School of Physical Education, Nanchang University, Nanchang, China.
School of Sport Science, Beijing Sport University, Beijing, China.
BMJ Open. 2024 Nov 17;14(11):e080186. doi: 10.1136/bmjopen-2023-080186.
This study aimed to compare the effectiveness of different wearable intervention strategies in reducing sedentary time (ST) and prolonged sitting (PS) on healthy adults.
A network meta-analysis (NMA).
PubMed, Web of Science, SPORTDiscus, ProQuest, Opengrey, Medline and Cochrane Central Register of Controlled Trials were searched up to 1 June 2024.
Randomised controlled trials (RCTs) that examined the effect of wearable device interventions on ST and PS among healthy adults were included.
Two independent reviewers used standardised methods to search, screen and code included studies. Bias risks were assessed using Cochrane tools (Risk of Bias 2.0). Data were analysed using a frequentist framework NMA to directly and indirectly compare the effects of the five different intervention strategies (comparators). The results were reported as standardised mean differences (SMDs) with 95% CI and surface under cumulative ranking curve (SUCRA) was used to rank the best interventions. The five comparators were as follows: (1) wearable-only intervention (only using wearable devices for self-monitoring); (2) wearable combined with online intervention (ie, online coaching and social media support); (3) wearable combined with offline intervention (ie, face-to-face seminars and courses); (4) comparison group (ie, traditional, non-wearable interventions); (5) control group (ie, maintaining daily routine, waitlist).
12 RCTs with a total of 2957 participants were included. Results of NMA showed that the 'wearable+online' has significantly better effects in reducing ST compared with control group, comparison group and 'wearable only', with moderate to large effect sizes (SMD=0.96, 95% CI 0.65 to 1.27; SMD=0.87, 95% CI 0.21 to 1.53; SMD=0.78, 95% CI 0.14 to 1.42, respectively). However, no significant differences were identified between the groups in reducing PS. The SUCRA values were ranked as wearable+online (98.1%), wearable+offline (64.4%,), 'wearable only' (40.5%), comparison group (25.9%) and control group (21.1%) for ST reduction. Similar rankings were observed for PS reduction, with probabilities of 69.9%, 61.1%, 59.7%, 37.1% and 22.1%, respectively.
Wearable+online is the best intervention strategy for reducing ST in healthy adults. Additionally, none of the wearable-based interventions effectively reduced PS in healthy adults, but as there is little research on PS, it should receive more attention in the future. CRD42021290017.
本研究旨在比较不同可穿戴干预策略在减少健康成年人久坐时间（ST）和长时间坐立（PS）方面的有效性。
网络荟萃分析（NMA）。
PubMed、Web of Science、SPORTDiscus、ProQuest、Opengrey、Medline 和 Cochrane 对照试验中心注册库进行了检索，截至 2024 年 6 月 1 日。
包括健康成年人中可穿戴设备干预对 ST 和 PS 影响的随机对照试验（RCT）。
两名独立评审员使用标准化方法进行搜索、筛选和编码纳入的研究。使用 Cochrane 工具（风险偏倚 2.0）评估偏倚风险。使用似然框架 NMA 对数据进行分析，以直接和间接比较五种不同干预策略（对照）的效果。结果以标准化均数差值（SMD）表示，置信区间为 95%，累积排序曲线下面积（SUCRA）用于对最佳干预措施进行排名。五种对照分别为：（1）仅可穿戴设备干预（仅使用可穿戴设备进行自我监测）；（2）可穿戴设备联合在线干预（即在线辅导和社交媒体支持）；（3）可穿戴设备联合线下干预（即面对面研讨会和课程）；（4）对照组（即传统的、非可穿戴干预）；（5）对照组（即维持日常活动、候补组）。
纳入了 12 项 RCT，共 2957 名参与者。NMA 的结果表明，与对照组、比较组和“仅可穿戴设备”相比，“可穿戴设备+在线”在减少 ST 方面具有显著更好的效果，具有中等至较大的效应量（SMD=0.96，95%置信区间 0.65 至 1.27；SMD=0.87，95%置信区间 0.21 至 1.53；SMD=0.78，95%置信区间 0.14 至 1.42）。然而，各组在减少 PS 方面没有发现显著差异。ST 减少的 SUCRA 值分别为可穿戴设备+在线（98.1%）、可穿戴设备+线下（64.4%）、“仅可穿戴设备”（40.5%）、对照组（25.9%）和对照组（21.1%）。PS 减少的相似排名分别为可穿戴设备+在线（69.9%）、可穿戴设备+线下（61.1%）、“仅可穿戴设备”（59.7%）、对照组（37.1%）和对照组（22.1%）。
可穿戴设备+在线是减少健康成年人 ST 的最佳干预策略。此外，基于可穿戴设备的干预措施均不能有效减少健康成年人的 PS，但由于 PS 的研究较少，未来应给予更多关注。CRD42021290017。
