Interventions for promoting physical activity

  • Review
  • Intervention

Authors


Abstract

Background

Little is known about the effectiveness of strategies to enable people to achieve and maintain recommended levels of physical activity.

Objectives

To assess the effectiveness of interventions designed to promote physical activity in adults aged 16 years and older, not living in an institution.

Search methods

We searched The Cochrane Library (issue 1 2005), MEDLINE, EMBASE, CINAHL, PsycLIT, BIDS ISI, SPORTDISCUS, SIGLE, SCISEARCH (from earliest dates available to December 2004). Reference lists of relevant articles were checked. No language restrictions were applied.

Selection criteria

Randomised controlled trials that compared different interventions to encourage sedentary adults not living in an institution to become physically active. Studies required a minimum of six months follow up from the start of the intervention to the collection of final data and either used an intention-to-treat analysis or, failing that, had no more than 20% loss to follow up.

Data collection and analysis

At least two reviewers independently assessed each study quality and extracted data. Study authors were contacted for additional information where necessary. Standardised mean differences and 95% confidence intervals were calculated for continuous measures of self-reported physical activity and cardio-respiratory fitness. For studies with dichotomous outcomes, odds ratios and 95% confidence intervals were calculated.

Main results

The effect of interventions on self-reported physical activity (19 studies; 7598 participants) was positive and moderate (pooled SMD random effects model 0.28 95% CI 0.15 to 0.41) as was the effect of interventions (11 studies; 2195 participants) on cardio-respiratory fitness (pooled SMD random effects model 0.52 95% CI 0.14 to 0.90). There was significant heterogeneity in the reported effects as well as heterogeneity in characteristics of the interventions. The heterogeneity in reported effects was reduced in higher quality studies, when physical activity was self-directed with some professional guidance and when there was on-going professional support.

Authors' conclusions

Our review suggests that physical activity interventions have a moderate effect on self-reported physical activity, on achieving a predetermined level of physical activity and cardio-respiratory fitness. Due to the clinical and statistical heterogeneity of the studies, only limited conclusions can be drawn about the effectiveness of individual components of the interventions. Future studies should provide greater detail of the components of interventions.

Resumo

Intervenções para promover atividade física

Introdução

Pouco se sabe sobre a efetividade das estratégias para alcançar e manter níveis recomendados de atividade física

Objetivos

Avaliar a efetividade de intervenções para promoção de atividade física em adultos com 16 anos de idade ou mais, que não estejam internados em asilos.

Métodos de busca

Foram pesquisados a The Cochrane Library (issue 1 2005), MEDLINE, EMBASE, CINAHL, PsycLIT, BIDS ISI, SPORTDISCUS, SIGLE, SCISEARCH (desde seu início até Dezembro 2004). As listas de referências de artigos relevantes foram verificadas. Não houve restrições quanto ao idioma.

Critério de seleção

Ensaios clínicos randomizados que compararam diferentes intervenções para incentivar adultos sedentários, que não estavam internados em asilos, a se tornarem fisicamente ativos. Os estudos deveriam ter ao menos seis meses de acompanhamento desde o início da intervenção até a coleta final dos dados e utilizar análise por intenção de tratar ou, caso não tivessem feito esse tipo de análise, deveriam ter uma taxa de perda de follow-up menor que 20%.

Coleta dos dados e análises

Pelo menos dois autores verificaram de forma independente a qualidade de cada estudo e extraíram os dados. Os autores dos estudos foram contatados para informações adicionais quando fosse necessário. As diferenças médias padronizadas (standardised mean diferences- SMD) e os intervalos de confiança (CI) de 95% foram calculados para variáveis contínuas de atividade física auto relatada e para a aptidão cardiorrespiratória. Para os estudos com desfechos dicotômicos, a razão de chances (odds ratio-OR) e os IC 95% foram calculados.

Principais resultados

As intervenções produziram um aumento significativo moderado na atividade física auto-relatada (19 estudos; 7598 participantes): SMD combinada com modelo randômico 0.28, IC95% 0.15 – 0.41. As intervenções também melhoraram a capacidade cardiorrespiratória (11 estudos; 2195 participantes): SMD combinada com modelo randômico 0.52, IC95% 0.14 – 0.90. Foi detectada heterogeneidade significativa nos efeitos descritos assim como nas características das intervenções. A heterogeneidade nos efeitos foi menor nos estudos de alta qualidade, quando a atividade física foi auto-dirigida com alguma supervisão profissional e quando havia apoio profissional contínuo.

Conclusão dos autores

Esta revisão sugere que intervenções para promover atividade física têm um efeito moderado sobre atividade física auto relatada, sobre a capacidade de atingir níveis de atividade física pré-determinados e sobre a capacidade cardiorrespiratória. Conclusões quanto à efetividade dos componentes individuais das intervenções são limitadas devido à heterogeneidade clínica e estatística dos estudos. Futuros estudos devem descrever em maior detalhe os componentes das intervenções para promover atividade física.

Plain language summary

Interventions for promoting physical activity

Not taking enough physical activity leads to an increased risk of a number of chronic diseases including coronary heart disease. Regular physical activity can reduce this risk and also provide other physical and possibly mental health benefits. The majority of adults are not active at recommended levels. The findings of this review indicate that professional advice and guidance with continued support can encourage people to be more physically active in the short to mid-term. More research is needed to establish which methods of exercise promotion work best in the long-term to encourage specific groups of people to be more physically active.

Resumo para leigos

Intervenções para promover atividade física

As pessoas que não realizam atividades físicas em quantidade suficiente tem maior risco de desenvolver várias doenças crônicas incluindo problemas cardíacos coronarianos. A atividade física regular pode reduzir esses riscos e também proporciona outros benefícios físicos e possivelmente benefícios para a saúde mental. A maioria dos adultos não realiza uma atividade física dentro dos níveis recomendados. Segundo os achados desta revisão, o aconselhamento e apoio profissional contínuo podem incentivar adultos a serem mais ativos a curto e a médio prazo. Mais pesquisas são necessárias para saber qual é o método de incentivo ao exercício que funciona melhor a longo prazo para incentivar grupos específicos de pessoas a serem mais ativas fisicamente.

Notas de tradução

Traduzido por: Brazilian Cochrane Centre
Tradução patrocinada por: None

எளியமொழிச் சுருக்கம்

உடலியக்க நடவடிக்கையை மேம்படுத்துவதற்கான சிகிச்சை தலையீடுகள்

போதுமான உடலியக்க நடவடிக்கையை மேற்கொள்ளாமல் இருப்பது இதயத்தமனி நோயை உள்ளடக்கிய பல எண்ணிக்கையிலான நாள்பட்ட நோய்களின் அதிகரித்த அபாயத்திற்கு வழி வகுக்கும். ஒழுங்கான உடலியக்க நடவடிக்கை, இந்த அபாயத்தை குறைக்கக் கூடும் மற்றும் பிற உடல், மற்றும் சாத்தியப்படும் மனநல நன்மைகளையும் வழங்கும். பெரும்பான்மையான வயது வந்தவர்கள் பரிந்துரைக்கப்பட்ட அளவுகளில் உடலியக்க சுறுசுறுப்பின்றி உள்ளனர். தொழில்முறை ஆலோசனை மற்றும் தொடர்ச்சியான ஆதரவுடனான வழி நடத்துதல் ஆகியவை மக்களை குறுகிய முதல் மத்திய-காலக் கட்டத்தில், அதிக உடலியக்க சுறுசுறுப்புடன் இருக்க ஊக்கப்படுத்தும் என்று இந்த திறனாய்வின் முடிவுகள் சுட்டிக்காட்டுகின்றன. நீண்ட-காலக் கட்டத்தில், குறிப்பிட்ட மக்கள் குழுக்களை அதிக உடலியக்க சுறுசுறுப்புடன் இருப்பதற்கு ஊக்கப்படுத்த உடற்பயிற்சி மேம்பாட்டின் எந்த முறைகள் சிறப்பாக வேலை செய்யும் என்பதை நிலைநாட்டுவதற்கு அதிக ஆராய்ச்சி தேவைப்படுகிறது.

மொழிபெயர்ப்பு குறிப்புகள்

மொழிபெயர்ப்பாளர்கள்: சிந்தியா ஸ்வர்ணலதா ஸ்ரீகேசவன், தங்கமணி ராமலிங்கம், ப்ளசிங்டா விஜய், ஸ்ரீகேசவன் சபாபதி.

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