Effect of behavior-change interventions on daily physical activity in patients with intermittent claudication: the OPTIMA systematic review with meta-analysis
Abaraogu, Ukachukwu O, Dall, Philippa, Seenan, Chris, Rhodes, Sarah, Gorely, Trish, McParland, Joanna, Brittenden, Julie, Anieto, Ebuka, Booth, Lorna, Gormal, Cathy, Dearling, Jeremy, Fenton, Candida, Audsley, Sarah, Fairer, Kimberley, Bearne, Lindsay and Skelton, Dawn A (2024) Effect of behavior-change interventions on daily physical activity in patients with intermittent claudication: the OPTIMA systematic review with meta-analysis. European Journal of Preventive Cardiology. ISSN 2047-4881
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Abstract
Aims The study aimed to synthesize evidence of daily physical activity (PA) following Behavior-change technique (BCT)-based interventions compared to any control in individuals with peripheral arterial disease/intermittent claudication (PAD/IC); and examine the relationship between BCTs and daily PA. Methods Systematic search of 11 databases from inception to 30/11/2022 was conducted, plus weekly email alerts of new literature until 31/8/2023. Studies comparing BCT-based interventions with any control were included. Primary analysis involved a pairwise random-effects meta-analysis. Risk of bias was assessed using the Cochrane-RoB-2 and ROBINS-I tools. Certainty of evidence was evaluated with the GRADE system. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Outcome measures were short-term (<6 months) change in daily PA, and maintenance of the daily PA (6 months or longer) reported as standardized mean differences (SMDs) with 95% confidence intervals (95%CIs). Results Forty-one studies (4,339 patients; 26 RCTs/3,357 patients; 15 non-RCTs/982 patients; study mean age 60.3 to 73.8, 29.5% female) were included. Eleven RCTs (15 comparisons, 952 participants) suggested that BCT-based interventions increased daily PA in the short term compared to non-SET [increase of 0.20 SMD (95%CI: 0.07 to 0.33), ∼473 steps/day] with high certainty. Evidence of maintenance of daily PA (≥6 months) is unclear [increase of 0.12 SMD (95%CI: -0.04 to 0.29); ∼288 steps/day; 6RCTs, 8 comparisons, 899 participants], with moderate certainty. For daily PA, compared to SET it was inconclusive both for < 6months change [-0.13 SMD, 95%CI: -0.43 to 0.16); 3RCTs, 269 participants; low certainty] and ≥6months [-0.04 SMD, 95%CI: -0.55 to 0.47); 1 RCT, 89 participants; very low certainty]. It was unclear whether the number of BCTs or any BCT domain were independently related to an increase in PA. Conclusion BCT-based interventions improve short-term daily PA in people with PAD/IC compared to non-SET controls. Evidence for maintenance of the improved PA at 6 months or longer and comparison with SET is uncertain. BCT-based interventions are effective choices for enhancing daily PA in PAD/IC.
Item Type: | Article |
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Uncontrolled Keywords: | peripheral arterial disease, intermittent claudication, behaviour change techniques, behaviour change interventions, physical activity |
Subjects: | R Medicine > R Medicine (General) |
Divisions: | Faculty of Health & Science > School of Allied Health Sciences |
SWORD Depositor: | Pub Router |
Depositing User: | Pub Router |
Date Deposited: | 30 Sep 2024 11:05 |
Last Modified: | 30 Sep 2024 11:05 |
URI: | https://oars.uos.ac.uk/id/eprint/4247 |
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