Eaton C B, Menard L M
Brown University School of Medicine, Department of Family Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860, USA.
Br J Sports Med. 1998 Mar;32(1):11-6. doi: 10.1136/bjsm.32.1.11.
To assess the efficacy of physical activity promotion in primary care office settings.
Systematic review of clinical trials in which the efficacy of physical activity promotion was investigated in a primary care office setting with at least one month of follow up.
A total of 13,981 adults, aged 17-85+, were included from 203 practices in eight trials assessing physical activity promotion in primary care office settings.
Odds ratios and 95% confidence intervals were calculated comparing the number of participants who increased their physical activity or were active at follow up in the intervention group with a control group for each study.
Five of eight trials where positive with statistically significant results (range 0.91-6.56), but significant biases or limited clinical relevance of the outcomes were found in all trials. Short term trials of less than one year (four of four were positive), single-risk-factor trials (three of three were positive), randomised clinical trials (two of three were positive), and those assessing moderate levels of physical activity (three of four were positive) were most likely to find benefit. Only one of four trials lasting longer than a year were positive.
There is limited evidence from well designed trials that office based physical activity promotion in primary care settings is efficacious in promoting changes in physical activity that could conceivably have lasting clinical benefits.
评估在基层医疗诊所环境中促进身体活动的效果。
对临床试验进行系统评价,这些试验在基层医疗诊所环境中研究了促进身体活动的效果,并进行了至少一个月的随访。
八项评估基层医疗诊所环境中促进身体活动的试验共纳入了来自203个医疗点的13981名17 - 85岁以上的成年人。
计算每项研究中干预组与对照组相比,在随访时增加身体活动或保持活跃的参与者人数的比值比和95%置信区间。
八项试验中有五项呈阳性,结果具有统计学意义(范围为0.91 - 6.56),但在所有试验中均发现显著偏倚或结果的临床相关性有限。少于一年的短期试验(四项均为阳性)、单危险因素试验(三项均为阳性)、随机临床试验(三项中有两项为阳性)以及评估中等强度身体活动的试验(四项中有三项为阳性)最有可能发现益处。四项持续时间超过一年的试验中只有一项为阳性。
设计良好的试验提供的证据有限,表明在基层医疗环境中基于诊所的身体活动促进措施在促进身体活动变化方面是有效的,而这些变化可能会带来持久的临床益处。