Use of new technologies for the promotion of physical activity in patients with mental illness: A systematic review

Table 1 Characteristics and main findings of the studies

Ref.	Device	Features	Design	Sample	Measures and scales	Main findings
Aschbrenner et al[27], 2016	Wearable device (Fitbit Zip)	Accelerometer, step and distance registration	Pilot study pre-post	13 patients with overweight and psychiatric disorders	Satisfaction questionnaire 6-MWT; weight (kg)	At 6 mo 45% of the participants were underweight and 45% improved their physical condition
Haller et al[28], 2018	Internet platform	Heart rate monitor and resistance bands	RCT	20 patients with MDD (moderate and severe)	Depression scales: (1) QIDS; (2) Self-efficacy, quality of life and physical activity; and (3) General health status SF-36	Feasible and effective in patients with moderate to severe depressive symptoms, improving quality of life and decreasing depressive symptoms
Lambert et al[29], 2018	eMotion (Web)	Accelerometer. Weekly module course. Interactive worksheets	RCT	62 patients with at least moderate depressive symptoms and anxiety	PHQ-8. Vigorous physical activity	Depression levels were lower in the intervention group than in the control group
Macias et al[30], 2015	WellWave	Digital library with readings, personal messages and a variety of activities	Pilot study	10 patients with obesity and mental illness (schizophrenia, MDD or BD)	Self-assessments. Number of steps and walking time	Seven of the ten participants increased the number and duration of weekly walks. High app participation
Naslund et al[31], 2016	Wearable device (Fitbit Zip)	Accelerometer. Podometer. Progress Log	Prospective	34 patients with psychiatric disorders (various diagnoses)	Weight (kg). 6-MWT	Higher average daily steps were associated with greater weight loss
Naslund et al[32], 2016	Wearable device (Fitbit Zip)	Accelerometer. Podometer. Progress Log	Exploratory study	11 patients with severe mental illness and obesity	Quantitative usability and satisfaction questionnaire. Interviews	The use of the app motivates participants to engage in physical exercise
Naslund et al[33], 2018	Facebook	Messages, posting of posts, photos	Exploratory study	25 patients with mental illness (MDD, BD and schizophrenia, obesity under pharmacological treatment)	FB Interactions. 6-MWT. Weekly group attendance	Participants who actively contributed to the Facebook group have a higher weight loss
Pfirrmann et al[34], 2018	Web	Forum, psychoeducation	Analysis of four clinical trials	5 participants with oesophageal carcinoma, 5 with liver disease, 5 with MDD and 5 with cystic fibrosis	-	Efficacy as an exercise enhancer in all pathologies
Young and Morgan[35], 2018	SHED-IT	Measuring tape, pedometer	Pre-post study	209 male patients with overweight and depressive symptoms	PHQ-8. Weight (kg)	Reduction of weight and depressive symptoms, with a high level of engagement and satisfaction

6-MWT: 6-minute walk test; BD: Bipolar disorder; FB: Facebook; MDD: Major depressive disorder; MINI: Mini international neuropsychiatric interview; PANSS: Positive and negative syndrome scale; SCID: Structured clinical interview for axis-I DSM-IV disorders; RCT: Randomized controlled trial; PHQ: Patient health questionnaire.

Table 2 User satisfaction with the different device

Ref.	Device	Positive	Negative	Suggested improvements
Macias et al[30], 2015	WellWave	Personal messages, reading library	-	Test whether learning how to use the app can increase personal satisfaction
Naslund et al[31], 2016	Wearable device	Self-monitoring	Difficulties of use	Make tutorials on the use of the device
Naslund et al[32], 2016	Wearable device	Self-monitoring	Difficulties of use	Make tutorials on the use of the device. Participants are satisfied with the use of the app
Aschbrenner et al[27], 2016	Wearabledevice	Self-monitoring	Difficulties of use	Make tutorials on the use of the device before. High level of satisfaction
Haller et al[28], 2018	Web platform	Easy to use, self-monitoring	Does not include follow-up	Include monitoring as web-based apps show a trend towards non-use over time. Show a trend towards non-use over time
Lambert et al[29], 2018	eMotion	Self-monitoring	Not assessed	Not assessed
Naslund et al[33], 2018	Facebook	Accessibility, facilitates communication between people in the same condition. Allows information sharing and feedback	Not assessed	Not assessed
Pfirrmann et al[34], 2018	Web	Forum. Unspecific information	Not assessed	Not assessed
Young and Morgan[35], 2018	SHED-IT	Self-monitoring	Not assessed	Longer-term programme of longer duration

apps: Applications.