ObjectiveTo systematically review randomised controlled trials (RCTs) using a wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in patients with cardiovascular disease (CVD).DesignSystematic review and meta-analysis of RCTs.Data sourcesPubMed, Embase and Web of Science from inception to June 2022.Eligibility criteriaRandomised controlled studies including patients with CVD over 18 years of age at the end of a cardiac rehabilitation programme comparing an intervention group using a wearable physical activity monitoring device with feedback with usual care or with a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walk test (6-MWT) or a change in peak oxygen uptake (V̇O2peak) as endpoints.ResultsSixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardised mean difference (SMD) 0.85; 95% CI (0.42; 1.27); p<0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI (0.18; 1.82); p<0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI (0.27; 1.16); p<0.01), but no significant interaction was found between subgroups (p=0.55). 6-MWT distance and V̇O2peakshowed only small effects (SMD 0.34; 95% CI (−0.11; 0.80); p=0.02 and SMD 0.54; 95% CI (0.03; 1.03); p=0.07, respectively).ConclusionThe use of wearable physical activity monitoring devices appears to help patients with CVD to increase their daily walking activity and thus their physical activity, particularly in the short term.PROSPERO registration numberCRD42022300423.

Funding Acknowledgements Type of funding sources: None. Background Despite the known benefits of physical activity, patients with cardiovascular disease do not practice enough nor maintain a regular physical activity for their health [1-4] . Walking is one of the easiest ways to stay physically active and can be implemented easily in everyday life [5]. Wearable physical activity monitoring devices have the potential to help increase physical activity through self-monitoring and feedback. Purpose To review randomized controlled trials using wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in cardiovascular diseases (CVD) patients. Methods Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Data Sources: PubMed, Embase, Web of Science. Eligibility criteria: Randomized controlled studies including patients over 18 years of age with CVD comparing an intervention group using a wearable physical activity monitoring device with feedback to usual care or to a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walking test (6MWT) or a change in peak oxygen uptake (VO2 peak). Outcomes: Primary outcome was daily number of steps, secondary ouctomes were distance covered in the 6-minute walking test (6MWT) and/or peak oxygen uptake (VO2 peak). Results Sixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardized mean difference ((SMD) 0.85; 95% CI [0.42; 1.27], p &lt; 0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI [0.18; 1.82], p &lt; 0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI [0.27; 1.16], p &lt; 0.01) but no significant interaction was found between subgroups (p = 0.55). Six MWT distance and VO2 peak showed only small effects (SMD 0.34 (95% CI [-0.11; 0.80], p = 0.02) and SMD 0.53 (95% CI [0.03; 1.03], p = 0.07), respectively).

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