Curtin School of Allied Health, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.
Physiotherapy Department, Royal Perth Hospital, Perth, Western Australia, Australia.
Phys Ther. 2021 Jul 1;101(7). doi: 10.1093/ptj/pzab097.
In people with chronic obstructive pulmonary disease (COPD), the authors sought to explore (1) the effect of any intervention on the time spent in sedentary behavior and, (2) which behavior change techniques (BCTs) have shown promise in achieving this lifestyle target.
Five electronic databases were searched on January 7, 2021. Studies were included if they (1) recruited people with stable COPD, (2) applied an intervention ≥4 weeks, and (3) measure sedentary time (ST) before and after the intervention period using wearable technology or via self-reports of television viewing. The primary analyses were restricted to data reported in randomized controlled trials (RCTs). All BCTs described during the intervention periods were mapped using an established taxonomy.
Of the 1142 records identified, 8 were RCTs, of which 6 had exercise training as the intervention. Random effects meta-analysis of data from 4 of these 6 trials that implemented exercise training showed no clear effect on ST (mean difference, -3.4 minutes; 95% CI, -27.9-21.0 minutes). Commonly mapped BCTs in the majority of studies included action planning and instruction on how to perform the behavior. Of all the BCTs mapped, 25% were reported with sufficient information to be graded "beyond reasonable doubt."
Despite robust evidence that exercise training improves functional outcomes and reduces dyspnea, this intervention does not seem to translate into behavior change. The primary analysis demonstrated that, in adults with COPD, the effect of exercise training on ST was, at best, uncertain. The BCTs embedded within the interventions were often poorly reported. Future RCTs are required that appropriately report BCT and ST to improve the precision of our estimate of the effect exercise training may have on ST, and BCTs used during intervention periods need to be reported with greater specificity.
In people with COPD, there is currently limited evidence to suggest that exercise training will reduce sedentary behavior. To move this area of research forward, BCTs embedded within these interventions need to be described with greater precision.
In people with COPD, interventions such as exercise training do not seem to produce a reduction in sedentary behavior (ie, time spent sitting or lying down) during daily life. The techniques used to help people change their sedentary behavior were poorly reported, so we do not know what exactly was done and therefore cannot know what may have worked well.
在患有慢性阻塞性肺疾病（COPD）的人群中，作者旨在探索：（1）任何干预措施对久坐行为时间的影响，以及（2）哪些行为改变技术（BCT）在实现这一生活方式目标方面显示出了前景。
于 2021 年 1 月 7 日在五个电子数据库中进行检索。如果研究符合以下标准，则被纳入：（1）招募稳定期 COPD 患者，（2）应用干预措施≥4 周，以及（3）在干预期间使用可穿戴技术或通过自我报告电视观看来测量久坐时间（ST）。主要分析仅限于随机对照试验（RCT）中报告的数据。使用既定分类法对干预期间描述的所有 BCT 进行映射。
在确定的 1142 条记录中，有 8 项 RCT，其中 6 项的干预措施为运动训练。对其中 6 项实施运动训练的 RCT 数据进行随机效应荟萃分析显示，ST 无明显变化（平均差异，-3.4 分钟；95%CI，-27.9 至 21.0 分钟）。在大多数研究中，常见的 BCT 包括行动计划和关于如何执行行为的指导。在所有映射的 BCT 中，有 25%的报告具有足够的信息，可以被评为“毫无疑问”。
尽管有强有力的证据表明运动训练可改善功能结局和减轻呼吸困难，但该干预措施似乎并未转化为行为改变。主要分析表明，在 COPD 成人中，运动训练对 ST 的影响充其量是不确定的。干预措施中嵌入的 BCT 报告往往不够详细。需要开展新的 RCT，以便更准确地报告 BCT 和 ST，从而提高我们对运动训练可能对 ST 产生影响的估计的准确性，并且需要更具体地报告干预期间使用的 BCT。
在 COPD 患者中，目前有限的证据表明运动训练可减少久坐行为。为了推动这一研究领域的发展，需要更精确地描述这些干预措施中嵌入的 BCT。
在 COPD 患者中，运动训练等干预措施似乎并没有减少日常生活中的久坐行为（即，坐着或躺着的时间）。用于帮助人们改变久坐行为的技术报告很差，因此我们不知道具体做了什么，也因此无法知道哪些可能效果良好。
