School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
Arch Phys Med Rehabil. 2018 Oct;99(10):2059-2075. doi: 10.1016/j.apmr.2017.12.013. Epub 2018 Jan 11.
To (1) systematically review the literature on behavioral interventions for people with multiple sclerosis (MS) that aim to change physical activity (PA) behavior; and (2) explore whether these interventions are clinically effective in improving PA, are theory based, and use established behavior change techniques (BCTs).
A systematic electronic search was conducted on databases EBSCO (including AMED, Biomedical Reference Collection: Expanded, CINHAL, MEDLINE, PsycArticles, PsycInfo), PubMed, EMBASE, and Web of Science from April 2017 to May 2017.
Studies were included if (1) the interventions aimed to change PA behavior among people with MS; (2) PA was recognized as a primary outcome measure; and (3) they had a randomized controlled trial (RCT) design.
The resulting behavioral interventions were coded using the Theory Coding Scheme and the CALO-RE taxonomy to assess theory base and BCTs. A meta-analysis was conducted to assess effectiveness.
Fourteen RCTs were included. Combined, there was a significant (P=.0003; d=1.00; 95% confidence interval, .46-1.53) short-term change in self-report PA behavior for studies with nonactive control groups. There was no change in objective or long-term PA. Studies failed to discuss results in relation to theory and did not attempt to refine theory. Fifty percent of BCTs within the CALO-RE were used, with BCTs of "goal-setting" and "action-planning" being the most frequently used.
Current evidence supports the efficacy of PA intervention on subjective but not objective outcomes. However, conclusions from this review should be interpreted with caution because of the small number of studies included and small sample size. Further, while using theory in intervention design, interventions in this review have not reported the refining of theory. Exploration of the use of additional BCTs to change PA behavior is also required within future interventions.
（1）系统回顾旨在改变多发性硬化症（MS）患者体力活动（PA）行为的行为干预措施的文献；（2）探索这些干预措施在改善 PA 方面是否具有临床效果，是否基于理论，并使用已建立的行为改变技术（BCTs）。
2017 年 4 月至 5 月，在 EBSCO（包括 AMED、Biomedical Reference Collection: Expanded、CINHAL、MEDLINE、PsycArticles、PsycInfo）、PubMed、EMBASE 和 Web of Science 数据库中进行了系统电子检索。
如果（1）干预措施旨在改变 MS 患者的 PA 行为；（2）PA 被视为主要结果测量指标；（3）它们具有随机对照试验（RCT）设计，则纳入研究。
使用理论编码方案和 CALO-RE 分类法对产生的行为干预措施进行编码，以评估理论基础和 BCTs。进行了荟萃分析以评估效果。
纳入了 14 项 RCT。对于没有非活动对照组的研究，综合来看，短期自我报告 PA 行为有显著变化（P=.0003；d=1.00；95%置信区间，.46-1.53）。客观或长期 PA 没有变化。研究未能根据理论讨论结果，也未试图完善理论。在使用的 CALO-RE 内的 50%的 BCTs 中，“目标设定”和“行动计划”的 BCTs使用最频繁。
目前的证据支持 PA 干预对主观但非客观结果的有效性。但是，由于纳入的研究数量较少且样本量较小，因此应谨慎解释本综述的结论。此外，虽然在干预设计中使用了理论，但这些综述中的干预措施并未报告理论的精炼。未来干预措施中还需要探索使用其他 BCT 来改变 PA 行为。
