Stavric Verna, Kayes Nicola M, Rashid Usman, Saywell Nicola L
Rehabilitation Innovation Center, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
Centre for Person-Centered Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
Front Rehabil Sci. 2022 Jun 24;3:925620. doi: 10.3389/fresc.2022.925620. eCollection 2022.
The aim of this systematic review was to determine the effectiveness of self-guided digital physical activity (PA) and exercise interventions to improve physical activity and exercise (PA&E) outcomes for people living with chronic health conditions. Digital health interventions, especially those with minimal human contact, may offer a sustainable solution to accessing ongoing services and support for this population.
A comprehensive and systematic search was conducted up to December 2021, through seven databases, for randomized trials that evaluated the effect of self-guided web- or internet-based PA interventions on physical activity or exercise outcomes. Included studies had to have interventions with minimal human contact and interaction with participants needed to be automatically generated. All studies were screened for eligibility and relevant data were extracted. Two independent reviewers assessed the risk of bias using the Cochrane risk of bias tool. Standardized mean differences and 95% confidence intervals (CI) were calculated. PA data were pooled, and forest plots were generated.
Sixteen studies met the eligibility criteria and included a total of 2,439 participants. There was wide variation in health conditions and intervention characteristics in mode and parameters of delivery, and in the application of theory and behavioral strategies. Self-reported PA in the intervention group was greater than controls at the end of the intervention [standardized mean difference (SMD) 0.2, 95% CI = 0.1, 0.3] and at follow up (SMD 0.3, 95% CI 0.2-0.5). The difference in objectively measured PA was small and non-significant (SMD 0.3, 95% CI -0.2 to 0.9). All interventions included behavioral strategies and ten of the sixteen were underpinned by theory.
Self-guided digital PA&E interventions provided a positive effect on PA immediately after the intervention. An unexpected and positive finding was a sustained increase in PA at follow-up, particularly for interventions where the behavioral strategies were underpinned by a theoretical framework. Interventions with minimal contact have the potential to support sustained PA engagement at least as well as interventions with supervision.
https://www.crd.york.ac.uk/prospero/, identifier: CRD42019132464.
本系统评价旨在确定自我引导式数字体育活动（PA）和运动干预对改善慢性病患者体育活动和运动（PA&E）结果的有效性。数字健康干预，尤其是那些人际接触极少的干预措施，可能为该人群获得持续服务和支持提供一个可持续的解决方案。
截至2021年12月，通过七个数据库进行了全面系统的检索，以查找评估自我引导式基于网络或互联网的PA干预对体育活动或运动结果影响的随机试验。纳入的研究必须具有极少人际接触的干预措施，且与参与者的互动需自动生成。对所有研究进行资格筛选并提取相关数据。两名独立评审员使用Cochrane偏倚风险工具评估偏倚风险。计算标准化均数差值和95%置信区间（CI）。汇总PA数据并生成森林图。
16项研究符合纳入标准，共纳入2439名参与者。健康状况、干预特征在实施模式和参数、理论及行为策略应用方面存在广泛差异。干预组在干预结束时自我报告的PA高于对照组[标准化均数差值（SMD）0.2，95%CI = 0.1，0.3]，在随访时也是如此（SMD 0.3，95%CI 0.2 - 0.5）。客观测量的PA差异较小且无统计学意义（SMD 0.3，95%CI -0.2至0.9）。所有干预措施都包括行为策略，16项中有10项有理论支持。
自我引导式数字PA&E干预在干预后立即对PA产生了积极影响。一个意外且积极的发现是随访时PA持续增加，特别是对于行为策略有理论框架支持的干预措施。人际接触极少的干预措施至少与有监督的干预措施一样有潜力支持持续的PA参与。
