基于移动健康的运动干预对周围动脉疾病患者的有效性：系统评价和荟萃分析。

BACKGROUND: Peripheral artery disease (PAD) affects over 236 million people worldwide, and exercise interventions are commonly used to alleviate symptoms of this condition. However, no previous systematic review has evaluated the effects of mobile health (mHealth)-based exercise interventions for patients with PAD. OBJECTIVE: This study aimed to assess the effect of mHealth-based exercise interventions on walking performance, functional status, and quality of life in patients with PAD. METHODS: A systematic review and meta-analysis were conducted. We searched in seven databases to identify randomized controlled trials of patients with PAD published in English up to December 4, 2020. Studies were included if patients participated in mHealth-based exercise interventions and were assessed for walking performance. We analyzed pooled effect size on walking performance, functional status, and quality of life based on the standardized mean differences between groups. RESULTS: A total of seven studies were selected for the systematic review, and six studies were included in the meta-analysis. The duration of interventions in the included studies was 12 to 48 weeks. In the pooled analysis, when compared with the control groups, the mHealth-based exercise intervention groups were associated with significant improvements in pain-free walking (95% CI 0.13-0.88), maximal walking (95% CI 0.03-0.87), 6-minute walk test (6MWT) distance (95% CI 0.59-1.24), and walking distance (95% CI 0.02-0.49). However, benefits of the interventions on walking speed, stair-climbing ability, and quality of life were not observed. CONCLUSIONS: mHealth-based exercise interventions for patients with PAD were beneficial for improving pain-free walking, maximal walking, and 6MWT distance. We found that exercise interventions using mHealth are an important strategy for improving the exercise effectiveness and adherence rate of patients with PAD. Future studies should consider the use of various and suitable functions of mHealth that can increase the adherence rates and improve the effectiveness of exercise.

背景：外周动脉疾病（PAD）影响全球超过 2.36 亿人，运动干预通常用于缓解这种疾病的症状。然而，以前没有系统评价评估基于移动健康（mHealth）的运动干预对 PAD 患者的影响。

目的：本研究旨在评估基于 mHealth 的运动干预对 PAD 患者步行表现、功能状态和生活质量的影响。

方法：进行了系统评价和荟萃分析。我们在七个数据库中搜索了截至 2020 年 12 月 4 日发表的以 PAD 患者为对象的英文随机对照试验。如果患者参加了基于 mHealth 的运动干预并对步行表现进行了评估，则纳入研究。我们根据组间标准化均数差值分析了对步行表现、功能状态和生活质量的汇总效应大小。

结果：共选择了 7 项研究进行系统评价，其中 6 项研究纳入荟萃分析。纳入研究的干预持续时间为 12 至 48 周。在汇总分析中，与对照组相比，基于 mHealth 的运动干预组在无痛步行（95%CI 0.13-0.88）、最大步行（95%CI 0.03-0.87）、6 分钟步行测试（6MWT）距离（95%CI 0.59-1.24）和步行距离（95%CI 0.02-0.49）方面均有显著改善。然而，干预对步行速度、爬楼梯能力和生活质量的益处并未观察到。

结论：基于 mHealth 的运动干预对 PAD 患者有益，可改善无痛步行、最大步行和 6MWT 距离。我们发现，使用 mHealth 的运动干预是提高 PAD 患者运动效果和依从性的重要策略。未来的研究应考虑使用各种合适的 mHealth 功能，以提高依从率并改善运动效果。