Which are the most effective digital health components to promote physical activity in interventions for people with a chronic condition?

Abstract
Introduction Physical inactivity is a risk factor for the development and progression of chronic conditions. Digital health solutions have the potential to increase physical activity for people with chronic conditions, however interventions are often complex and include multiple components. This component network meta-analysis (CNMA) investigated which intervention components were the most effective in promoting physical activity within studies that use digital health as part of their intervention.

Materials and Methods We searched MEDLINE, Embase, CINAHL, and CENTRAL (December 2nd, 2022) for randomized control trials that use digital health tools to promote physical activity for people with one or more of seven predefined chronic conditions of interest. Intervention components were categorized and extracted for each study along with physical activity data, trial characteristics and participant characteristics. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and the certainty of evidence was assessed using the GRADE approach.

Results Out of 16.109 studies, 99 studies representing 14.562 individual participants were included in the CNMA. Exercise therapy combined with self-management and self-management alone showed a statistically significant effect on improving physical activity when compared to either usual care or minimal self-management. The certainty of evidence was rated low to very low.

Conclusion Digitally delivered exercise therapy + self-management and self-management have a small effect on increasing physical activity for people with chronic conditions, however with a low certainty of evidence. Future studies should focus on better reporting of their exact components for both interventions and comparator groups.