Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
Open Heart. 2021 Feb;8(1). doi: 10.1136/openhrt-2020-001351.
To assess the effectiveness of a low-cost pragmatic intervention (structured education and ongoing text message support) to increase daily physical activity in participants 12-48 months after a coronary heart disease cardiac event (myocardial infarction, angina or acute coronary syndrome) diagnosis.
A single-centre randomised controlled trial of 291 adults randomised to a structured education programme (n=145) or usual care (n=146). The programme consisted of two 2.5 hour sessions delivered 2 weeks apart, followed by supplementary text message support. The GENEActiv accelerometer assessed the primary outcome at 12 months (change in overall physical activity (expressed in milli gravitational (m) units) from baseline). Secondary outcomes included anthropometric, physical function, cardiovascular, biochemical and patient-reported outcome measures. Linear regression was used to compare outcome measures between groups on a modified intention-to-treat basis.
Participants' mean age was 66.5±9.7 years, 84.5% males, 82.5% white British and 15.5% south Asian. At 12 months, there was no difference between the groups in terms of change in overall physical activity (-0.23 m (95% CI -1.22 to 0.75), p=0.64) and the programme was well accepted (88% attendance). Exploratory analyses showed that average moderate to vigorous physical activity (MVPA) levels increased in individuals not meeting physical activity guidelines (≥150 min per week) on enrolment compared with those who did, by 8 minutes per day (8.04 (95% CI 0.99 to 15.10), p=0.03).
The programme was well attended but showed no change in physical activity levels. Results show high baseline MVPA levels and suggest that Physical Activity after Cardiac EventS education may benefit cardiac patients not currently meeting activity guidelines.
ISRCTN91163727.
评估一种低成本实用干预措施（结构化教育和持续的短信支持）在冠心病心脏事件（心肌梗死、心绞痛或急性冠状动脉综合征）诊断后 12-48 个月增加参与者日常身体活动的有效性。
一项针对 291 名成年人的单中心随机对照试验，将参与者随机分为结构化教育计划组（n=145）或常规护理组（n=146）。该计划包括两次为期 2.5 小时的课程，间隔 2 周进行，然后提供补充短信支持。GENEActiv 加速度计在 12 个月时评估主要结局（从基线开始整体身体活动的变化（以毫重力单位表示））。次要结局包括人体测量、身体功能、心血管、生化和患者报告的结局测量。使用线性回归在修改后的意向治疗基础上比较组间的结局测量值。
参与者的平均年龄为 66.5±9.7 岁，84.5%为男性，82.5%为白种英国人，15.5%为南亚人。在 12 个月时，两组在整体身体活动变化方面没有差异（-0.23m（95%CI-1.22 至 0.75），p=0.64），并且该计划得到了很好的接受（88%的出勤率）。探索性分析显示，与符合活动指南（每周≥150 分钟）的参与者相比，不符合指南的参与者的平均中度至剧烈体力活动（MVPA）水平在入组时增加了 8 分钟/天（8.04（95%CI0.99 至 15.10），p=0.03）。
该计划的出勤率很高，但身体活动水平没有变化。结果显示基线 MVPA 水平较高，表明心脏事件后体力活动教育可能使目前不符合活动指南的心脏患者受益。
ISRCTN91163727。
