激活行为以减少中风后久坐行为：一项非随机可行性研究。
Activating Behavior to Reduce Sedentary Behavior After Stroke: A Nonrandomized Pilot Feasibility Study.
机构信息
Emily A. Kringle, PhD, OTR/L, is Postdoctoral Research Fellow, Division of Academic Internal Medicine and Geriatrics, College of Medicine, University of Illinois at Chicago. At the time of the study, she was Graduate Student Researcher, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;
Lauren Terhorst, PhD, is Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
出版信息
Am J Occup Ther. 2020 Nov/Dec;74(6):7406205030p1-7406205030p10. doi: 10.5014/ajot.2020.040345.
IMPORTANCE
Reducing poststroke sedentary behavior is important for reducing recurrent stroke risk, yet interventions to achieve this are scant.
OBJECTIVE
To assess the feasibility of, and estimate change in sedentary behavior over time associated with, a behavioral intervention.
DESIGN
Single-arm delayed baseline with postintervention and 8-wk follow-up assessment.
SETTING
Community based.
PARTICIPANTS
Ambulatory, community-dwelling people with chronic stroke and reported ≥6 hr daily sitting time (N = 21).
INTERVENTION
Activating Behavior for Lasting Engagement (ABLE) was delivered by an occupational therapist 3×/wk for 4 wk. ABLE involves activity monitoring, activity scheduling, self-assessment, and collaborative problem solving.
OUTCOMES AND MEASURES
Feasibility (participant safety, adherence, satisfaction, and reliable intervention delivery) was assessed against preestablished benchmarks. Changes over time in sedentary behavior (assessed with an ActivPAL micro3 device) and participation (Stroke Impact Scale-Participation subscale) were described.
RESULTS
ABLE was safe (0 serious adverse events), adhered to (11.95 sessions/participant), and reliably delivered (90.00%-97.50% adherence). Participant satisfaction was unmet (Client Satisfaction Questionnaire-8, M = 28.75, SD = 3.84). ABLE was associated with a mean group reduction in prolonged sitting of 54.95 min (SD = 81.10) at postintervention and 14.08 (SD = 58.95) at follow-up. ABLE was associated with a negligible mean group increase over time in participation at postintervention (M = 1.48%, SD = 8.52) and follow-up (M = 1.33%, SD = 15.38).
CONCLUSIONS AND RELEVANCE
The ABLE intervention is feasible and may be associated with within-group reduction in sedentary behavior over time. Further refinement is indicated.
WHAT THIS ARTICLE ADDS
The ABLE intervention uses engagement in meaningful daily activities to reduce sedentary behavior after stroke. These findings suggest that ABLE can be delivered safely and consistently. Further research is required to enhance participant satisfaction and determine the effects of ABLE on stroke survivors' sedentary behavior.
重要性
减少卒中后久坐行为对于降低复发性卒中风险很重要，但目前针对这一目标的干预措施却很少。
目的
评估一种行为干预措施的可行性，并估计其随时间推移对久坐行为的改变。
设计
单臂延迟基线，干预后进行评估，并在 8 周时进行随访。
设置
社区基础。
参与者
有慢性卒中且报告每天久坐时间≥6 小时的活动能力良好的社区居住者（N=21）。
干预措施
由职业治疗师每周进行 3 次、共 4 周的激活行为以实现持久参与（ABLE）。ABLE 包括活动监测、活动计划、自我评估和协作解决问题。
结局和测量指标
根据预先设定的基准评估可行性（参与者的安全性、依从性、满意度和可靠的干预措施的实施）。描述随时间推移久坐行为（通过 ActivPAL micro3 设备评估）和参与度（卒中影响量表-参与子量表）的变化。
结果
ABLE 是安全的（无严重不良事件），依从性好（每个参与者 11.95 次/组），并且可靠地实施（依从率 90.00%-97.50%）。参与者的满意度未达到（客户满意度问卷-8，M=28.75，SD=3.84）。ABLE 使组内久坐时间平均减少 54.95 分钟（SD=81.10），在干预后和随访时分别减少 14.08 分钟（SD=58.95）。ABLE 与组内随时间推移的参与度略有增加相关，在干预后（M=1.48%，SD=8.52）和随访时（M=1.33%，SD=15.38）。
结论和相关性
ABLE 干预措施是可行的，可能与随时间推移久坐行为的减少有关。还需要进一步改进。
这篇文章的新增内容
ABLE 干预措施使用参与有意义的日常活动来减少卒中后的久坐行为。这些发现表明，ABLE 可以安全且一致地实施。需要进一步研究来提高参与者的满意度，并确定 ABLE 对卒中幸存者久坐行为的影响。
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