Physical Activity Interventions Comprising Wearables and Smartphone Applications on Physical Activity: a Systematic Review and Meta-analysis

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          Abstract

          Background

          Worldwide physical activity levels of adults are declining, which is associated with increased chronic disease risk. Wearables and smartphone applications offer new opportunities to change physical activity behaviour. This systematic review summarizes the evidence regarding the effect of wearables and smartphone applications on promoting physical activity.

          Methods

          PubMed, EMBASE and Cochrane databases were searched for RCTs, published since January 2008, on wearables and smartphone applications to promote physical activity. Studies were excluded when the study population consisted of children or adolescents, the intervention did not promote physical activity or comprised a minor part of the intervention, or the intervention was Internet-based and not accessible by smartphone. Risk of bias was assessed by the Cochrane collaboration tool. The primary outcome was changed in physical activity level. Meta-analyses were performed to assess the pooled effect on (moderate-to-vigorous) physical activity in minutes per day and daily step count.

          Results

          Eighteen RCTs were included. Use of wearables and smartphone applications led to a small to moderate increase in physical activity in minutes per day (SMD = 0.43, 95% CI = 0.03 to 0.82; I 2 = 85%) and a moderate increase in daily step count (SMD = 0.51, 95% CI = 0.12 to 0.91; I 2 = 90%). When removing studies with an unclear or high risk of bias, intervention effects improved and statistical heterogeneity was removed.

          Conclusions

          This meta-analysis showed a small to moderate effect of physical activity interventions comprising wearables and smartphone applications on physical activity. Hence, wearables and smartphone applications are likely to bring new opportunities in delivering tailored interventions to increase levels of physical activity.

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          Most cited references36

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          Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.

          Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the eff ect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level. For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population. Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9-9·6) of type 2 diabetes, 10% (5·6-14·1) of breast cancer, and 10% (5·7-13·8) of colon cancer. Inactivity causes 9% (range 5·1-12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0·68 (range 0·41-0·95) years. Physical inactivity has a major health eff ect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially. None.
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            Global physical activity levels: surveillance progress, pitfalls, and prospects

            The Lancet, 380(9838), 247-257
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              Sedentary Behavior Research Network (SBRN) – Terminology Consensus Project process and outcome

              Background The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need. Method First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey. Results Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided. Conclusion It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0525-8) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                R.Gal@umcutrecht.nl
                A.M.May@umcutrecht.nl
                elonvanovermeeren@gmail.com
                M.Simons@uu.nl
                E.Monninkhof@umcutrecht.nl
                Journal
                Sports Med Open
                Sports Med Open
                Sports Medicine - Open
                Springer International Publishing (Cham )
                2199-1170
                2198-9761
                3 September 2018
                3 September 2018
                December 2018
                : 4
                : 42
                Affiliations
                [1 ]ISNI 0000000120346234, GRID grid.5477.1, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, , Utrecht University, ; STR 6.131, Universiteitsweg 100, PO Box 85500, 3508 GA Utrecht, The Netherlands
                [2 ]ISNI 0000000120346234, GRID grid.5477.1, Department of Human Geography and Spatial Planning, , Utrecht University, ; Utrecht, The Netherlands
                Author information
                http://orcid.org/0000-0001-7340-4581
                Article
                157
                10.1186/s40798-018-0157-9
                6120856
                30178072
                0188634a-3f59-47dc-b594-dcab15358ef0
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 4 May 2018
                : 24 August 2018
                Funding
                Funded by: Sport & Society, Utrecht University, The Netherlands
                Funded by: ZonMw (NL)
                Award ID: 016.156.050
                Award Recipient :
                Categories
                Systematic Review
                Custom metadata
                © The Author(s) 2018

                wearables,smartphone applications,physical activity
                wearables, smartphone applications, physical activity

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