Alley Stephanie J, Waters Kim M, Parker Felix, Peiris D L I H K, Fien Samantha, Rebar Amanda L, Vandelanotte Corneel
Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Building 7, Bruce Highway, Rockhampton, QLD, 4701, Australia.
Appleton Institute, School of Health Medical and Applied Science, Central Queensland University, 151-171 Boundary Road, Ooralea, QLD, 4740, Australia.
Int J Behav Nutr Phys Act. 2024 Dec 18;21(1):144. doi: 10.1186/s12966-024-01694-4.
Physical activity is important for healthy ageing, however most older adults are inactive. Numerous reviews with a range of inclusion criteria have been conducted on digital interventions to promote physical activity in older adults, and a synthesis of these is needed. Therefore, the objective of this study is to conduct an umbrella review and meta-meta-analysis on the effectiveness of digital interventions to promote physical activity in older adults.
Nine databases were searched from January 2010 to December 2023. Systematic reviews and meta-analyses of primary studies using digital physical activity interventions to target healthy older adults or clinical populations of older adults with a self-reported or device measured physical activity outcome were eligible for inclusion.
In total, 22 systematic reviews and meta-analyses covering 185 primary research papers were eligible for inclusion. The total number of participants across all primary studies was 28,198. Most (21, 95%) reviews and meta-analyses were rated as having a low or critically low AMSTAR-2 confidence rating. Of the 22 included systematic reviews, 13 (59%) conducted a meta-analysis and 10 (45%) conducted a narrative synthesis. Most systematic reviews with a narrative synthesis found strong evidence for a positive effect or moderate evidence for a positive effect for physical activity outcomes (7/9, 78%) and steps (3/3, 100%). The meta-meta-analysis of primary papers included in meta-analyses demonstrated a significant moderate effect for steps and a significant small effect for total PA and MVPA. The strength of effect did not vary by intervention components (activity tracker, app-based, SMS/phone, web-based, and face-to-face), population (primary or secondary prevention), control group (none, other digital intervention, or non-digital intervention), or outcome measurement (self-reported or device measured). Only 3 (14%) reviews included longer term follow up outcomes after the end of the intervention, with mixed results.
Evidence from 22 reviews and meta-analyses suggests that digital physical activity interventions are effective at increasing physical activity in older adults. Further primary research is needed in adults 65 years and over exclusively, and with longer-term follow up of physical activity outcomes. Future reviews should include a published protocol and interpret results according to risk-of-bias.
身体活动对健康老龄化很重要，但大多数老年人缺乏身体活动。针对促进老年人身体活动的数字干预措施，已经进行了许多纳入标准各异的综述，需要对这些综述进行综合分析。因此，本研究的目的是对促进老年人身体活动的数字干预措施的有效性进行一项伞状综述和元元分析。
检索了从2010年1月到2023年12月的九个数据库。使用数字身体活动干预措施针对健康老年人或有自我报告或设备测量的身体活动结果的老年临床人群的原始研究的系统综述和元分析符合纳入标准。
总共有22项系统综述和元分析涵盖185篇原始研究论文符合纳入标准。所有原始研究的参与者总数为28198人。大多数（21项，95%）综述和元分析被评为AMSTAR-2置信度评级低或极低。在纳入的22项系统综述中，13项（59%）进行了元分析，10项（45%）进行了叙述性综合分析。大多数进行叙述性综合分析的系统综述发现了身体活动结果（7/9，78%）和步数（3/3，100%）有积极效果的有力证据或中等证据。对元分析中纳入的原始论文进行的元元分析表明，步数有显著的中等效果，总身体活动量和中等至剧烈身体活动量有显著的小效果。效果强度在干预组成部分（活动追踪器、基于应用程序、短信/电话、基于网络和面对面）、人群（一级或二级预防）、对照组（无、其他数字干预或非数字干预）或结果测量（自我报告或设备测量）方面没有差异。只有3项（14%）综述纳入了干预结束后的长期随访结果，结果不一。
22项综述和元分析的证据表明，数字身体活动干预措施在增加老年人身体活动方面是有效的。需要专门针对65岁及以上成年人进行进一步的原始研究，并对身体活动结果进行长期随访。未来的综述应包括已发表的方案，并根据偏倚风险解释结果。
