一项用于减轻冠状动脉疾病患者久坐行为的远程强化计划：一项随机对照试验。

A remote booster program to attenuate sedentary behaviour in patients with coronary artery disease: A Randomized Controlled Trial.

作者信息

Kroesen Sophie H, van Bakel Bram M A, de Bruin Marijn, Pisters Martijn F, Ortega Francisco B, Hopman Maria T E, Thijssen Dick H J, Bakker Esmée A, Eijsvogels Thijs M H

机构信息

Department of Medical BioSciences, Radboud university medical centre, Nijmegen, The Netherlands.

Department of IQ healthcare, Radboud university medical centre, Nijmegen, The Netherlands.

出版信息

Eur J Prev Cardiol. 2025 Mar 20. doi: 10.1093/eurjpc/zwaf162.

DOI:10.1093/eurjpc/zwaf162

PMID:40112182

Abstract

AIMS

Sedentary time (ST) can be reduced in patients with coronary artery disease (CAD) during cardiac rehabilitation (CR), but most patients relapse to sedentarism within months. We examined the effectiveness of a 3-week remote booster intervention on ST changes in CAD patients.

METHODS

CAD patients who previously (2.0 [1.9-2.2] years) completed CR were included in this randomized controlled trial (1:1, stratified for gender). All participants received usual care, whereas booster participants additionally received a 3-week remote behavioral change intervention. The primary outcome was the change in accelerometer-derived ST from baseline to post-intervention and secondary outcomes included changes in sedentary behaviour and physical activity (PA) characteristics. A baseline constrained linear mixed-model on an intention-to-treat basis was used.

RESULTS

Participants (19% female, booster: n=21, control: n=21) were 69 [63-75] years old. Greater decreases in ST (-1.3 (95% confidence interval (CI): -2.0; -0.6) versus -0.1 (95% CI: -0.8; 0.6) h/day, p-interaction=0.012) and number of prolonged sedentary bouts (-1.1 (95% CI: -1.6; -0.6) versus 0.2 (95% CI: -0.3; 0.7) bouts/day, p-interaction<0.001) in combination with larger increases in light PA (+1.1 (95% CI: +0.5; +1.8) versus +0.2 (95% CI: -0.4; +0.8) h/day, p-interaction=0.030) were found for the booster versus control group. Changes in moderate-to-vigorous PA (p-interaction=0.13) and step count (p-interaction=0.18) did not differ between groups.

CONCLUSION

The remote booster program effectively reduced ST and increased light PA in CAD patients. These findings highlight the potential to change physical (in)activity behaviour of patients beyond completion of traditional CR programs.

TRIAL REGISTRATION

NCT06038188 (Clinical Trials.gov).

摘要

目的

在心脏康复（CR）期间，冠心病（CAD）患者的久坐时间（ST）可有所减少，但大多数患者在数月内又恢复到久坐状态。我们研究了为期3周的远程强化干预对CAD患者ST变化的有效性。

方法

本随机对照试验（1:1，按性别分层）纳入了先前（2.0[1.9 - 2.2]年）完成CR的CAD患者。所有参与者均接受常规护理，而强化干预组参与者还额外接受了为期3周的远程行为改变干预。主要结局是从基线到干预后通过加速度计测量的ST变化，次要结局包括久坐行为和身体活动（PA）特征的变化。采用意向性分析的基线受限线性混合模型。

结果

参与者（19%为女性，强化干预组：n = 21，对照组：n = 21）年龄为69[63 - 75]岁。与对照组相比，强化干预组的ST下降幅度更大（-1.3（95%置信区间（CI）：-2.0；-0.6）小时/天对-0.1（95%CI：-0.8；0.6）小时/天，p交互作用 = 0.012），久坐持续时间减少更多（-1.1（95%CI：-1.6；-0.6）次/天对0.2（95%CI：-0.3；0.7）次/天，p交互作用<0.001），同时轻度PA增加幅度更大（+1.1（95%CI：+0.5；+1.8）小时/天对+0.2（95%CI：-0.4；+0.8）小时/天，p交互作用 = 0.030）。两组之间中等到剧烈PA的变化（p交互作用 = 0.13）和步数变化（p交互作用 = 0.18）无差异。