Cramp Anita G, Brawley Lawrence R
Department of Kinesiology, McMaster University, Hamilton, ON, CA, USA.
Int J Behav Nutr Phys Act. 2006 Aug 22;3:23. doi: 10.1186/1479-5868-3-23.
When examining the prevalence of physical inactivity by gender and age, women over the age of 25 are at an increased risk for sedentary behavior. Childbearing and motherhood have been explored as one possible explanation for this increased risk. Post natal exercise studies to date demonstrate promising physical and psychological outcomes, however few physical activity interventions have been theory-driven and tailored to post natal exercise initiates. The purpose of this study was to compare the effects of a group-mediated cognitive behavioral intervention based upon social-cognitive theory and group dynamics (GMCB) to a standard care postnatal exercise program (SE).
A randomized, two-arm intervention design was used. Fifty-seven post natal women were randomized to one of two conditions: (1) a standard exercise treatment (SE) and (2) a standard exercise treatment plus group-mediated cognitive behavioral intervention (GMCB). Participants in both conditions participated in a four-week intensive phase where participants received standard exercise training. In addition, GMCB participants received self-regulatory behavioral skills training via six group-mediated counseling sessions. Following the intensive phase, participants engaged in a four-week home-based phase of self-structured exercise. Measures of physical activity, barrier efficacy, and proximal outcome expectations were administered and data were analyzed using ANCOVA procedures.
ANCOVA of change scores for frequency, minutes, and volume of physical activity revealed significant treatment effects over the intensive and home-based phases (p's < 0.01). In addition, ANCOVA of change in mean barrier efficacy and proximal outcome expectations at the conclusion of the intensive phase demonstrated that GMCB participants increased their initial level of barrier efficacy and outcome expectations while SE participants decreased (p < 0.05).
While both exercise programs resulted in improvements to exercise participation, the GMCB intervention produced greater improvement in overall physical activity, barrier efficacy and proximal outcome expectations.
在按性别和年龄考察身体活动不足的患病率时，25岁以上的女性久坐行为风险增加。生育和为人母被视为这一风险增加的一种可能解释。迄今为止的产后运动研究显示出了良好的身体和心理效果，然而，很少有体育活动干预是基于理论且针对产后运动初学者量身定制的。本研究的目的是比较基于社会认知理论和群体动力学的小组介导认知行为干预（GMCB）与标准护理产后运动计划（SE）的效果。
采用随机双臂干预设计。57名产后女性被随机分为两种情况之一：（1）标准运动治疗（SE）和（2）标准运动治疗加小组介导认知行为干预（GMCB）。两种情况下的参与者都参加了为期四周的强化阶段，在此阶段参与者接受标准运动训练。此外，GMCB参与者通过六次小组介导的咨询课程接受自我调节行为技能培训。强化阶段之后，参与者进入为期四周的家庭自我组织运动阶段。进行了身体活动、障碍效能和近端结果期望的测量，并使用协方差分析程序对数据进行分析。
对身体活动频率、分钟数和量的变化分数进行协方差分析，结果显示在强化阶段和家庭阶段均有显著的治疗效果（p值<0.01）。此外，在强化阶段结束时对平均障碍效能和近端结果期望变化进行的协方差分析表明，GMCB参与者提高了他们最初的障碍效能和结果期望水平，而SE参与者则有所下降（p<0.05）。
虽然两种运动计划都使运动参与度得到了改善，但GMCB干预在总体身体活动、障碍效能和近端结果期望方面产生了更大的改善。
