Does objective feedback decrease sedentary behavior in geriatric rehabilitation? A systematic review

ObjectiveTo assess the effectiveness of interventions using feedback from objective measurements to reduce sedentary behavior in older adults during rehabilitation. Data SourceCochrane Library, Web of Science, PubMed, Embase and Emcare were systematically searched for controlled trials in May 2023. Study Inclusion and Exclusion CriteriaStudies in post-acute settings involving older individuals, providing feedback as part of the intervention and reporting effects on sedentary behavior were included. Data ExtractionStudy characteristics, aim, methodology, intervention content, and outcome measures with effect sizes relating to sedentary behavior were extracted. Data synthesisA narrative synthesis was used to describe the data. ResultsEleven studies with diverse methods and reported outcomes were included. Feedback was focused only on sedentary behavior (one study), on sedentary behavior and physical activity (four studies), or only on physical activity (six studies). All studies showed high bias risk in at least one quality assessment domain. Six studies reported a significant decrease in sedentary behavior, while five reported no effect. No harms were reported. ConclusionThe effect of feedback-based interventions on sedentary behavior in geriatric rehabilitation remains inconclusive. Interventions differed considerably in content and methodology, and high-quality evidence is lacking. Future research should focus on improving research methodology, optimizing strategies to reduce sedentary behavior and finding the minimum reduction of sedentary behavior required to create a clinically relevant difference. Key pointsAlthough some studies indicate a (small) reduction in sedentary behaviour following interventions with objective feedback for older individuals in rehabilitation, effects remain inconclusive. Interventions to decrease sedentary behaviour differ considerably in content and methodology. Despite substantial evidence on the health risks associated with sedentary behaviour, there is a lack of high-quality studies on feedback to reduce sedentary time during rehabilitation.