Randomized Face-to-Face vs. Home Exercise Interventions in Pregnant Women with Gestational Diabetes.
Randomized Face-to-Face vs. Home Exercise Interventions in Pregnant Women with Gestational Diabetes.
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DOI：
10.1016/j.psychsport.2017.02.003
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发表时间：
2017-05
影响因子：
3.4
通讯作者：
Ulbrecht JS
中科院分区：
文献类型：
--
作者：
Downs DS;Dinallo JM;Birch LL;Paul IM;Ulbrecht JS
评估以理论为基础的半强化(面对面；F2F)运动干预和最少接触(家庭)运动干预对妊娠期糖尿病(GDM)孕妇运动及其动机决定因素、血糖水平和胰岛素使用的影响。随机对照试验，包括两个干预组和对照组(标准护理)。受试者(N=65)被随机分为对照组(标准产前护理/GDM饮食咨询)、家庭(标准护理+电话教育/支持+家庭锻炼)或F2F(标准护理+现场教育/支持+每周2天指导锻炼)组，从妊娠至分娩20周。在基线(妊娠20周)和随访(妊娠32周)时对运动和动机决定因素进行评估。血糖水平(空腹/餐后mg/dL)和胰岛素使用从医疗记录中推断出来。在32周的随访中，F2F组的运动分钟数、计步器步数/天和动机决定因素(态度、主观规范、知觉控制、意图)显著高于对照组(p‘s<；0.05)，运动分钟和主观规范显著高于Home组(p’s<；0.05)；这些影响大小为中大(η2=.11-.23)。妊娠36周的餐后血糖有中等影响(η2=0.13)，F2F组的值低于对照组。虽然不显著，但F2F组开始使用胰岛素的时间(33周)晚于Home组(27周)和对照组(31周)。基于理论的F2F运动干预具有多种健康益处，可能是促进妊娠期糖尿病女性运动动机和行为的必要途径。
Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). Randomized control trial with two intervention arms and control (standard care). Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery. Assessments of exercise and motivational determinants were obtained at baseline (20-weeks gestation) and follow-up (32-weeks gestation). Blood glucose levels (fasting/postprandial mg/dL) and insulin use were extrapolated from medical records. At the 32-week follow-up, the F2F group had significantly higher exercise min, pedometer steps/day, and motivational determinants (attitude, subjective norm, perceived control, intention) than controls (p’s < .05) and significantly higher exercise min and subjective norm than the Home group (p’s < .05); these effect sizes were medium-large (η2 = .11–.23). There was a medium effect (η2 = .13) on postprandial blood glucose at 36-weeks gestation with the F2F group having lower values than controls. Although not significant, the F2F group started insulin later (33 weeks gestation) than the Home (27 weeks) and Control (31 weeks) groups. A theoretically-based, F2F exercise intervention has multiple health benefits and may be the necessary approach for promoting exercise motivation and behavior among GDM women.