Evidence Summary

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Counseling with activity monitors improves physical activity and health outcomes in patients with type 2 diabetes

Vaes AW, Cheung A, Atakhorrami M, et al Effect of 'activity monitor-based' counseling on physical activity and health-related outcomes in patients with chronic diseases: A systematic review and meta-analysis. Annals of Medicine, 2013. Volume 45, Issue 5-6, pages 397-412.

Review question

How effective is activity monitor-based counseling for patients with chronic diseases including type-2 diabetes, chronic obstructive pulmonary disease (COPD), or chronic heart failure?


People with chronic disease are less likely to be physically active than healthy people, even though physical activity is beneficial for preventing the progression of various chronic diseases.


Activity monitors, such as pedometers, have become for tracking physical activity. Health care practitioners can use feedback from these devices to encourage patients to be more active.

How the review was done

This summary is based on a meta-analysis of 24 randomized controlled trials. Twenty-one trials with 2763 participants assessed outcomes related to type-2 diabetes (T2D). The average age of participants ranged from 47 to 70 years old. Three trials with 145 participants also examined outcomes related to chronic-obstructive pulmonary disease (COPD). The average age ranged from 61 to 66 years old. No studies looked at chronic heart failure.


The interventions involved one-on-one counseling and activity goal setting, followed by the use of an activity-monitor device. The participants in the intervention were compared with participants receiving usual care, education, or encouragement to engage in physical activity. Program length was 5 weeks to 5 years, with an average of 31 weeks. Physical activity was measured immediately before and after the intervention period.

What the researchers found

As is illustrated in the table below, activity monitor-based counseling improves the following outcomes in patients with type-2 diabetes when compared with usual care or physical activity advice/education. The results for COPD could not be combined due to important differences in the outcomes measured.


This was a well-done review. The included studies varied in quality, but only three were classified by the authors as low quality.


Activity monitor-based counseling improves type-2 diabetes outcomes when compared with usual care or physical activity advice/education. The effects on patients with COPD were not conclusive.

Table header


Effect (SMD)

Physical Activity


Hemoglobin A1c


Body Mass Index


Systolic Blood Pressure


Diastolic Blood Pressure

Not significant

Health-related quality of life

Not significant



The lower number in a blood pressure reading. It is the pressure when the heart rests between beats.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
The higher number in a blood pressure reading. It is the pressure in the arteries when the heart beats.

Related Web Resources

  • Type 2 diabetes: Screening for adults

    Health Link B.C.
    People at average risk for type 2 diabetes should be tested every 3 years after age 40. You may need to be tested more frequently if you are at higher risk. Find out your risk with the Canadian Diabetes Risk Assessment Questionnaire (link in this resource).
  • High blood sugar can increase cognitive decline

    Berkeley Wellness
    New research shows that if you have high blood sugar, you might be more at risk for cognitive decline as you age. Whether or not you have diabetes, it is important to keep your blood sugar under control.
  • Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?

    This patient decision aid helps People with prediabetes considering treatment to help prevent type 2 diabetes decide on whether to make a major lifestyle change or take the medicine metformin by comparing the benefits, risks, and side effects of both options.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

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