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Cited by 43Mobile Health and mHealth ApplicationsPhysical Activity and HealthDigital Mental Health Interventions

Digital tools to support the maintenance of physical activity in people with long-term conditions: A scoping review

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Clarkson, Paul, Stephenson, Aoife, Grimmett, Chloe, Cook, Katherine, Clark, Carol, Muckelt, Paul E, O’Gorman, Philip, Saynor, Zoe +3 more·2022·DIGITAL HEALTH
DOI 10.1177/20552076221089778PMC PMC9005829
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Abstract

Objective: This scoping review aimed to bring together and identify digital tools that support people with one or more long-term conditions to maintain physical activity and describe their components and theoretical underpinnings. Methods: Searches were conducted in Cumulative Index to Nursing and Allied Health Literature, Medline, EMBASE, IEEE Xplore, PsycINFO, Scopus, Google Scholar and clinical trial databases, for studies published between 2009 and 2019, across a range of long-term conditions. Screening and data extraction was undertaken by two independent reviewers and the Preferred Reporting Items for Scoping Reviews guidelines informed the review's conduct and reporting. Results: A total of 38 results were identified from 34 studies, with the majority randomised controlled trials or protocols, with cardiovascular disease, type 2 diabetes mellitus and obesity the most common long-term conditions. Comorbidities were reported in >50% of studies but did not clearly inform intervention development. Most digital tools were web-browser-based ± wearables/trackers, telerehabilitation tools or gaming devices/components. Mobile device applications and combination short message service/activity trackers/wearables were also identified. Most interventions were supported by a facilitator, often for goal setting/feedback and/or monitoring. Physical activity maintenance outcomes were mostly reported at 9 months or 3 months post-intervention, while theoretical underpinnings were commonly social cognitive theory, the transtheoretical model and the theory of planned behaviour. Conclusions: This review mapped the literature on a wide range of digital tools and long-term conditions. It identified the increasing use of digital tools, in combination with human support, to help people with long-term conditions, to maintain physical activity, commonly for under a year post-intervention. Clear gaps were the lack of digital tools for multimorbid long-term conditions, longer-term follow-ups, understanding participant's experiences and informs future questions around effectiveness.

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  • Some studies reported transient elevations in physical activity levels during DHI implementation.

    “some studies reported transient elevations in physical activity levels during DHI implementation (44)”

    From The effectiveness of digital health intervention on glycemic control and physical activity in patients with type 2 diabetes: a systematic review and meta-analysis (2025) · cites this paper as [44]

    The Results section, ‘Maintenance period and measurement of PA’ (page unavailable), describes when physical activity was measured after interventions, but does not report whether activity rose during implementation or whether any rise was transient. Searches for increases during intervention and declines at follow-up found no passage establishing that pattern. (LLM, conf=0.72)

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References 92 · Cited by 43

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  1. [7]Saunders DH Sanderson M Hayes S, et al. Physical fitness training for stroke patients. Cochrane Database Syst Rev 2020; 3: CD003316. 32196635 PMC7083515
  2. [8]Moseng T Tveter AT Holm I, et al. Patients with musculoskeletal conditions do less vigorous physical activity and have poorer physical fitness than population controls: a cross-sectional study. Physiotherapy 2014; 100: 319– 324 24529543
  3. [9]Rausch Osthoff A Niedermann K Braun J, et al. EULAR Recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. ARD 2018; 77: 1251– 1260 29997112
  4. [10]Marley J Tully MA Porter-Armstrong A, et al. The effectiveness of interventions aimed at increasing physical activity in adults with persistent musculoskeletal pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2017; 18(1): 482 29166893 PMC5700658
  5. [11]Carson KV Chandratilleke MG Picot J, et al. Physical training for asthma. Cochrane Database Syst Rev 2013; 30: CD001116 PMC11930393 24085631
  6. [13]Irani I Niyomyart A Hickman RL. Systematic review of technology-based interventions targeting chronically ill adults and their caregivers. WJNR 2020; 42: 1– 19 PMC8096122 31941418
  7. [14]Berry A McCabe CS Muir S, et al. Digital behaviour change interventions to facilitate physical activity in osteoarthritis: a systematic review. Phys Ther Rev 2018; 23(3): 197– 206
  8. [18]Jiang X Ming WK You JH. The cost-effectiveness of digital health interventions on the management of cardiovascular diseases: systematic review. J Med Internet Res 2019; 21(6): e13166. 31210136 PMC6601257
  9. [19]Pereira PB Johnson C Vorderstrasse A. Internet delivered diabetes self-management education: a review. Diabetes Technology and Therapeutics 2015; 17: 55– 63 25238257
  10. [22]Samdal GB Eide GE Barth T, et al. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta-regression analyses. IJBNPA 2017; 14: 42 28351367 PMC5370453
  11. [23]McCabe C McCann M Brady AM. Computer and mobile technology interventions for self-management in chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2017;5 (5): CD011425. 28535331 PMC6481891
  12. [24]Griffiths AJ White CM Thain PK, et al. The effect of interactive digital interventions on physical activity in people with inflammatory arthritis: a systematic review. Rheumatol Int 2018; 38: 1623– 1634 29556750 PMC6105152
  13. [25]Stellefson M Chaney B Barry AE, et al. Web 2.0 chronic disease self-management for older adults: a systematic review. J Med Internet Res 2013; 15: e35 23410671 PMC3636299
  14. [26]Walker KC Valentiner LS Langberg H. Motivational factors for initiating, implementing, and maintaining physical activity behavior following a rehabilitation program for patients with type 2 diabetes: a longitudinal, qualitative, interview study. Patient Prefer and Adherence 2018; 12: 145– 152 PMC5779276 29403266
  15. [27]Nigg CR Borrelli B Maddock J, et al. A theory of physical activity maintenance. Appl. Psychol Int Rev Appl. Psychol 2008; 57: 544– 560.
  16. [29]Fjeldsoe B Neuhaus M Winkler E, et al. Systematic review of maintenance of behaviour change following physical activity and dietary interventions. Health Psychol 2011; 30: 99– 109 21299298
  17. [33]Levac D Colquhoun H O’Brien K. Scoping studies: advancing the methodology. Implement Sci 2010; 5: 69. 20854677 PMC2954944
  18. [34]Maden M Cunliffe A McMahon N., et al. Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews—a systematic methodology review. Syst Rev 2017; 6: 66. 29284538 PMC5747153
  19. [36]Michie S Richardson M Johnston M, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med 2013; 46: 81– 95. 23512568
  20. [37]Strobach T Englert C Jekauc D, et al. Predicting adoption and maintenance of physical activity in the context of dual-process theories. Perform Enhanc Health 2020; 8(1): 100162
  21. [39]Organisation for the Review of Care and Health Apps (ORCHA). Digital health trends and opportunities for 2021. https://orchahealth.com/wp-content/uploads/2021/01/COVID_Report_Jan_2021_final-version.pdf. (2021, accessed 19 March 2021).
  22. [42]Arksey H O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005; 8: 19– 32
  23. [43]Clarkson P Adams J Muckelt P, et al. (Protocol) maintaining physical activity through the use of digital tools for people with a long-term condition/s (LTCs): a scoping review. Protocols.io 2020a, DOI: 10.17504/protocols.io.bf7gjrjw · DOI
  24. [46]Roberts AL Fisher A Smith L, et al. Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2017; 11: 704– 719 28779220 PMC5671545
  25. [47]Garg S Garg D Turin TC, et al. Web-based interventions for chronic back pain: a systematic review. J Med Internet Res. 2016; 18: 139 PMC4978860 27460413
  26. [49]Ottenbacher AJ Day RS Taylor WC, et al. Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer 2012; 20: 2483– 2489 22249915 PMC3641190
  27. [51]Burke S Wurz A Bradshaw A, et al. Physical activity and quality of life: a meta-synthesis of qualitative research. Cancers (Basel). 2017; 9: 53. PMC5447963 28531109
  28. [54]Lubans DR Morgan PJ Collins CE, et al. Exploring the mechanisms of weight loss in the SHED-IT intervention for overweight men: a mediation analysis. Int J Behav Nutr Phys Act 2009; 6: 76. 19922613 PMC2784746
  29. [55]Hurkmans EJ van den Berg MH Ronday KH, et al. Maintenance of physical activity after internet-based physical activity interventions in patients with rheumatoid arthritis. Rheumatology 2010; 49: 167– 172. 19995857
  30. [57]Reid RD Morrin LI Beaton LJ, et al. Randomized trial of an internet-based computer-tailored expert system for physical activity in patients with heart disease. Eur J Prev Cardiol 2012; 19: 1357– 1364. 21903744
  31. [58]Bossen D Veenhof C Van Beek KE, et al. Effectiveness of a web-based physical activity intervention in patients with knee and/or hip osteoarthritis: randomized controlled trial. J Med Internet Res 2013; 15: e257. 24269911 PMC3841352
  32. [59]Ström M Uckelstam C Andersson G, et al. Internet-delivered therapist-guided physical activity for mild to moderate depression: a randomized controlled trial. Peer J 2013; 1: 178 PMC3792189 24109561
  33. [60]Devi R Powell J Singh S. A web-based program improves physical activity outcomes in a primary care angina population: randomized controlled trial. J Med Internet Res 2014; 16: e186. 25217464 PMC4180351
  34. [61]Jennings CA Vandelanotte C Caperchione CM, et al. Effectiveness of a web-based physical activity intervention for adults with type 2 diabetes—a randomised controlled trial. Prev. Med 2014; 60: 33– 40. 24345601
  35. [62]van der Weegen S Verwey R Spreeuwenberg M, et al. It’s LiFe! Mobile and web-based monitoring and feedback tool embedded in primary care increases physical activity: a cluster randomized controlled trial. J Med Internet Res 2015; 17: e184. 26209025 PMC4529491
  36. [63]Olson EA McAuley E. Impact of a brief intervention on self-regulation, self-efficacy and physical activity in older adults with type 2 diabetes. J Behav Med 2015; 38: 886– 898. 26162648 PMC4628895
  37. [64]Vorrink SN Kort HS Troosters T, et al. Efficacy of an mHealth intervention to stimulate physical activity in COPD patients after pulmonary rehabilitation. Eur Resp Journal 2016; 48: 1019– 1029. 27587557
  38. [65]Thorup C Hansen J Grønkjær M, et al. Cardiac patients’ walking activity determined by a step counter in cardiac telerehabilitation: data from the intervention arm of a randomized controlled trial. J Med Internet Res. 2016; 18: 69. PMC4835668 27044310
  39. [66]Givon N Zeilig G Weingarden H, et al. Video games used in a group setting is feasible and effective to improve indicators of physical activity in individuals with chronic stroke: a randomized controlled trial. Clin Rehabil 2016; 30: 383– 392. 25952586
  40. [67]Yang YP Wang CJ Wang JJ, et al. The effects of an activity promotion system on active living in overweight subjects with metabolic abnormalities. Obesity Research & Clinical Practic 2017; 11: 718– 727 28729003
  41. [69]Dor-Haim H Katzburg S Leibowitz D. A novel digital platform for a monitored home-based cardiac rehabilitation program. J Vis Exp 2019;146:e59019. doi: 10.3791/59019. 31058908 · DOI
  42. [70]Patel MS Small DS Harrison JD, et al. Effectiveness of behaviorally designed gamification interventions with social incentives for increasing physical activity among overweight and obese adults across the United States: the STEP UP randomized clinical trial. JAMA Intern Med 2019; 179: 1– 9. PMC6735420 31498375
  43. [71]Avila A Claes J Buys R, et al. Home-based exercise with telemonitoring guidance in patients with coronary artery disease: does it improve long-term physical fitness? Eur J Prev Cardiol 2019; 27: 367– 377. 31787026
  44. [72]Lari H Noroozi A Tahmasebi R. Impact of short message service (SMS) education based on a health promotion model on the physical activity of patients with type II diabetes. MJMS 2018; 25: 67– 77 PMC6422558 30899188
  45. [73]Verwey R van der Weegen S Spreeuwenberg M, et al. A monitoring and feedback tool embedded in a counselling protocol to increase physical activity of patients with COPD or type 2 diabetes in primary care: study protocol of a three-arm cluster randomised controlled trial. BMC Fam Pract. 2014; 15: 93. 24885096 PMC4030038
  46. [74]Alonso-Domínguez R Gómez-Marcos MA Patino-Alonso MC, et al. Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial. BMJ Open 2017; 7: e016191. PMC5640135 28912193
  47. [75]Harrison JD Jones JM Small DS, et al. Social incentives to encourage physical activity and understand predictors (STEP UP): design and rationale of a randomized trial among overweight and obese adults across the United States. Contemp Clin Trials 2019; 80: 55– 60. 30954675
  48. [76]Barry VW McClain AC Shuger S, et al. Using a technology-based intervention to promote weight loss in sedentary overweight or obese adults: a randomized controlled trial study design. Diabetes Metab Syndr Obes 2011; 4: 67– 77. 21448324 PMC3064410
  49. [77]Kloek CJ Bossen D Veenhof C, et al. Effectiveness and cost-effectiveness of a blended exercise intervention for patients with hip and/or knee osteoarthritis: study protocol of a randomized controlled trial. BMC Musculoskelet Disord 2014; 15: 69. 25103686 PMC4243525
  50. [78]Fife-Schaw C de Lusignan S Wainwright J, et al. Comparing exercise interventions to increase persistence with physical exercise and sporting activity among people with hypertension or high normal blood pressure: study protocol for a randomised controlled trial. Trials 2014; 15: 36. 25168762 PMC4155107
  51. [79]Banos RM Mensorio MS Cebolla A, et al. An internet-based self-administered intervention for promoting healthy habits and weight loss in hypertensive people who are overweight or obese: a randomized controlled trial. BMC Cardiovasc Disord 2015; 15: 83. 26239241 PMC4523030
  52. [80]Jaarsma T Klompstra L Ben Gal T, et al. Increasing exercise capacity and quality of life of patients with heart failure through wii gaming: the rationale, design and methodology of the HF-Wii study; a multicentre randomized controlled trial. Eur J Heart Fail 2015; 17: 743– 748. 26139585 PMC5034753
  53. [81]Brouwers RWM Kraal JJ Traa SC, et al. Effects of cardiac telerehabilitation in patients with coronary artery disease using a personalised patient-centred web application: protocol for the SmartCare-CAD randomised controlled trial. BMC Cardiovasc Disord 2017; 17: 46. 28143388 PMC5282829
  54. [82]Ingram W Webb D Taylor RS, et al. Multicentred randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support in individuals with metabolic, musculoskeletal and mental health conditions: protocol for the e-coachER trial. BMJ Open. 2018; 8: e022382. PMC6157530 30244214
  55. [83]Cox NS McDonald CF Alison JA, et al. Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: protocol for a randomised controlled trial. BMC Pulm Med 2018; 18: 71. 29764393 PMC5952573
  56. [84]Bonn SE Alexandrou C Hjörleifsdottir Steiner K, et al. App-technology to increase physical activity among patients with diabetes type 2 - the DiaCert-study, a randomized controlled trial. BMC Public Health 2018; 18: 19. PMC5761151 29316905
  57. [85]Volders E Bolman CAW de Groot RHM, et al. The effect of active Plus, a computer-tailored physical activity intervention, on cognitive functioning of elderly people with chronic illness(es) - study protocol for a randomized controlled trial. BMC Public Health 2019; 19: 197 31470829 PMC6717346
  58. [86]Sharma A Mentz RJ Granger BB, et al. Utilizing mobile technologies to improve physical activity and medication adherence in patients with heart failure and diabetes mellitus: rationale and design of the TARGET-HF-DM trial. Am Heart J 2019; 211: 22– 33. 30831331
  59. [87]Jones TM Dear BF Hush JM, et al. Mymoves program: feasibility and acceptability study of a remotely delivered self-management program for increasing physical activity among adults with acquired brain injury living in the community. Phys Ther, 2016; 96: 1982– 1993. 27515944
  60. [88]Vorderstrasse A Melkus GD Feinglos M, et al. Abstract 17519: virtual environment for diabetes self-management education and support: preliminary RCT outcomes. Circulation 2017; 136: A17519.
  61. [89]Hawkins J Charles JM Edwards M, et al. Acceptability and feasibility of implementing accelorometry-based activity monitors and a linked web portal in an exercise referral scheme: feasibility randomized controlled trial. J Medical Internet Res 2019; 21: e12374. PMC6460312 30924791
  62. [90]Barnason SA Young L Kupzyk K, et al. Abstract 18101: examining self-efficacy and patient activation mechanisms in a weight management intervention for overweight and obese cardiac rehabilitation patients. Circulation 2016; 134: 18101.
  63. [91]Verwey R Van der Weegen S Spreeuwenberg M, et al. Process evaluation of physical activity counselling with and without the use of mobile technology: a mixed methods study. Int J Nurs Stud 2016; 53: 3– 16. 26518108
  64. [95]Aromatario O Van Hoye A Vuillemin A, et al. How do mobile health applications support behaviour changes? A scoping review of mobile health applications relating to physical activity and eating behaviours. Public Health 2019; 175: 8– 18. 31374453
  65. [97]Craig P Dieppe P Macintyre S, et al. Developing and evaluating complex interventions: the new medical research council guidance. BMJ (Clinical Research ed.) 2008; 337: a1655. PMC2769032 18824488
  66. [98]Romeo AV Edney SM Plotnikoff RC, et al. Examining social-cognitive theory constructs as mediators of behaviour change in the active team smartphone physical activity program: a mediation analysis. BMC Public Health 2021; 21: 88. 33413209 PMC7792171
  67. [99]Stacey FG James EL Chapman K, et al. A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors. J Cancer Surviv 2015; 9: 305– 338. 25432633 PMC4441740
  68. [101]Duff OM Walsh DM Furlong BA, et al. Behavior change techniques in physical activity eHealth interventions for people with cardiovascular disease: systematic review. J Med Internet Res 2017; 19: e281. 28768610 PMC5559649
  69. [104]Sutcliffe K Thomas J Stokes G, et al. Intervention component analysis (ICA): a pragmatic approach for identifying the critical features of complex interventions. Syst Rev 2015; 4: 40. 26514644 PMC4627414
  70. [105]Morton K Dennison L May C, et al. Using digital interventions for self-management of chronic physical health conditions: a meta-ethnography review of published studies. Patient Educ Couns. 2016; 100: 616– 635. 28029572 PMC5380218
  71. [106]Lorig KR Sobel DS Ritter PL, et al. Effect of a self-management program on patients with chronic disease. ECP 2001; 4: 256– 262. 11769298
  72. [111]Roth GA Mensah GA Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD.2019 study. J Am Coll Cardiol 2019; 76(25): 2982– 3021. doi: 10.1016/j.jacc.2020.11.010 PMC7755038 33309175 · DOI · Paper page
  73. [112]Glovaci D. Fan W. Wong N.D. Epidemiology of diabetes Mellitus and cardiovascular disease. Curr Cardiol Rep 2019; 21: 21. 30828746
  74. [114]Forsat ND Palmowski A Palmowski Y, et al. Recruitment and retention of older people in clinical research: a systematic literature review. J Am Geriatr Soc 2020; 68: 2955– 2963. 33075140
  75. [116]Wahlich C Chaudhry UAR Fortescue R, et al. Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up: a systematic review and meta-analysis. BMJ Open 2020; 10: e034541 PMC7228538 32371512

Authors
Clarkson, P., Stephenson, A., Grimmett, C., Cook, K., Clark, C., Muckelt, P. E., O’Gorman, P., Saynor, Z., Adams, J., Stokes, M., & McDonough, S.
Affiliations
  • National Institute for Health and Care Research (GB)
  • Royal College of Surgeons in Ireland (IE)
  • University of Winchester (GB)
  • Bournemouth University (GB)
  • Arthritis UK (GB)
  • University of Portsmouth (GB)
Corresponding author
Clarkson, Paul
ORCID
Venue
DIGITAL HEALTH
Publisher
SAGE Publications
Published
2022-01
Volume
8
Pages
205520762210897
ISSN
2055-2076 (ISSN-L)
DOI
10.1177/20552076221089778
PMC
PMC9005829
OpenAlex
W4224290987
Cited by
43
References
92
Citations by year
2026: 9 · 2025: 8 · 2024: 11 · 2023: 14 · 2022: 1
FWCI
1.64
Type
journal article
Language
en
Open access
Licence
Locations
  • Digital Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bournemouth University Research Online (Bournemouth University) (acceptedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
NIHR Applied Research Collaboration Wessex
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
physical activity maintenance, chronic disease, digital health interventions, mobile health apps, wearable activity trackers, telerehabilitation, gamification, social cognitive theory, transtheoretical model, theory of planned behavior, cardiovascular disease, type 2 diabetes, obesity, multimorbidity, goal setting, human support

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