Peiris Casey L, Taylor Nicholas F, Hull Susan, Anderson Amanda, Belski Regina, Fourlanos Spiros, Shields Nora
1 Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Physiotherapy, La Trobe University , Melbourne, Australia .
2 Northern Centre for Health Education and Research and Community Therapy Services , Northern Health, Epping, Australia .
Metab Syndr Relat Disord. 2018 Mar;16(2):110-116. doi: 10.1089/met.2017.0127. Epub 2018 Jan 23.
One quarter of the world's adults have metabolic syndrome. Lifestyle modification is the first line of intervention as improvements in diet and exercise can have positive effects on the individual components of metabolic syndrome. The primary aim of this research was to evaluate the effect of an 8-week lifestyle intervention program for people with metabolic syndrome on emergency department presentations, hospital admissions, and metabolic parameters.
A retrospective case-control study of adults (n = 58, mean age 60 ± 7 years) with metabolic syndrome referred to a group lifestyle self-management intervention program between 2013 and 2015. The intervention program consisted of 8 weekly sessions of group exercise and education delivered in a community healthcare setting. The intervention group (n = 29) was compared with a group of people who declined to attend the program (n = 29). Data were collected from the time a participant was referred to the program, and all participants were followed for a minimum of 100 days.
Participants who attended the lifestyle intervention program had significantly fewer emergency department presentations [risk ratio (RR) 0.31, 95% confidence interval (CI) 0.11 to 0.83] and potentially avoidable emergency department presentations (RR 0.06, 95% CI 0.004 to 0.097) over the follow-up period (mean 495 ± 224 days per participant). There were no differences between the groups in hospital admissions and there were insufficient data to determine changes in metabolic parameters. Lifestyle group participants increased their exercise capacity [6-min walk test mean difference (MD) 41 m, 95% CI 20 to 62, P < 0.001] and had a mild decrease in weight (MD -0.8 kg, 95% CI -1.5 to -0.2, P = 0.018) and waist circumference (MD -1.3 cm, 95% CI -2.1 to -0.6, P = 0.002) after 8 weeks.
Implementation of a group lifestyle intervention program to improve activity and self-management skills may assist in decreasing emergency department presentations.
全球四分之一的成年人患有代谢综合征。生活方式的改变是首要干预措施，因为饮食和运动的改善对代谢综合征的各个组成部分都能产生积极影响。本研究的主要目的是评估一项为期8周的生活方式干预计划对代谢综合征患者急诊科就诊、住院情况及代谢参数的影响。
对2013年至2015年间参加团体生活方式自我管理干预计划的患有代谢综合征的成年人（n = 58，平均年龄60±7岁）进行回顾性病例对照研究。干预计划包括在社区医疗环境中进行的8次每周一次的团体运动和教育课程。将干预组（n = 29）与一组拒绝参加该计划的人（n = 29）进行比较。从参与者被转介到该计划时开始收集数据，所有参与者至少随访100天。
在随访期间（每位参与者平均495±224天），参加生活方式干预计划的参与者急诊科就诊次数显著减少[风险比（RR）0.31，95%置信区间（CI）0.11至0.83]，以及潜在可避免的急诊科就诊次数（RR 0.06，95%CI 0.004至0.097）。两组在住院情况上没有差异，且没有足够数据来确定代谢参数的变化。生活方式组参与者的运动能力有所提高[6分钟步行试验平均差值（MD）41米，95%CI 20至62，P < 0.001]，体重（MD -0.8千克，95%CI -1.5至-0.2，P = 0.018）和腰围（MD -1.3厘米，95%CI -2.1至-0.6，P = 0.002）在8周后略有下降。
实施团体生活方式干预计划以提高活动能力和自我管理技能可能有助于减少急诊科就诊次数。
