Self-monitoring to increase physical activity in patients with cardiovascular disease: a systematic review and meta-analysis
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Background and aims
It is important to encourage physical activity in patients with cardiovascular disease (CVD), and self-monitoring is considered to contribute to increased physical activity. However, the effects of self-monitoring on CVD patients remain to be established. In this study, we examined the influence of self-monitoring on physical activity of patients with CVD via a systematic review and meta-analysis.
Screening of randomized controlled trials only was undertaken twice on PubMed (date of appraisal: August 29, 2017). The inclusion criteria included outpatients with CVD, interventions for them, daily step counts as physical activity included in the outcome, and self-monitoring included in the intervention. Assessments of the risk of bias and meta-analysis in relation to the mean change of daily step counts were conducted to verify the effects of self-monitoring.
From 205 studies retrieved on PubMed, six studies were included, with the oldest study published in 2005. Participants included 693 patients of whom 541 patients completed each study program. Their mean age was 60.8 years, and the ratio of men was 79.6%. From these 6 studies, a meta-analysis was conducted with 269 patients of 4 studies including only RCTs with step counts in the intervention group and the control group, and self-monitoring significantly increased physical activity (95% confidence interval, 1916–3090 steps per day, p < 0.05). The average intervention period was about 5 months. Moreover, four studies involved intervention via the internet, and five studies confirmed the use of self-monitoring combined with other behavior change techniques.
The results suggest that self-monitoring of physical activity by patients with CVD has a significantly positive effect on their improvement. Moreover, the trend toward self-monitoring combined with setting counseling and activity goals, and increased intervention via the internet, may lead to the future development and spread of self-monitoring for CVD patients.
KeywordsSelf-monitoring Cardiovascular disease Physical activity Steps Systematic review Meta-analysis
Behavior change techniques
Body mass index
Randomized controlled trial
Standardized mean difference
This study was benefitted by the support and encouragement of Taku Shinoda (Kobe University Graduate School of Health Sciences, Kobe University), Masashi Kanai (Kobe University Graduate School of Health Sciences), and Masato Ogawa (Kobe University Graduate School of Health Sciences). We also thank Dr. Minato Nakazawa, Department of International Health, Graduate School of Health Sciences, Kobe University, for statistical support in the present study.
This work was supported by a Grant from JSPS KAKENHI (No. JP17K01500). Neither the authors nor their associated institutions report any financial relationships with industry relevant to this study.
Compliance with ethical standards
Conflict of interest
All authors declare no conflicts of interest in relation to the work reported in this manuscript.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent form is not required.
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