Do boosters support long-term physical activity maintenance after an intervention? A systematic review

Kathryn Remmes Martin, Chloe Charlotte Schroeder, Daniel Whibley

Research output: Contribution to journalAbstractpeer-review


Physical activity (PA) is an important health behaviour, particularly for individuals with rheumatic and musculoskeletal disease (RMD). While PA interventions can successfully increase PA levels, they often reduce over time post-intervention. One strategy for supporting PA maintenance is the introduction of a booster after an initial intervention, though this is less studied. This current review aims to identify whether evidence exists that supports the efficacy of booster components to support PA maintenance.
A systematic review was undertaken and used a search strategy designed to broadly detect articles focused on PA interventions and long-term maintenance. Eligibility criteria: randomized control trials including healthy community dwelling adults or those with RMD aged 25 years or older. Trials had to include a PA intervention at baseline for all subjects with subsequent randomization to either a booster or nonbooster arm, and a PA outcome measure. Cohorts comprised exclusively of non-RMD clinically defined populations (e.g., cancer, diabetes)
were excluded. Six electronic bibliographic databases were searched, including Medline and Cochrane Library, with no date restrictions (date of last search December 2014). Study quality and risk of bias were assessed in accordance with the Scottish Intercollegiate Guidelines Network. All stages were independently undertaken by reviewer pairs and consensus was reached after discussion for any discrepancy. A narrative synthesis of results was undertaken.
16,664 unique studies were identified. After screening by journal, title and abstract, 47 full-text articles were assessed for eligibility, with eight included in the final synthesis. Of these, two were in the workplace, three focused on older adults, and one consisted of individuals with lower-extremity OA. Study duration ranged from 2 to 18 months and employed diverse PA outcome measures, including self-report questionnaires and/or objective markers (e.g., accelerometry). PA interventions included website, mail, in-person counselling, and exercise
training sessions. Booster components included mail, email, telephone counselling calls. No identified studies reported significant differences between PA levels between booster and non-booster groups at long-term follow-up. Issues of low sample size/power and sources of bias found in quality assessment suggest definitive conclusions cannot be made.
A limited number of studies have compared boosters to a control group after a cohort has received the same PA intervention. There is a particular paucity of research focused on those with RMD and what is available is heterogeneous and of questionable quality. Evidence strongly supports PA as beneficial to those with RMD, however further research is required to elucidate the role of boosters in the role of supporting long-term maintenance. Attention should be given to the development and rigorous testing of boosters following intervention to
support long-term maintenance of PA in RMD populations for sustained health and symptom benefit.
Original languageEnglish
Article number3241
Pages (from-to)3886-3887
Number of pages2
JournalArthritis & Rheumatology
Issue numberSuppl S10
Early online date29 Sept 2015
Publication statusPublished - 1 Oct 2015


  • Physical Activity
  • Health Beaviour
  • Rheumatic and musculoskeletal disease


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