Examining control group changes in physical activity levels in people with coronary heart disease: a systematic review and meta-analyses

Aims There is evidence to suggest that physical activity measurement alone can improve physical activity levels, but this has not been investigated in people with coronary heart disease (CHD). This systematic review aims to examine changes in physical activity levels in control groups of physical activity intervention studies for people with CHD and possible explanatory factors. Methods and results Five electronic databases (Medline, CINAHL, PsycINFO, SportDiscus and the Cochrane Central Register of Controlled Trials) were searched from inception to January 2024. Physical activity (controlled) intervention studies measuring physical activity (device-measured or self-reported) in people with CHD were included. Meta-analyses were completed using generic inverse variance with random effects model and 95% confidence intervals. Twenty-six studies with a total of 4372 participants were included. Fourteen studies were included in meta-analyses. Meta-analysis showed a statistically significant improvement in the percentage of control group participants meeting physical activity guidelines (9.16%, 95% CI: 3.67 to 14.65, P = 0.001). Meta-analyses for MET minutes.week⁻¹ and moderate-to-vigorous physical activity minutes.week⁻¹ were not significant. Noteworthy improvements (≥10%) in physical activity were found in 42% of studies. Factors associated with noteworthy improvements were hospital setting, receiving measurement plus usual care, self-reported and self-administered physical activity measures, and measurement of other health behaviours. Conclusion There is some evidence to suggest that measuring physical activity may improve physical activity levels in people with CHD, particularly in a hospital setting. Further research is indicated to ascertain how these factors can be leveraged to increase physical activity levels in this group. Registration PROSPERO CRD42023426603 (Registered 25 May 2023).