Does objective feedback decrease sedentary behavior in geriatric rehabilitation? A systematic review

medRxiv

Abstract

Abstract Objective To assess the effectiveness of interventions using feedback from objective measurements to reduce sedentary behavior in older adults during rehabilitation. Data Source Cochrane Library, Web of Science, PubMed, Embase and Emcare were systematically searched for controlled trials in May 2023. Study Inclusion and Exclusion Criteria Studies in post-acute settings involving older individuals, providing feedback as part of the intervention and reporting effects on sedentary behavior were included. Data Extraction Study characteristics, aim, methodology, intervention content, and outcome measures with effect sizes relating to sedentary behavior were extracted. Data synthesis A narrative synthesis was used to describe the data. Results Eleven studies with diverse methods and reported outcomes were included. Feedback was focused only on sedentary behavior (one study), on sedentary behavior and physical activity (four studies), or only on physical activity (six studies). All studies showed high bias risk in at least one quality assessment domain. Six studies reported a significant decrease in sedentary behavior, while five reported no effect. No harms were reported. Conclusion The effect of feedback-based interventions on sedentary behavior in geriatric rehabilitation remains inconclusive. Interventions differed considerably in content and methodology, and high-quality evidence is lacking. Future research should focus on improving research methodology, optimizing strategies to reduce sedentary behavior and finding the minimum reduction of sedentary behavior required to create a clinically relevant difference. Key points Although some studies indicate a (small) reduction in sedentary behaviour following interventions with objective feedback for older individuals in rehabilitation, effects remain inconclusive. Interventions to decrease sedentary behaviour differ considerably in content and methodology. Despite substantial evidence on the health risks associated with sedentary behaviour, there is a lack of high-quality studies on feedback to reduce sedentary time during rehabilitation.

Authors 5

1. Suzanne M Debeij corresponding Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center;

   University Network for the Care Sector South-Holland, Leiden University Medical Center, Leiden, the Netherlands

2. Miriam L. Haaksma Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center;

   University Network for the Care Sector South-Holland, Leiden University Medical Center, Leiden, the Netherlands

3. Peter Alexander van de Hoef

   University of Applied Sciences Utrecht

   Affiliation as printed

   HU University of Applied Sciences

   National eHealth Living Lab, Leiden, the Netherlands

   Research Group Innovation of Human Movement Care, Research Center Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, the Netherlands

4. Wilco P. Achterberg Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center;

   University Network for the Care Sector South-Holland, Leiden University Medical Center, Leiden, the Netherlands

5. Eléonore F van Dam van Isselt Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center;

   University Network for the Care Sector South-Holland, Leiden University Medical Center, Leiden, the Netherlands