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Wearable activity monitors in home based exercise therapy for patients with intermittent claudication: a systematic review

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Title: Wearable activity monitors in home based exercise therapy for patients with intermittent claudication: a systematic review
Authors: Chan, C
Sounderajah, V
Normahani, P
Acharya, A
Markar, SR
Darzi, A
Bicknell, C
Riga, C
Item Type: Journal Article
Abstract: OBJECTIVE: Intermittent claudication (IC) can severely limit functional capacity and quality of life. Supervised exercise therapy is the recommended first line management; however, this is often limited by accessibility, compliance and cost. As such, there has been an increased interest in the use of wearable activity monitors (WAMs) in home based telemonitoring exercise programmes for claudicants. This review aims to evaluate the efficacy of WAM as a feedback and monitoring tool in home based exercise programmes for patients with IC. DATA SOURCES: A search strategy was devised. The databases MEDLINE, EMBASE, and Web of Science were searched through to April 2020. REVIEW METHODS: Randomised trials and prospective trials were included. Eligible trials had to incorporate WAMs as a feedback tool to target walking/exercise behaviour. The primary outcome was the change in walking ability. Study quality was assessed with risk of bias tool. RESULTS: A total of 1148 records were retrieved. Of these, eight randomised controlled trials and one prospective cohort study, all of which compared a WAM intervention against standard care and/or supervised exercise, met the inclusion criteria. Owing to heterogeneity between studies, no meta-analysis was conducted. WAM interventions improved measures of walking ability (heterogeneous outcomes such as maximum walking distance, claudication distance and six minute walk distance), increased daily walking activity (steps/day), cardiovascular metrics (maximum oxygen consumption), and quality of life. CONCLUSION: There is some evidence that home based WAM interventions are beneficial for improving walking ability and quality of life in patients with IC. However, existing studies are limited by inadequate sample size, duration, and appropriate power. Achieving consensus on outcome reporting and study methods, as well as maximising device adherence, is needed.
Issue Date: Apr-2021
Date of Acceptance: 25-Nov-2020
URI: http://hdl.handle.net/10044/1/85944
DOI: 10.1016/j.ejvs.2020.11.044
ISSN: 1078-5884
Publisher: Elsevier
Start Page: 676
End Page: 687
Journal / Book Title: European Journal of Vascular and Endovascular Surgery
Volume: 61
Issue: 4
Copyright Statement: © Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
National Institute of Health Research
Funder's Grant Number: RDB04 79560
Keywords: Exercise
Fitness trackers
Intermittent claudication
Wearable electronic devices
Fitness trackers
Intermittent claudication
Wearable electronic devices
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Publication Status: Published
Conference Place: England
Online Publication Date: 2021-01-12
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine
Institute of Global Health Innovation

This item is licensed under a Creative Commons License Creative Commons