Abaraogu Ukachukwu O, Dall Philippa, Seenan Chris, Rhodes Sarah, Gorely Trish, McParland Joanna, Brittenden Julie, Anieto Ebuka M, Booth Lorna, Gormal Cathy, Dearling Jeremy, Fenton Candida, Audsley Sarah, Fairer Kimberley, Bearne Lindsay, Skelton Dawn A
Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcadeens Road, Glasgow G4 0BA, UK.
Division of Biological Sciences and Health, School of Health and Life Sciences, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, Technology Avenue, South Lanarkshire G72 0LH, UK.
Eur J Prev Cardiol. 2025 Jan 27;32(2):156-168. doi: 10.1093/eurjpc/zwae296.
The study aimed to synthesize evidence of daily physical activity (PA) following Behavior-change technique (BCT)-based interventions compared to any control in individuals with peripheral arterial disease/intermittent claudication (PAD/IC); and examine the relationship between BCTs and daily PA.
Systematic search of 11 databases from inception to 30/11/2022 was conducted, plus weekly email alerts of new literature until 31/8/2023. Studies comparing BCT-based interventions with any control were included. Primary analysis involved a pairwise random-effects meta-analysis. Risk of bias was assessed using the Cochrane-RoB-2 and ROBINS-I tools. Certainty of evidence was evaluated with the GRADE system. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Outcome measures were short-term (<6 months) change in daily PA, and maintenance of the daily PA (6 months or longer) reported as standardized mean differences (SMDs) with 95% confidence intervals (95%CIs). Forty-one studies (4339 patients; 26 RCTs/3357 patients; 15 non-RCTs/982 patients; study mean age 60.3 to 73.8, 29.5% female) were included. Eleven RCTs (15 comparisons, 952 participants) suggested that BCT-based interventions increased daily PA in the short term compared to non-SET [increase of 0.20 SMD (95%CI: 0.07 to 0.33), ∼473 steps/day] with high certainty. Evidence of maintenance of daily PA (≥6 months) is unclear [increase of 0.12 SMD (95%CI: -0.04 to 0.29); ∼288 steps/day; 6RCTs, 8 comparisons, 899 participants], with moderate certainty. For daily PA, compared to SET it was inconclusive both for < 6months change [-0.13 SMD, 95%CI: -0.43 to 0.16); 3RCTs, 269 participants; low certainty] and ≥6months [-0.04 SMD, 95%CI: -0.55 to 0.47); 1 RCT, 89 participants; very low certainty]. It was unclear whether the number of BCTs or any BCT domain was independently related to an increase in PA.
BCT-based interventions improve short-term daily PA in people with PAD/IC compared to non-SET controls. Evidence for maintenance of the improved PA at 6 months or longer and comparison with SET is uncertain. BCT-based interventions are effective choices for enhancing daily PA in PAD/IC.
本研究旨在综合基于行为改变技术（BCT）的干预措施与外周动脉疾病/间歇性跛行（PAD/IC）个体的任何对照相比，每日身体活动（PA）的证据；并研究BCT与每日PA之间的关系。
对11个数据库从建库至2022年11月30日进行系统检索，并每周发送新文献电子邮件提醒直至2023年8月31日。纳入比较基于BCT的干预措施与任何对照的研究。主要分析采用成对随机效应荟萃分析。使用Cochrane-RoB-2和ROBINS-I工具评估偏倚风险。用GRADE系统评估证据的确定性。遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。结局指标为每日PA的短期（<6个月）变化以及每日PA的维持情况（6个月或更长时间），以标准化均数差（SMD）及95%置信区间（95%CI）报告。纳入41项研究（4339例患者；26项随机对照试验/3357例患者；15项非随机对照试验/982例患者；研究平均年龄60.3至73.8岁，29.5%为女性）。11项随机对照试验（15项比较，952名参与者）表明，与非特定对照相比，基于BCT的干预措施在短期内增加了每日PA[SMD增加0.20（95%CI：0.07至0.33），约473步/天]，确定性高。每日PA维持（≥6个月）的证据不明确[SMD增加0.12（95%CI：-0.04至0.29）；约288步/天；6项随机对照试验，8项比较，899名参与者]，确定性中等。对于每日PA，与特定对照相比，<6个月变化[-0.13 SMD，95%CI：-0.43至0.16）；3项随机对照试验，269名参与者；低确定性]和≥6个月[-0.04 SMD，95%CI：-0.55至0.47）；1项随机对照试验，89名参与者；非常低确定性]均无定论。尚不清楚BCT的数量或任何BCT领域是否与PA增加独立相关。
与非特定对照相比，基于BCT的干预措施可改善PAD/IC患者的短期每日PA。6个月或更长时间维持改善后的PA以及与特定对照比较的证据尚不确定。基于BCT的干预措施是增强PAD/IC患者每日PA的有效选择。
