P09 Randomised controlled trials of community-based physical activity interventions in adults with long-term follow-up and objective physical activity measurements: a systematic review and meta-analysis

Background In most trials and systematic reviews that evaluate exercise-based interventions in reducing depressive symptoms, it is difficult to separate treatment from prevention. Aims To evaluate the effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression. Method We searched PubMed, PsycINFO, Embase, WOS, SPORTDiscus, CENTRAL, OpenGrey and other sources up to 25 May 2020. We selected randomised controlled trials (RCTs) that compared exclusively exercise-based interventions with control groups, enrolling participants without clinical depression, as measured using validated instruments, and whose outcome was reduction of depressive symptoms and/or incidence of new cases of people with depression. Pooled standardised mean differences (SMDs) were calculated using random-effect models (registration at PROSPERO: CRD42017055726). Results A total of 14 RCTs (18 comparisons) evaluated 1737 adults without clinical depression from eight countries and four continents. The pooled SMD was −0.34 (95% CI −0.51 to −0.17; P < 0.001) and sensitivity analyses confirmed the robustness of this result. We found no statistical evidence of publication bias and heterogeneity was moderate (I2 = 54%; 95% CI 22–73%). Only two RCTs had an overall low risk of bias and three had long-term follow-up. Multivariate meta-regression found that a larger sample size, country (Asia) and selective prevention (i.e. people exposed to risk factors for depression) were associated with lower effectiveness, although only sample size remained significant when adjustment for multiple tests was considered. According to the Grading of Recommendations Assessment, Development and Evaluation tool, the quality of evidence was low. Conclusions Exercise-based interventions have a small effect on the reduction of depressive symptoms in people without clinical depression. It could be an alternative to or complement psychological programmes, although further higher-quality trials with larger samples and long-term follow-up are needed.

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Child outcomes after induction of labour or expectant management in women with preterm prelabour rupture of membranes between 34 and 37 weeks of gestation: study protocol of the PPROMEXIL Follow-up trial. A long-term follow-up study of the randomised controlled trials PPROMEXIL and PPROMEXIL-2

BMJ Open ◽

10.1136/bmjopen-2020-046046 ◽

2021 ◽

Vol 11 (6) ◽

pp. e046046

Author(s):

Annemijn A de Ruigh ◽

Noor E Simons ◽

Janneke Van ‘t Hooft ◽

Aleid G van Wassenaer-Leemhuis ◽

Cornelieke S H Aarnoudse-Moens ◽

...

Keyword(s):

Randomised Controlled Trials ◽

Expectant Management ◽

Induction Of Labour ◽

Late Preterm ◽

Controlled Trials ◽

Link Type ◽

Long Term Follow Up ◽

Randomised Controlled

IntroductionLate preterm prelabour rupture of membranes (PROM between 34+0 and 36+6 weeks gestational age) is an important clinical dilemma. Previously, two large Dutch randomised controlled trials (RCTs) compared induction of labour (IoL) to expectant management (EM). Both trials showed that early delivery does not reduce the risk of neonatal sepsis as compared with EM, although prematurity-related risks might increase. An extensive, structured long-term follow-up of these children has never been performed.Methods and analysisThe PPROMEXIL Follow-up trial (NL6623 (NTR6953)) aims to assess long-term childhood outcomes of the PPROMEXIL (ISRCTN29313500) and PPROMEXIL-2 trial (ISRCTN05689407), two multicentre RCTs using the same protocol, conducted between 2007 and 2010 evaluating IoL versus EM in women with late preterm PROM. The PPROMEXIL Follow-up will analyse children of mothers with a singleton pregnancy (PPROMEXIL trial n=520, PPROMEXIL-2 trial n=191, total IoL n=359; total EM n=352). At 10–12 years of age all surviving children will be invited for a neurodevelopmental assessment using the Wechsler Intelligence Scale for Children-V, Color-Word Interference Test and the Movement Assessment Battery for Children-2. Parents will be asked to fill out questionnaires assessing behaviour, motor function, sensory processing, respiratory problems, general health and need for healthcare services. Teachers will fill out the Teacher Report Form and answer questions regarding school attainment. For all tests means with SDs will be compared, as well as predefined cut-off scores for abnormal outcome. Sensitivity analyses consisting of different imputation techniques will be used to deal with lost to follow-up.Ethics and disseminationThe study has been granted approval by the Medical Centre Amsterdam (MEC) of the AmsterdamUMC (MEC2016_217). Results will be disseminated through peer-reviewed journals and summaries shared with stakeholders. This protocol is published before analysis of the results.Trial registration numberNL6623 (NTR6953).

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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 ◽

10.1136/bmjopen-2019-034541 ◽

2020 ◽

Vol 10 (5) ◽

pp. e034541

Author(s):

Charlotte Wahlich ◽

Umar A R Chaudhry ◽

Rebecca Fortescue ◽

Derek G Cook ◽

Shashivadan Hirani ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Community Based ◽

Intervention Effects ◽

Meta Analyses

ObjectiveTo identify randomised controlled trials (RCTs) of physical activity (PA) interventions with objective PA outcomes in adults and to evaluate whether intervention effects were sustained beyond 12 months.DesignSystematic review and meta-analysis.Data sourcesSeven databases (Medline, Embase, PsycINFO, Web of Science, Cochrane library, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and ASSIA (Applied Social Sciences Index and Abstracts)) were searched from January 2000 until December 2019.Eligibility criteriaRCTs reporting objective PA outcomes beyond 12 months with community-based participants aged ≥18 years were included; those where controls received active interventions, including advice to increase PA levels, were excluded.Data extraction and synthesisTwo independent reviewers completed extraction of aggregate data and assessed risk of bias. Meta-analyses used random-effects models at different follow-up points. Primary outcomes were daily steps and weekly minutes of moderate-to-vigorous PA (MVPA).ResultsOf 33 282 records identified, nine studies (at generally low risk of bias) were included, five in meta-analyses with 12 months to 4 year follow-up. We observed 12 month increases for intervention vs control participants in steps/day (mean difference (MD)=554 (95% CIs: 384 to 724) p<0.0001, I2=0%; 2446 participants; four studies) and weekly MVPA minutes (MD=35 (95% CI: 27 to 43) p<0.0001, I2=0%; 2647 participants; four studies). Effects were sustained up to 4 years for steps/day (MD=494 (95% CI: 251 to 738) p<0.0001, I2=0%; 1944 participants; four studies) and weekly MVPA minutes (MD=25 (95% CI: 13 to 37) p<0.0001, I2=0%; 1458 participants; three studies).ConclusionsThere are few PA interventions with objective follow-up beyond 12 months, more studies are needed. However, this review provided evidence of PA intervention effects beyond 12 months and sustained up to 4 years for both steps/day and MVPA. These findings have important implications for potential long-term health benefits.PROSPERO registration numberCRD42017075753.

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Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-097600 ◽

2017 ◽

Vol 52 (19) ◽

pp. 1234-1240 ◽

Cited By ~ 27

Author(s):

Diana P Pozuelo-Carrascosa ◽

Antonio García-Hermoso ◽

Celia Álvarez-Bueno ◽

Mairena Sánchez-López ◽

Vicente Martinez-Vizcaino

Keyword(s):

Physical Activity ◽

Cardiorespiratory Fitness ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Healthy Children ◽

Physical Activity Interventions ◽

School Based ◽

Registration Number ◽

Randomised Controlled

ObjectiveTo conduct a meta-analysis of randomised controlled trials aimed at testing whether school-based physical activity programmes improve cardiorespiratory fitness (CRF) in children.DesignSystematic review with meta-analysis.Data sourcesUsing keywords, we performed a computerised search in five databases: MEDLINE, EMBASE, CINAHL, Web of Science and SportDiscus.Eligibility criteria for selecting studiesStudies that assessed the effectiveness of school-based physical activity programmes on improving CRF in children (3–12 years old). We selected interventions that included an additional physical activity programme and not only a physical activity educational component. The reference lists of selected full-text articles and systematic reviews were also searched for relevant studies. Pooled effect size (Hedges′ g) was calculated assuming a random-effects model.ResultsTwenty trials with 7287 healthy children aged 3–12 years were included in the meta-analysis. School-based physical activity interventions with aerobic games and activities were associated with a significant small increase in CRF (Hedges′ g=0.22; 95% CI 0.14 to 0.30; p<0.001). Based on subgroup analysis, the increase in CRF was significant in girls (Hedges′ g=0.25; 95% CI 0.13 to 0.37; p<0.001), but not in boys (Hedges′ g=0.02; 95% CI −0.10 to 0.14; p=0.731).SummaryModerate quality evidence supports the effectiveness of school-based physical activity interventions on improving CRF in children.Trial registration numberProtocol PROSPERO registration number CRD42016050173.

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New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-Analysis of Randomised Controlled Trials (Preprint)

10.2196/preprints.28168 ◽

2021 ◽

Author(s):

Marion Sommers-Spijkerman ◽

Judith Austin ◽

Ernst Bohlmeijer ◽

Wendy Pots

Keyword(s):

Mental Health ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Well Being ◽

Evidence Base ◽

Effect Sizes ◽

Controlled Trials ◽

Long Term Follow Up ◽

Randomised Controlled

BACKGROUND There is a need for regularly updating the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing. OBJECTIVE The current study presents an updated meta-analysis of randomised controlled trials assessing the effects of online MBIs on mental health, as well as the potential moderators of those effects. METHODS A systematic literature search was conducted in PsycINFO, PubMed and Web of Science up to July 19th, 2019. Seventy trials totalling 91 comparisons were included. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges’ g) were calculated for depression, anxiety, stress, well-being and mindfulness, using a random effects model. RESULTS The findings revealed statistically significant moderate pre-to-post effects on stress (g=0.41) and mindfulness (g=0.43) and small effects on depression (g=0.31) and anxiety (g=0.23). For well-being, a significant effect was found only when omitting low quality studies (g=0.34). Significant but small follow-up effects were found for depression (g=0.25), anxiety (g=0.17) and stress (g=-0.11). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. For stress and mindfulness, studies that used an inactive control condition yielded larger effects. CONCLUSIONS Our findings do not only demonstrate that the field of online MBIs is booming, but also corroborate previous evidence that online MBIs are beneficial for improving mental health outcomes in a broad range of samples. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence and long-term follow-up measurements.

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