Objective To estimate the effectiveness of physical activity monitor (PAM) based interventions among adults and explore reasons for the heterogeneity. Design Systematic review and meta-analysis. Study selection The electronic databases MEDLINE, Embase, SPORTDiscus, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched on 4 June 2021. Eligible randomised controlled trials compared interventions in which adults received feedback from PAMs with control interventions in which no feedback was provided. No restrictions on type of outcome measurement, publication date, or language were applied. Data extraction and synthesis Two reviewers independently extracted data and assessed risk of bias. Random effects meta-analyses were used to synthesise the results. The certainty of evidence was rated by the Grading of Recommendations Assessment and Evaluation (GRADE) approach. Main outcome measures The three primary outcomes of interest were physical activity, moderate to vigorous physical activity, and sedentary time. Results 121 randomised controlled trials with 141 study comparisons, including 16 743 participants, were included. The PAM based interventions showed a moderate effect (standardised mean difference 0.42, 95% confidence interval 0.28 to 0.55) on physical activity, equivalent to 1235 daily steps; a small effect (0.23, 0.16 to 0.30) on moderate to vigorous physical activity, equivalent to 48.5 weekly minutes; and a small insignificant effect (−0.12, −0.25 to 0.01) on sedentary time, equal to 9.9 daily minutes. All outcomes favoured the PAM interventions. Conclusions The certainty of evidence was low for the effect of PAM based interventions on physical activity and moderate for moderate to vigorous physical activity and sedentary time. PAM based interventions are safe and effectively increase physical activity and moderate to vigorous physical activity. The effect on physical activity and moderate to vigorous physical activity is well established but might be overestimated owing to publication bias. Study registration PROSPERO CRD42018102719.

Background There is increasing focus on earlier rehabilitation in patients with traumatic or hypoxic brain injury or stroke. This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. Methods We searched Medline, CENTRAL, EMBASE, four other databases and 13 selected clinical trial registries until April 2020. Eligible randomised clinical trials compared early head-up mobilisation versus standard care in patients with severe acquired brain injury and were analysed conducting random-and fixed-effects meta-analyses and Trial Sequential Analysis (TSA). Certainty of evidence was assessed by GRADE. Main results We identified four randomised clinical trials (total n = 385 patients) with severe acquired brain injury (stroke 86% and traumatic brain injury 13%). Two trials were at low risk and two at high risk of bias. We found no evidence of a difference between early mobilisation vs. standard care on mortality or poor functional outcome at end of the intervention (relative risk (RR) 1.19, 95% CI 0.93 to 1.53; I 2 0%; very low certainty) or at maximal follow-up (RR 1.03, 95% CI 0.89 to 1.21; I 2 0%; very low certainty). We found evidence against an effect on quality of life at maximal follow-up. The proportion of patients with at least one serious adverse event did not differ at end of intervention or at maximal follow-up. For most comparisons, TSA suggested that further trials are needed.

ObjectiveThe use of physical activity monitors (PAMs) in the adult population is increasing rapidly and previous systematic reviews are outdated. The objective of this systematic review and meta-analysis is to estimate the effect of PAM-based interventions on physical activity behavior in adults. Furthermore, the impact of intervention, study, and participants characteristics will be investigated.Methods and designRandomized controlled trials and randomized cross-over trials including adult participants will be included if the study compares any PAM-based intervention where the participants receive feedback on their physical activity level measured by PAMs, to control interventions where participants do not receive feedback from PAMs. This protocol is detailed according to the recommendations of the Cochrane Handbook, and it is reported according to the preferred reporting items for systematic reviews and meta-analyses protocols statement. The results from the literature search will be presented in a PRISMA flow chart. The effects from individual studies will be summarized in a random effects meta-analysis and the impact of diagnosis of the participants, type of feedback, type of intervention, and control intervention will be investigated in stratified meta-analysis and meta-regressions analysis. The results on daily physical activity, moderate to vigorous physical activity, sedentary time, and adverse events will be presented in a summary of findings table.DiscussionThe results will be useful to researchers, policy makers, and health care professionals when the intention is to increase physical activity in the adult population.PROSPERO registration CRD42018102719 Electronic supplementary materialThe online version of this article (10.1186/s13643-019-0970-3) contains supplementary material, which is available to authorized users.