JMIR Publications

ABSTRACT

Background:

The global aging population faces great challenges. Wearable activity trackers have emerged as tools to promote physical activity among older adults, potentially improving health outcomes. However, the effectiveness of such interventions on physical activity, body composition and physical function among community-dwelling older adults remains debated.

Objective:

This study conducted a systematic review and meta-analysis to evaluate the impact of wearable activity tracker-based interventions on physical activity, body composition and physical function among community-dwelling older adults.

Methods:

We searched the PubMed, Embase, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception until February 2024 to identify related randomized controlled trials (RCTs). The outcomes were focused on physical activity (physical activity time, daily step count and daily sedentary time), body composition (body mass index and mass fat) and physical function (time up & go test and chair stand test). Mean differences (MDs) with 95% confidence intervals (CIs) or standardized mean differences (SMDs) with 95% CIs were calculated. Subgroup analysis by different controls (usual care or conventional interventions) and different follow-ups (immediate or short term) were performed. The Physiotherapy Evidence Database (PEDro) scale and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach were used to evaluate the quality of the methodology and the certainty of evidence, respectively.

Results:

In total 22 trials with 4506 participants were eligible for analysis. Compared to usual care, the wearable activity tracker-based interventions significantly increased physical activity time (SMD = 0.25; 95% CI 0.05 to 0.44; P = 0.01) and daily step counts (SMD = 0.62; 95% CI 0.36 to 0.87; P < 0.001) immediately post-intervention, while no significant improvements were observed in body mass index (MD = 0.38; 95% CI -0.12 to 0.87; P = 0.13), body fat (MD = 0.58; 95% CI -0.64 to 1.80; P = 0.35), time up & go test (MD = 0.14; 95% CI -0.87 to 1.16; P = 0.78) or chair stand test (SMD = -0.31; 95% CI -0.62 to 0.00; P = 0.05). These interventions were at least as effective as conventional interventions but did not show superiority. Compared with usual care, the interventions utilizing wearable activity trackers only demonstrated a notable increase in daily step count over the short-term follow-up (SMD = 0.23; 95% CI 0.11 to 0.36; P = 0.0002).

Conclusions:

Wearable activity trackers-based interventions are effective in enhancing physical activity immediately post-intervention but do not significantly impact body composition or physical function among community-dwelling older adults. In addition, wearable activity trackers-based interventions appear to be comparable to conventional interventions. Nevertheless, more research should explore the short- or long-term impacts of such interventions and identify strategies to further enhance their effectiveness. Clinical Trial: PROSPERO CRD42024516900;