# Effectiveness of outdoor fitness equipment intervention on health outcomes: a systematic review and meta-analysis

## TL;DR

This study reviews how outdoor fitness equipment improves physical activity, fitness, and mental health, showing significant benefits across multiple health outcomes.

## Contribution

The study provides a systematic review and meta-analysis of OFE interventions, revealing their effectiveness on diverse health outcomes.

## Key findings

- OFE interventions significantly improve physical activity and physical fitness, including cardiorespiratory fitness and muscle strength.
- Psychological health benefits include improved mental well-being, reduced loneliness, and better self-efficacy.
- Health-related improvements include better quality of life, reduced fall risk, and improved blood lipid levels.

## Abstract

Outdoor fitness equipment (OFE) is an environmental infrastructure in public areas to facilitate structured physical activity. This systematic review aims to evaluate the effectiveness of OFE intervention on health outcomes.

We searched five online databases (PubMed, Scopus, Web of Science, Embase, and The Cochrane Library) from inception to Nov 3, 2025. Randomized and non-randomized controlled studies that employed OFE interventions were included. We assessed methodological quality using the modified Downs and Black checklist. Primary outcomes included physical activity, physical fitness, psychological well-being, and other health-related results.

Fourteen studies underwent systematic review, of which eleventh provided sufficient data for meta-analyses, and 11 were rated as high quality. The OFE intervention notably increased physical activity. Significantly improvements were observed in physical fitness, including cardiorespiratory fitness (SMD = 0.53), lower limb muscle strength (SMD = 0.35), upper limb muscle strength (SMD = 0.25), and balance (SMD = 0.83). Improvements were also evident in psychological health, including mental well-being (SMD = 0.48), loneliness (SMD = 0.33), depression, stress symptoms, and self-efficacy. Furthermore, there were significant advancements in health-related issues such as quality of life (SMD = 1.06), fall risk (SMD = 1.01), hypertension, hypoglycemia, and blood lipid levels.

The findings provide a comprehensive overview of the effectiveness of OFE intervention on health outcomes. The evidence indicates that OFE intervention effectively improves physical activity, physical fitness, psychological health, and health-related issues. High-quality RCTs are required to determine effective OFE intervention protocols and facilitate translation into practice.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42023449759, CRD42023449759.