DIGITAL HEALTH INTERVENTIONS FOR PHYSICAL ACTIVITY IN CHRONIC KIDNEY DISEASE: SYSTEMATIC REVIEW
MEG LETTON1,2, Thai Binh Tran1,3,4, SHANAE FLOWER1, MICHAEL WEWEGE3,5, AMANDA YING WANG4,6,7, CAROLINA SANDLER8,9,10, SHAUNDEEP SEN4, RIA ARNOLD1,3,4 1School of Medical, Indigenous & Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia2Neuroscience Research Australia, Randwick, New South Wales, Australia3School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia 4Department of Renal Medicine, Concord Repatriation and General Hospital, Sydney, NSW, Australia; Concord Clinical School, University of Sydney, Concord, New South Wales, Australia 5Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia6Renal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia7The Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia8School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia9The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia10Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
Abstract
Aim
We aimed to systematically review the evidence regarding digital interventions to promote physical activity in people with chronic kidney disease (CKD).
Background
Digital self-management and support tools have demonstrated potential for cost reduction and high satisfaction in people with CKD. Although physical activity is a key component of care, the effect of digital interventions that promote physical activity on health outcomes is unknown.
Methods
We searched bibliographic databases including PubMed, CINAHL, Embase and Cochrane from 1 January 2000 to 1 December 2022. We included studies that explored the use of digital interventions that promoted physical activity for adults with CKD, including pre-dialysis, maintenance dialysis and transplant recipients. Study quality was assessed using the Cochrane risk of bias and NIH Quality Assessment Tool for Pre-Post Studies with No Control Group for randomised and non-randomised studies respectively. A narrative synthesis was completed.
Results
From 4008 records, 6 studies comprising 268 participants were eligible, including four randomised controlled trials and two single-group studies. All stages of CKD were represented but grouping varied between studies. Digital interventions included webpages and application software alone or with activity trackers. Interventions lasted between 12-weeks and 12-months and generally included physical activity counselling. One study included a personalised exercise program. There was high acceptability and feasibility but inconsistent measures of physical activity, exercise self-efficacy, body composition, functional mobility, and psychological outcomes were reported.
Conclusion
Our review demonstrated insufficient evidence to confidently determine the effect of digital interventions that promoted physical activity on health outcomes. The small number of studies and high risk of bias necessitate cautious interpretation. However, we identified 11 trial registrations which suggests this is a growing area of research.
Biography
Thái Bình (Bình) Trần is a doctoral candidate at the University of Wollongong. Between 2018 and 2022, Bình trained as an exercise physiologist and clinical researcher at the University of New South Wales and Prince of Wales Clinical School. In 2023, he obtained an Australia Government Research Training Program scholarship to begin a PhD candidature. His current area of research is health service research, including exercise physiology as part of care for tertiary kidney management. Outside of research, Bình works as an exercise physiologist delivering disability care, neurological rehabilitation, and mental healthcare for communities in the South-Western Sydney regions.