Richardson Caroline R, Goodrich David E, Larkin Angela R, Ronis David, Holleman Robert G, Damschroder Laura J, Lowery Julie C
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI.
The Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI.
Transl J Am Coll Sports Med. 2016 Nov;1(15):133-142. doi: 10.1249/TJX.0000000000000017.
Walking programs improve health outcomes in adults at risk for cardiovascular disease and self-monitoring strategies can improve adherence to such programs. The objective of this study was to determine if a six-month internet-based walking program using web-enhanced pedometers results in more weight loss than walking programs based on time or simple pedometer-step count goals in adults with or at risk for cardiovascular disease (CVD).
This was a multi-site, randomized controlled trial of 255 male Veterans who were ambulatory, insufficiently active, BMI ≥ 28, and who reported 1 ≥ CVD risk factors. Participants were randomized to one of three self-monitoring strategies to increase walking: (1) time-based walking goals; (2) simple pedometer-based walking goals; and (3) web-enhanced pedometer feedback goals with Internet-mediated feedback. All participants also attended five individual weight loss sessions with a dietitian. The main outcome measure was change in weight at six months (kg) and secondary outcomes were change in accelerometer-measured physical activity (min) and change in health-related quality of life at six months.
The 255 participants had a mean age of 56.3 years (SD = 10.0), BMI=36.3 (SD = 5.3) with a mean of 5.2 (SD = 2.3) medical comorbidities. Dropouts were distributed evenly across the three groups and 72% of participants completed the program. At six months, participants in the web-enhanced pedometer arm lost significantly more weight (-1.9 kg, 95% CI=-2.7, -1.1) than those in the time-based group (-0.7 kg, 95% CI=-1.5, 0.0; p = 0.04) and simple pedometer group (-0.6 kg, 95% CI=-1.4, 0.2; p = 0.02).
Internet-enhanced pedometers result in greater weight loss in Veterans than walking programs using time-based walking goals or simple pedometers.
步行计划可改善有心血管疾病风险的成年人的健康状况，自我监测策略可提高对这类计划的依从性。本研究的目的是确定，对于患有心血管疾病（CVD）或有CVD风险的成年人，一项为期六个月、基于网络并使用网络增强型计步器的步行计划，是否比基于时间或简单计步器步数目标的步行计划能带来更多的体重减轻。
这是一项多中心随机对照试验，纳入了255名男性退伍军人，他们能够行走、活动不足、体重指数（BMI）≥28，且报告有≥1项CVD风险因素。参与者被随机分配到三种自我监测策略之一以增加步行量：（1）基于时间的步行目标；（2）基于简单计步器的步行目标；（3）带有互联网介导反馈的网络增强型计步器反馈目标。所有参与者还与营养师一起参加了五次个人减肥课程。主要结局指标是六个月时体重的变化（千克），次要结局指标是加速度计测量的身体活动变化（分钟）以及六个月时健康相关生活质量的变化。
255名参与者的平均年龄为56.3岁（标准差=10.0），BMI=36.3（标准差=5.3），平均有5.2（标准差=2.3）种合并症。退出者在三组中分布均匀，72%的参与者完成了该计划。六个月时，使用网络增强型计步器组的参与者体重减轻显著更多（-1.9千克，95%置信区间=-2.7，-1.1），高于基于时间组（-0.7千克，95%置信区间=-1.5，0.0；p=0.04）和简单计步器组（-0.6千克，95%置信区间=-1.4，0.2；p=0.02）。
与使用基于时间的步行目标或简单计步器的步行计划相比，网络增强型计步器能使退伍军人减轻更多体重。
