目的:本系统综述旨在根据对中风患者运动行为的客观测量,确定哪些干预措施可以增加身体活动(PA)和减少久坐行为(SB)。
方法:PubMed(Medline),EMBASE,Scopus,CINAHL(EBSCO),和WebofScience数据库被搜索到2023年1月3日发表的文章。
方法:Start3.0.3BETA软件用于筛选标题,摘要,和研究全文:随机对照试验设计;中风患者(≥18岁);旨在增加PA或降低SB的干预措施;和客观测量仪器。
方法:数据提取标准化,考虑参与者和兴趣评估。评估纳入研究的偏倚风险和证据质量。
结果:纳入了28项研究,涉及1855名患者。Meta分析显示,在卒中后急性/亚急性期,运动干预结合行为改变技术(BCT)增加了每日步数(SMD=0.65,p=0.0002)和中等强度体力活动(MVPA)持续时间(SMD=0.68,p=0.0004)的PA(SMD=0.68,p=0.0004).此外,仅基于BCT的干预措施在极低质量证据的情况下增加了身体活动水平(SMD(LPA)=0.36,p=0.02;SMD(MVPA)=0.56,p=0.0004),在低质量证据的情况下减少了久坐行为(SMD=0.48,p=0.03).在中风后慢性期,在中等质量证据(SMD=0.68,p=0.002)的情况下,对PA频率(步数/天)的仅运动干预有统计学意义.总的来说,纳入研究的偏倚风险较低.
结论:在卒中后的急性/亚急性期,BCT结合运动的使用可以增加每天的步数和在MVPA上花费的时间。相比之下,在中风后慢性期,仅运动干预导致每日步数显著增加.
This systematic
review aimed to determine which interventions increase physical activity (PA) and decrease sedentary behavior (SB) based on objective measures of movement behavior in individuals with stroke.
The PubMed (Medline), EMBASE, Scopus, CINAHL (EBSCO), and Web of Science databases were searched for articles published up to January 3, 2023.
The StArt 3.0.3 BETA software was used to screen titles, abstracts, and full texts for studies with randomized controlled trial designs; individuals with stroke (≥18 years of age); interventions aimed at increasing PA or decreasing SB; and objective measurement instruments.
Data extraction was standardized, considering participants and assessments of interest. The risk of bias and quality of evidence of the included studies were assessed.
Twenty-eight studies involving 1855 patients were included. Meta-analyses revealed that in the post-stroke acute/subacute phase, exercise interventions combined with behavior change techniques (BCTs) increased both daily steps (standardized mean difference [SMD]=0.65, P=.0002) and time spent on moderate-to-vigorous intensity physical activities (MVPAs) duration of PA (SMD=0.68, P=.0004) with moderate-quality evidence. In addition, interventions based only on BCTs increased PA levels with very low-quality evidence (SMD (low-intensity physical activity)=0.36, P=.02; SMD (MVPA)=0.56, P=.0004) and decreased SB with low-quality evidence (SMD=0.48, P=.03). In the post-stroke chronic phase, there is statistical significance in favor of exercise-only interventions in PA frequency (steps/day) with moderate-quality evidence (SMD=0.68, P=.002). In general, the risk of bias in the included studies was low.
In the acute/subacute phase after stroke, the use of BCTs combined with exercise can increase the number of daily steps and time spent on MVPA. In contrast, in the post-stroke chronic phase, exercise-only interventions resulted in a significant increase in daily steps.