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通过RISE干预改善中风后患者的运动行为:一项随机多基线研究。

Improving Movement Behavior in People after Stroke with the RISE Intervention: A Randomized Multiple Baseline Study.

作者信息

Hendrickx Wendy, Wondergem Roderick, Veenhof Cindy, English Coralie, Visser-Meily Johanna M A, Pisters Martijn F

机构信息

Research Group Empowering Healthy Behavior, Department of Health Innovations and Technology, Fontys University of Applied Sciences, 5600 AH Eindhoven, The Netherlands.

Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands.

出版信息

J Clin Med. 2024 Jul 25;13(15):4341. doi: 10.3390/jcm13154341.

Abstract

High amounts of sedentary behavior increase the risk of cardiovascular disease. This study aimed to determine the preliminary effectiveness and feasibility of the RISE intervention to support community-dwelling people with stroke, who are highly sedentary, to reduce and interrupt sedentary time. Additionally, the added value of including participatory support was determined. A randomized, multiple-baseline study was conducted including 14 participants. All received the RISE intervention, a 15-week blended behavioral intervention in which a primary care physiotherapist provided personalized coaching in the home setting by using behavior-change techniques and the RISE eCoaching system, including an activity monitor and app to provide real time feedback. Half of the participants (randomly allocated) received participatory support from someone from their social network (e.g., partner or close friend) who joined them in the intervention. Preliminary effectiveness was determined with significant changes in total sedentary time and fragmentation (interruption) of sedentary time using a randomization test. Feasibility was assessed by adherence with the intervention protocol, safety, and satisfaction with the intervention. Participants significantly reduced total sedentary time ( = 0.01) by 1.3 h on average and increased their fragmentation ( < 0.01). Subgroup analyses showed significant improvements in both outcomes only in the group with participatory support. Thirteen (92.9%) participants completed the intervention, no related adverse events occurred, and the reported participant satisfaction was sufficient. The RISE intervention appears promising to support people with stroke who are highly sedentary to reduce and interrupt their sedentary time. Participatory support appears to contribute to greater results. : ISRCTN international trial registry, 10694741.

摘要

大量久坐行为会增加心血管疾病风险。本研究旨在确定RISE干预措施对支持社区中久坐不动的中风患者减少并中断久坐时间的初步有效性和可行性。此外,还确定了纳入参与式支持的附加价值。开展了一项随机多基线研究,纳入14名参与者。所有人都接受了RISE干预,这是一项为期15周的综合行为干预,由初级保健物理治疗师在家中通过运用行为改变技巧和RISE电子辅导系统提供个性化辅导,该系统包括一个活动监测器和应用程序以提供实时反馈。一半参与者(随机分配)获得来自其社交网络中的某人(如伴侣或密友)的参与式支持,此人会与他们一起参与干预。使用随机化检验,通过久坐总时长和久坐时间碎片化(中断)的显著变化来确定初步有效性。通过干预方案的依从性、安全性和对干预的满意度来评估可行性。参与者平均显著减少了1.3小时的久坐总时长(P = 0.01),并增加了久坐时间碎片化程度(P < 0.01)。亚组分析显示,仅在有参与式支持的组中,这两个结果均有显著改善。13名(92.9%)参与者完成了干预,未发生相关不良事件,且报告的参与者满意度良好。RISE干预措施似乎有望支持久坐不动的中风患者减少并中断其久坐时间。参与式支持似乎有助于取得更好的效果。注册号:ISRCTN国际试验注册库,10694741。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfa4/11313465/2f87b35bc10a/jcm-13-04341-g001.jpg

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