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Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing
  1. Riley CC Brown1,2,
  2. Jeff S Coombes1,2,
  3. Klaus Jungbluth Rodriguez1,2,
  4. Ingrid J Hickman3,4,5,
  5. Shelley E Keating1,2
  1. 1School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
  2. 2Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
  3. 3Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  4. 4Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
  5. 5Mater Research Institute, The University of Queensland, St Lucia, QLD, Australia
  1. Correspondence to Riley CC Brown, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia; riley.brown{at}


Objective To investigate the effectiveness of videoconferencing exercise interventions for people with chronic diseases.

Design Systematic review incorporating meta-analysis.

Data sources PubMed, Cinahl, MEDLINE, Web of Science, Embase and Scopus.

Eligibility criteria The current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Trials analysing participants with chronic disease undergoing aerobic and/or resistance exercise training over videoconferencing, with exercise capacity and/or quality of life outcomes were included. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life. Risk of bias was analysed using the Downs and Black quality checklist and the certainty of evidence with Grading of Recommendations, Assessment, Development and Evaluation (GRADE).

Results Thirty-two trials were included in this review, of which 12 were comparator trials. Small–moderate between-group (videoconferencing vs comparator) effects favouring videoconferencing were seen for studies using a non-exercising comparator for exercise capacity (standardised mean difference (SMD)=0.616, 95% CI 0.278 to 0.954; p=<0.001) and quality of life (SMD=0.400, 95% CI 0.099 to 0.701; p=0.009). Small effects favouring videoconferencing were observed for studies using an exercising comparator for quality of life (SMD=0.271, 95% CI 0.028 to 0.515; p=0.029) and exercise capacity (SMD=0.242, 95% CI 0.059 to 0.426; p=0.009). Moderate risk of bias was identified for included studies (16.3±3.6/28), with GRADE certainty ratings of ‘low’ (quality of life) and ‘moderate’ (exercise capacity). Session attendance was 70% and was reported in 23 trials. No serious adverse events relating to videoconferencing were found. Nine trials documented the total number of technical issues that occurred in 17% of the sessions. Positive satisfaction outcomes were associated with ease of access and usefulness of technology.

Conclusion In patients with chronic disease, videoconferencing exercise interventions appear to be feasible and effective for improving exercise capacity and quality of life. More robust methodology is needed in future studies to improve the certainty of the evidence.

PROSPERO registration number CRD42020191243.

  • exercise
  • exercise training
  • meta-analysis
  • noncommunicable diseases

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  • Contributors RCCB contributed to the design of the study, was responsible for the collection, analysis and interpretation of the data, and oversaw the writing of the manuscript. JSC contributed to the design of the study and the interpretation of data and provided feedback on drafts of the manuscript. KJR contributed to the collection of data. IJH provided feedback on drafts of the manuscript. SEK contributed to the design of the study, the analysis and interpretation of data, and provided feedback on drafts of the manuscript. All authors read and approved the final manuscript.

  • Funding In-kind contributions were received from The University of Queensland and the Department of Nutrition and Dietetics for the completion of this review. No external sources of funding were used to assist in the preparation of this article. SK is supported by the National Health and Medical Research Council of Australia via an Early Career Research Fellowship (122190).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.