Effectiveness of technology-based distance interventions promoting physical activity : Systematic review, meta-analysis and meta-regression

Objective: To determine the effectiveness of technology-based distance interventions for promoting physical activity, using systematic review and meta-analysis. Methods: A literature search of studies published between 2000 and 2015 was conducted in the following databases: CENTRAL, EMBASE, Ovid MEDLINE, CINAHL, PsycINFO, OTseeker, WOS and PEDro. Studies were selected according to the PICOS framework, as follows: P (population): adults; I (intervention): technology-based distance intervention for promoting physical activity; C (comparison) similar distance intervention without technology, O (outcomes) physical activity; S (study design) randomized controlled trial. Physical activity outcomes were extracted and quality was assessed by 2 independent authors. Results: Eight studies were included in the meta-analysis. The mean (standard deviation; range) me thodological quality score of the studies was 6 (1.3; 4-8). Technology-based distance interventions were not more or less effective than conventional treatment whether measured as steps/day (mean difference 1,657; 95% confidence interval (95% CI) -1,861 to 5,176, p = 0.18), physical activity min/week (mean difference 0.34; 95% CI -146.3 to 146.9, p = 0.92), or as overall physical activity (response ratio 1.1; 95% CI 0.8-1.4, p = 0.65). No associations between the intervention duration or study quality and physical activity outcomes were found. Data were statistically and clinically heterogeneous. Conclusion: The effectiveness of technology-based distance interventions for promoting physical activity is similar to that of conventional treatment.