Igwesi-Chidobe Chinonso N, Kengne Andre P, Sorinola Isaac O, Godfrey Emma L
University of Nigeria, Department of Medical Rehabilitation, Faculty of Health sciences and Technology, College of Medicine, Enugu Campus, Nigeria.
King's College London, Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, London, UK.
Int Health. 2018 May 1;10(3):137-148. doi: 10.1093/inthealth/ihy013.
Physical activity improves physiological, cognitive and psychosocial functioning in chronic non-communicable diseases (NCDs). This study reviewed papers on the effects and patients' experiences of physical activity interventions for chronic NCDs in Africa.
We conducted a systematic review of clinical and qualitative studies by searching eight bibliographic databases and grey literature until 19 April 2017. The mixed-methods appraisal and Cochrane Collaboration's tools were used for quality and risk of bias assessments. Three-stage sequential explanatory syntheses were done.
One randomized controlled trial (RCT), two non-controlled before and after studies and two qualitative studies of diabetic South African and Reunion patients were included. Exercise and sports unrelated to home and occupational activities were increased in the long term (1 year, moderate quality evidence) and short term immediately after a 4-week intervention (low quality evidence). There was conflicting evidence of intervention effects on home and occupational physical activities. Behaviour-change techniques improving chronic disease knowledge, addressing environmental barriers and stimulating/supporting physical activity were important to patients. Procedure-related components-health professional training and adequate health facilities-were important to patients, but were not addressed.
High quality RCTs are needed to confirm the intervention components for improving physical activity for chronic NCD management in Africa.
体育活动可改善慢性非传染性疾病（NCD）患者的生理、认知和心理社会功能。本研究综述了关于非洲慢性非传染性疾病体育活动干预效果及患者体验的相关论文。
我们通过检索八个文献数据库和灰色文献，对截至2017年4月19日的临床和定性研究进行了系统综述。采用混合方法评估工具和Cochrane协作网的工具进行质量和偏倚风险评估。进行了三阶段序贯解释性综合分析。
纳入了一项随机对照试验（RCT）、两项前后对照非对照研究以及两项关于南非和留尼汪岛糖尿病患者的定性研究。从长期来看（1年，中等质量证据）以及在4周干预后立即进行的短期观察中（低质量证据），与家庭和职业活动无关的运动和体育活动有所增加。关于干预对家庭和职业体育活动的影响，证据存在冲突。改善慢性病知识、解决环境障碍以及刺激/支持体育活动的行为改变技术对患者很重要。与程序相关的组成部分——卫生专业人员培训和充足的卫生设施——对患者很重要，但未得到解决。
需要高质量的随机对照试验来确定非洲慢性非传染性疾病管理中改善体育活动的干预组成部分。
