How should long-term free-living physical activity be targeted after stroke? A systematic review and narrative synthesis.
How should long-term free-living physical activity be targeted after stroke? A systematic review and narrative synthesis.
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DOI：
10.1186/s12966-018-0730-0
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发表时间：
2018-10-17
期刊：
影响因子：
--
通讯作者：
Avery L
中科院分区：
文献类型：
--
作者：
Moore SA;Hrisos N;Flynn D;Errington L;Price C;Avery L
增加身体活动 (PA) 水平（有规律的运动，例如步行和日常生活活动）并减少久坐时间，可以改善心血管健康并降低发病率和死亡率。能够独立活动的中风幸存者中，只有不到 30% 的人接受推荐水平的 PA。该人群的久坐行为也很常见。我们的目的是系统地回顾研究特征以及针对成年中风幸存者的自由生活 PA 和/或久坐行为的干预措施的前景。检索了七个电子数据库，以确定针对首次或复发性中风或短暂性脑缺血发作成人的 PA 和/或久坐行为的随机对照试验（≥3 个月的随访）。随机对照试验的质量评估框架用于评估研究内部和研究之间的偏倚风险。根据组内或组间结果差异，干预措施被评为“非常”、“相当”或“无希望”。干预描述是使用 TIDieR（干预描述和复制模板）清单捕获的。干预措施中的行为改变技术 (BCT) 使用 BCT 分类法 v1 进行编码，并通过计算承诺比率在研究之间进行比较。九项研究满足审查标准（N = 717 名随机卒中患者），但偏倚风险较高或不明确。没有一项研究针对久坐行为。六项研究非常/相当有希望（报告称干预后 PA 有所增加）。研究对参与者年龄、中风后时间、中风类型和中风位置的报告存在差异。发现了次优的干预描述、治疗保真度和结果测量标准化的缺乏。面对面和基于电话的自我管理计划被认为有望让中风幸存者参与 PA 行为改变。最佳接触强度、干预类型以及中风后实施干预的时间尚不清楚。确定了九个有希望的 BCT（比率≥2）：有关健康后果的信息；有关社会和环境后果的信息；目标设定-行为；解决问题；行动计划；对行为的反馈；生物反馈；社会支持未明确；和可靠的来源。未来的研究将受益于确定中风幸存者对分娩方式、环境和强度（包括体力活动测量）的偏好。干预措施需要证明和利用行为改变的理论/模型，并探索干预措施中有希望的 BCT 的最佳组合。本文的在线版本 (10.1186/s12966-018-0730-0) 包含补充材料，可供授权用户使用。
Increasing physical activity (PA) levels (regular movement such as walking and activities of daily living) and reducing time spent sedentary improves cardiovascular health and reduces morbidity and mortality. Fewer than 30% of independently mobile stroke survivors undertake recommended levels of PA. Sedentary behaviour is also high in this population. We aimed to systematically review the study characteristics and the promise of interventions targeting free-living PA and/or sedentary behaviour in adult stroke survivors. Seven electronic databases were searched to identify randomised controlled trials (≥3-months follow-up) targeting PA and/or sedentary behaviour in adults with first or recurrent stroke or transient ischaemic attack. The quality assessment framework for RCTs was used to assess risk of bias within and across studies. Interventions were rated as “very”, “quite” or “non-promising” based on within- or between-group outcome differences. Intervention descriptions were captured using the TIDieR (Template for Intervention Description and Replication) Checklist. Behaviour change techniques (BCTs) within interventions were coded using the BCT Taxonomy v1, and compared between studies by calculating a promise ratio. Nine studies fulfilled the review criteria (N = 717 randomised stroke patients) with a high or unclear risk of bias. None of the studies targeted sedentary behaviour. Six studies were very/quite promising (reported increases in PA post-intervention). Studies were heterogeneous in their reporting of participant age, time since stroke, stroke type, and stroke location. Sub-optimal intervention descriptions, treatment fidelity and a lack of standardisation of outcome measures were identified. Face to face and telephone-based self-management programmes were identified as having promise to engage stroke survivors in PA behaviour change. Optimal intensity of contact, interventionist type and time after stroke to deliver interventions was unclear. Nine promising BCTs (ratios ≥2) were identified: information about health consequences; information about social and environmental consequences; goal setting-behaviour; problem-solving; action planning; feedback on behaviour; biofeedback; social support unspecified; and credible source. Future research would benefit from establishing stroke survivor preferences for mode of delivery, setting and intensity, including measurement of physical activity. Interventions need to justify and utilise a theory/model of behaviour change and explore the optimal combination of promising BCTs within interventions. The online version of this article (10.1186/s12966-018-0730-0) contains supplementary material, which is available to authorized users.
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影响因子：
2.5
作者：
Avery L;Sniehotta FF;Denton SJ;Steen N;McColl E;Taylor R;Trenell MI
通讯作者：
Trenell MI
DOI：
10.1519/00124278-200202000-00013
发表时间：
2002-02-01
影响因子：
3.2
作者：
Gearhart, RF;Goss, FL;Robertson, RJ
通讯作者：
Robertson, RJ
DOI：
10.1016/j.apmr.2011.08.047
发表时间：
2012-03-01
影响因子：
4.3
作者：
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通讯作者：
Mead, Gillian E.
DOI：
10.3399/bjgp16x686617
发表时间：
2016-10
期刊：
The British journal of general practice : the journal of the Royal College of General Practitioners
影响因子：
--
作者：
Heron N;Kee F;Donnelly M;Cardwell C;Tully MA;Cupples ME
通讯作者：
Cupples ME
影响因子：
3
作者：
Katz-Leurer, M;Carmeli, E;Shochina, M
通讯作者：
Shochina, M