Are You Counting? Effectiveness of Interventions Using Activity Trackers and Smartphone Applications for Increasing Physical Activity in Older People Living in the Community: A Systematic Review With Meta-Analysis

OBJECTIVE: To evaluate the effectiveness of interventions using activity trackers and smartphone applications (apps) for increasing physical activity (steps per day) in people aged ≥60 years. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: We searched 6 electronic databases (including EMBASE and MEDLINE) from inception to January 2025. SELECTION CRITERIA: We included randomized controlled trials that used activity trackers or smartphone apps to promote physical activity in people aged ≥60 years. DATA SYNTHESIS: Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were conducted using random-effects models, and certainty of the evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. RESULTS: We included 29 trials with 3005 participants. In the short term (data point closest to the end of the intervention), activity trackers and apps may increase physical activity by about 1113 steps per day compared to minimal intervention (95% CI: 669, 1557; 20 trials; low-certainty evidence). When compared to other active interventions, activity trackers and apps may increase physical activity by 912 steps per day (95% CI: 412, 1413; 8 trials; very low–certainty evidence). Single trials reported intermediate (6 months) and long-term (12 and 24 months) effects, and suggested no sustained benefits. CONCLUSION: Activity tracker and app-based interventions may cause short-term increases in physical activity among older adults, but effects were not sustained. J Orthop Sports Phys Ther 2026;56(4):235-247. Epub 2 March 2026. doi:10.2519/jospt.2026.13825