PhysioUpdate 3rd February 2022

Copenhagen-based physiotherapist and researcher Rasmus Tolstrup Larsen is the lead author of a topical paper that examines whether fitness apps and other physical activity monitors (PAMs) help to boost adults' activity levels.

The team led by Mr Larsen, all of whom are based in Denmark, conducted a systematic review of the available evidence and published their findings in the prestigious journal The BMJ today (26 January).

They found that PAMs that provide direct feedback to users can have a small to moderate effect on boosting people’s activity levels – an increase of about 1,200 extra steps a day and 50 extra minutes of ‘moderate to vigorous’ activity a week.

Setting the context, Mr Larsen and his colleagues state that while modern PAM devices have the potential to change people’s behaviour, studies focusing on their effectiveness have tended to reach contrasting conclusions.

They searched databases for trials comparing activity levels in adults who received feedback from PAMs with control interventions in which no feedback was provided.

They found 121 randomised controlled trials involving 16,743 mainly healthy 18-to-65-year olds. Most trials took place in European (31 per cent) or north American (40 per cent) countries, with a median intervention period of 12 weeks. The median age of study participants was 47 years, with a higher proportion of women (median 77 per cent) than men.

Overall, the interventions showed a moderate effect on physical activity (equivalent to 1,235 daily steps), a small effect on moderate to vigorous physical activity (equivalent to 48.5 weekly minutes) and a small but insignificant effect on sedentary time (equal to 9.9 daily minutes).

For all outcomes, physical activity monitors that provided feedback were more effective than those that did not provide feedback.

The study 'provides evidence for using physical activity monitors for enhancing physical activity and moderate to vigorous physical activity at a time when large, feasible, and scalable interventions are urgently needed' [Rasmus Tolstrup Larsen et al.]

A 'first' in the field

The researchers acknowledge that the trials they included varied in design and methods and that the results may not apply in lower income countries. Nevertheless, they add, this is the first systematic review to summarise the entire body of evidence across different patient populations and different types of PAMs.

As such, they say this study ‘provides evidence for using physical activity monitors for enhancing physical activity and moderate to vigorous physical activity at a time when large, feasible, and scalable interventions are urgently needed’.

Mr Larsen and his team suggest that future studies could shed more light on how physical activity monitors can be used in combination with other behavioural change strategies or how they might affect sedentary time.

Why is the study so topical?

Mr Larsen and his colleagues note that physical inactivity, conducted at levels that are insufficient to meet current recommendations, has a 'large impact' on global public health. It is one of the major risk factors for non-communicable diseases and is estimated to be responsible for 9 per cent of all premature deaths globally, they add.

To read the full version of the research paper, titled Effectiveness of physical activity monitors in adults: systematic review and meta-analysis, visit: https://www.bmj.com/content/376/bmj-2021-068047

Mr Larsen’s educational background

Bachelor of Physiotherapy from Metropolitan University College of Copenhagen (2015)

Master of Science in Physiotherapy from University of Southern Denmark, June 2017

PhD fellow from Graduate School of Health and Medical Sciences, University of Copenhagen (ongoing)

Source: https://publichealth.ku.dk/staff/?pure=en%2Fpersons%2Frasmus-tolstrup-larsen(51e543c7-307c-4ac0-9d44-388cf7963f7b).html

People who are exposed to pesticides at work face increased risks of developing chronic obstructive pulmonary disease (COPD), according to researchers whose paper was published online in Thorax today (25 January).

A team led by Sara De Matteis, from the University of Cagliari in Sardinia, and the National Heart and Lung Institute at Imperial College London, notes that their findings are independent of two key COPD risk factors: smoking and asthma.

Sounding a positive note about the impact that focused preventive strategies can have on cases on COPD, the authors state that, according to recent estimates, about 14 per cent of all such cases are related to work.