THU0745-HPR Use of wearable activity trackers to improve physical activity behaviour in rheumatic conditions – a systematic review
Authors: T. Davergne, A. Pallot, L. Gossec, B. Fautrel
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients with rheumatic conditions, such as low back pain (LBP), lower limb osteoarthritis (OA) and chronic inflammatory rheumatic diseases (CIRDs) are vulnerable regarding physical inactivity, although they derive specific benefits from regular physical activity.<sup>1 2</sup> Wearable activity trackers (WATs), including simple pedometers and more advanced WATs (e.g. Fitbit), could be a promising strategy to improve physical activity levels. <h3>Objectives</h3> To obtain an overview regarding the adherence and effectiveness of WATs to increase physical activity levels and to reduce sedentary behaviours in rheumatic patients. <h3>Methods</h3> This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement (PROSPERO CRD42018083532). All articles available in English, published between 2000 and 2018 (January), in MEDLINE, EMBASE, PsycINFO and Central Register for Controlled Trials were screened as well as extensive hand search. Study selection and data collection were performed by two independent reviewers. Studies were included if they assessed WATs in patients with OA, LBP or CIRDs. Data collected pertained to (a) adherence (i.e.% days with the WAT worn), (b) efficacy on physical activity (i.e. increase in step counts or moderate to vigorous physical activity), (c) efficacy on symptoms (function, pain, quality of life). Standardised mean differences were calculated and reported as null (&lt;0.2) small (0.2–0.5) moderate (0.5–0.8) or large (&gt;0.8). <h3>Results</h3> Of 2378 abstracts, 15 studies were included in the review (of which, 7, 47%, published in 2017) with a total of 1344 patients: 42% men, range of mean age 16–64 years. Among the 15 studies, 7 (47%) were related to OA, 5 (33%) to LBP and only 3 (20%) to CIRDs. In all, 7 (47%) reported on advanced WATs and 8 (53%) on simple pedometers. (a) Adherence: 4/15 studies (27%) reported adherence, in a total of 416 patients. The weighted mean duration of the studies was 12.6 weeks and adherence was excellent (weighted mean time worn: 92.7% (SD 4.6)).(b) Efficacy on physical activity was reported in 11/15 (73%) studies (ie 876 patients). The mean increase in steps per day was 1579 (SD 770) in the intervention group over a weighted mean duration of 22.6 (SD 13.6) weeks. Effect sizes were null (2/10 studies), small (4/10 studies), moderate (3/10 studies) or large (1/10 studies) (figure 1). (c) For impact on symptoms, 14/15 (93%) studies reported on function, pain or quality of life (or several of these leading to 20 analyses). Overall, effect sizes were null (14/20, 70%) or small (6/20, 30%). <h3>Conclusions</h3> Short term adherence to WATs was high in published studies of LPB, OA or CIRDs but the efficacy to increase physical activity levels was small to moderate. There were no modifications of symptoms. The incorporation of WAT in patient care remains challenging. Further studies are needed, especially for CIRDs. <h3>References</h3> [1] O'Dwyer T. Rheumatology2014Oct 1;53(10):1812–7. [2] van der Heijde D, Ann Rheum Dis2017;210770. <h3>Disclosure of Interest</h3> None declared