Evidence map›Paper›PMID 40696422›Full record

SynthesisBMC medicine2025

Effectiveness of different intervention designs for improving physical activity in adults with cardiometabolic conditions over time: a systematic review and network meta-analysis of randomised controlled trials.

Alexander Hodkinson, Harsini Raaja Sulochana, Evangelos Kontopantelis, Charles Adeniji, Harm van Marwijk, Brian McMillan, Peter Bower, Maria Panagioti

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alexander HodkinsonDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK. alexander.hodkinson@manchester.ac.uk.
Harsini Raaja SulochanaDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Evangelos KontopantelisDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Charles AdenijiDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Harm van MarwijkDepartment of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Room 318a, Watson Building, Brigton, UK.
Brian McMillanDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Peter BowerDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Maria PanagiotiDivision of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAn active lifestyle can lessen the risk of cardiometabolic conditions and improve overall life quality. To support lifestyle change and help healthcare providers deliver optimal physical activity interventions, we aimed to compare the effectiveness of four different physical activity intervention designs (education, behaviour-change, motivational/goal-setting and multi-component) against usual care/minimal intervention in increasing physical activity among adults with cardiometabolic conditions.

methodsA systematic review and network meta-analysis of randomised controlled trials (RCTs) were conducted. Four databases were searched (January 2000-February 2025). PRIMARY OUTCOMES: steps per day, moderate-vigorous physical activity (MVPA) and combined physical activity. SECONDARY OUTCOMES: sedentary time, HbA1c, BMI, weight loss, SBP, DBP, cholesterol, LDL-C and HDL-C. Steps per day were analysed via time-course model-based meta-analysis. Bayesian random-effects network meta-analysis estimated mean differences (MD)/standardised mean differences (SMD) and 95% credible intervals (CrIs). Evidence quality was assessed using CINeMA.

resultsSixty-two trials comprising 8952 participants were included, 51 were analysed in the meta-analysis. Behaviour-change (MD = 3287, 95% CrI 1576 to 4997 steps per day), multi-component (MD = 2939, 95% CrI 1714 to 4164), education (MD = 2054, 95% CrI 369 to 3740) and motivational/goal-setting (MD = 1344, 95% CrI 243 to 2445) interventions were significantly more effective than usual care in increasing steps per day. Overall, combined physical activity interventions excluding minimal interventions and when compared to usual care only, increased steps per day significantly from baseline by 143 (95% CrI 114 to 182; median 18 weeks), with the highest number of steps per day predicted at around 75 weeks from baseline (MD = 738, 95% CrI 581 to 893). Only multi-component interventions were consistently found to significantly increase physical activity across all primary measures-steps per day, MVPA and combined physical activity-compared to usual care or minimal care. In terms of secondary outcomes, motivational (MD = - 0.28%, CrI = - 0.46 to - 0.10%) and multi-component interventions were associated with significant HbA1c reductions (MD = - 0.24%, CrI = - 0.47 to - 0.02%) compared to usual care; no significant effects were found on other secondary outcomes.

conclusionsMulti-component interventions were most effective at improving physical activity levels among people with cardiometabolic conditions. The crucial next step for patients, clinicians and policymakers is to enhance the understanding of how to tailor and implement these interventions effectively for sustained improvements in long-term physical activity levels.

trial registrationPROSPERO number CRD42023405306.

Indexed as

Cardiovascular DiseasesExerciseAdultCardiometabolic Risk FactorsHumansRandomized Controlled Trials as TopicCardiometabolic conditionsIntervention designNetwork meta-analysisPhysical activitySystematic review

Identifiers

PMID40696422
PMCPMC12285027

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.