在一项针对糖尿病前期或2型糖尿病患者基于计步器的为期两年的干预措施中，身体活动和久坐行为的相对时间：一项随机对照试验的二次分析
Relative time in physical activity and sedentary behaviour across a 2-year pedometer-based intervention in people with prediabetes or type 2 diabetes: a secondary analysis of a randomised controlled trial.
作者信息
Larsson Kristina, Von Rosen Philip, Rossen Jenny, Johansson Unn-Britt, Hagströmer Maria
机构信息
Department of Health Promoting Science, Sophiahemmet University, P.O. Box 5605, 114 86, Stockholm, Sweden.
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
出版信息
J Act Sedentary Sleep Behav. 2023 Jun 1;2(1):10. doi: 10.1186/s44167-023-00020-w.
BACKGROUND
People with prediabetes or type 2 diabetes (T2D) need to be physically active, including moderate-to-vigorous intensity physical activity (MVPA) and light-intensity physical activity (LIPA) and reduce time in sedentary behaviour (SB). Few studies have evaluated the effect of randomised controlled trials taking all movement behaviours into account. This study aimed to investigate the effects of a 2-year pedometer-based intervention in people with prediabetes or T2D on relative time in movement behaviours.
METHODS
Secondary analysis of longitudinal data on individuals with prediabetes or T2D from a three-armed randomised controlled trial, the Sophia Step Study, was conducted. The three groups were (1) a multi‑component group (self‑monitoring of steps with a pedometer plus counselling), (2) a single‑component group (self‑monitoring of steps with a pedometer, without counselling), and (3) a standard care group (control). The three behaviours MVPA, LIPA and SB during waking hours were measured with an ActiGraph GT1M accelerometer at baseline, 6, 12, 18 and 24 months. Relative time in MVPA, LIPA and SB for each participant at each time point was calculated and used as outcome measures. Linear mixed models assessed the effect of the intervention over time.
RESULTS
In total 184 participants with mean (SD) age 64.3 (7.6) years and 41% female was included. In the multi-component group, compared to the control group, a significant group-by-time interaction effect for relative time in all three behaviours was found at 6 and 18 months and for MVPA and SB at 24 months. In the single-component group, compared to the control group, an effect occurred in the MVPA and SB behaviours at 6 months and MVPA and LIPA at 24 months. The estimated marginal means ranged from 0.9 to 1.5% of more MVPA, 1.9-3.9% of less LIPA and from 0.5% of less SB to 1.7 more SB in the intervention groups compared to the control group.
CONCLUSIONS
The findings show a beneficial effect on all behaviours over time in the two intervention groups compared to the control group. A more pronounced effect occurred in the multi-component intervention compared to the single-component intervention, implicating the importance of counselling in pedometer-based interventions. Trial registration ClinicalTrials.gov, NCT02374788.
背景
糖尿病前期或2型糖尿病（T2D）患者需要进行身体活动，包括中等至剧烈强度的身体活动（MVPA）和轻度身体活动（LIPA），并减少久坐行为（SB）的时间。很少有研究评估将所有运动行为都考虑在内的随机对照试验的效果。本研究旨在调查一项基于计步器的为期2年的干预措施对糖尿病前期或T2D患者运动行为相对时间的影响。
方法
对一项三臂随机对照试验——索菲亚步数研究中糖尿病前期或T2D个体的纵向数据进行二次分析。三组分别为：（1）多成分组（使用计步器自我监测步数并接受咨询），（2）单成分组（使用计步器自我监测步数，不接受咨询），以及（3）标准护理组（对照组）。在基线、6、12、18和24个月时，使用ActiGraph GT1M加速度计测量清醒时间内的三种行为——MVPA、LIPA和SB。计算每个参与者在每个时间点的MVPA、LIPA和SB的相对时间，并将其用作结果指标。线性混合模型评估干预随时间的效果。
结果
总共纳入了184名参与者，平均（标准差）年龄为64.3（7.6）岁，女性占41%。在多成分组中，与对照组相比，在6个月和18个月时发现所有三种行为的相对时间存在显著的组×时间交互效应，在24个月时MVPA和SB也有显著交互效应。在单成分组中，与对照组相比，在6个月时MVPA和SB行为出现效应，在24个月时MVPA和LIPA出现效应。与对照组相比，干预组中MVPA增加的估计边际均值范围为0.9%至1.5%，LIPA减少1.9%至3.9%，SB减少0.5%至增加1.7%。
结论
研究结果表明，与对照组相比，两个干预组随着时间推移对所有行为都有有益影响。与单成分干预相比，多成分干预的效果更明显，这表明在基于计步器的干预中咨询的重要性。试验注册ClinicalTrials.gov，NCT02374788。
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