Jones Taryn M, Dean Catherine M, Hush Julia M, Dear Blake F, Titov Nickolai
Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia.
Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia.
Syst Rev. 2015 Apr 19;4:51. doi: 10.1186/s13643-015-0039-x.
Individuals living with acquired brain injury, typically caused by stroke or trauma, are far less likely to achieve recommended levels of physical activity for optimal health and well-being. With a growing number of people living with chronic disease and disability globally, self-management programs are seen as integral to the management of these conditions and the prevention of secondary health conditions. However, to date, there has been no systematic review of the literature examining the efficacy of self-management programs specifically on physical activity in individuals with acquired brain injury, whether delivered face-to-face or remotely. Therefore, the purpose of this review is to evaluate the efficacy of self-management programs in increasing physical activity levels in adults living in the community following acquired brain injury. The efficacy of remote versus face-to-face delivery was also examined.
A systematic review of the literature was conducted. Electronic databases were searched. Two independent reviewers screened all studies for eligibility, assessed risk of bias, and extracted relevant data.
Five studies met the inclusion criteria for this review. Studies were widely heterogeneous with respect to program content and delivery characteristics and outcomes, although all programs utilized behavioral change principles. Four of the five studies examined interventions in which physical activity was a component of a multifaceted intervention, where the depth to which physical activity specific content was covered, and the extent to which skills were taught and practiced, could not be clearly established. Three studies showed favorable physical activity outcomes following self-management interventions for stroke; however, risk of bias was high, and overall efficacy remains unclear. Although not used in isolation from face-to-face delivery, remote delivery via telephone was the predominant form of delivery in two studies with support for its inclusion in self-management programs for individuals following stroke.
The efficacy of self-management programs in increasing physical activity levels in community-dwelling adults following acquired brain injury (ABI) is still unknown. Research into the efficacy of self-management programs specifically aimed at improving physical activity in adults living in the community following acquired brain injury is needed. The efficacy of remote delivery methods also warrants further investigation.
PROSPERO CRD42013006748.
后天性脑损伤患者（通常由中风或创伤引起）达到促进最佳健康和幸福所需的推荐身体活动水平的可能性要低得多。随着全球慢性病和残疾患者数量的不断增加，自我管理项目被视为管理这些疾病以及预防继发性健康问题的重要组成部分。然而，迄今为止，尚未有系统的文献综述来研究自我管理项目对后天性脑损伤患者身体活动的有效性，无论这些项目是面对面实施还是远程实施。因此，本综述的目的是评估自我管理项目对后天性脑损伤后居住在社区的成年人提高身体活动水平的有效性。同时还研究了远程实施与面对面实施的效果差异。
对文献进行系统综述。检索了电子数据库。两名独立的评审员筛选所有研究的纳入资格、评估偏倚风险并提取相关数据。
五项研究符合本综述的纳入标准。尽管所有项目都采用了行为改变原则，但这些研究在项目内容、实施特点和结果方面差异很大。五项研究中有四项考察了将身体活动作为多方面干预措施之一的干预措施，其中身体活动具体内容的涵盖深度以及技能的传授和练习程度尚无法明确确定。三项研究显示，中风患者接受自我管理干预后身体活动结果良好；然而，偏倚风险较高，总体有效性仍不明确。虽然并非单独使用远程实施方式，但在两项研究中，通过电话进行的远程实施是主要的实施形式，支持将其纳入中风患者的自我管理项目。
自我管理项目对后天性脑损伤后居住在社区的成年人提高身体活动水平的有效性仍不明确。需要开展研究，专门针对提高后天性脑损伤后居住在社区的成年人的身体活动来研究自我管理项目的有效性。远程实施方法的有效性也值得进一步研究。
PROSPERO CRD42013006748 。
