Interventions for promoting physical activity

 

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.

 

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.

 

摘要

背景

促進體力活動的介入方法

對於能夠使人類達到並維持體力活動的建議等級之有效策略所知有限。

目標

評估對於設計來促進16歲以上，非機構居住者體力活動的介入方法之效用。

搜尋策略

我們搜尋了 The Cochrane Library (issue 1 2005), MEDLINE, EMBASE, CINAHL, PsycLIT, BIDS ISI, SPORTDISCUS, SIGLE, SCISEARCH (從最早可利用的資料到2004年12月)。’相關文章的參考文獻清單經過檢視。並沒有設定語言限制。

選擇標準

隨機分配控制試驗，比較以不同的介入方法，來鼓勵習慣久坐的非機構居住者變為習慣體力活動。研究必需從介入方法開始施行，最少追蹤六個月，來收集最後的資料，並且利用治療意向分析法，或是無法達成時，至少不大於20%研究對象失去追蹤。

資料收集與分析

至少兩位獨立的回顧者來評估每個實驗的品質及摘錄結果。當特殊需要時接觸實驗作者以獲取額外的資訊。計算標準差及95%信賴區間來連續測量自我報告的體力活動和心肺適應性。當實驗有叉狀分枝的結果，則計算勝算比及95%信賴區間。

主要結論

介入方法對於自我報告體力活動(19個研究 7598位參與者)，(共同標準差隨機效果模型0.28 95% 信賴區間0.15 to 0.41)和心肺適應性(11個研究 2195位參與者)，(共同標準差隨機效果模型0.52 95% 信賴區間0.14 to 0.90)的效果是正向且中等的。這些研究在介入方法的特色及報告的結果都有顯著的異質性。報告結果的異質性在較高品質的實驗，包括體力活動為自我指向並有一些專業的指導及進行中的專業協助時，有降低的情形。

作者結論

我們的回顧建議體力活動介入方法對自我報告的體力活動，實現預定的體力活動等級，和心肺適應性有中等程度的效果。因為這些實驗在臨床上及統計上的異質性，對於這些介入方法中個別成分的效果， 只能獲取有限的結論。未來的研究對於這些介入方法的成分應該提供更大的詳述 。

翻譯人

本摘要由臺北榮民總醫院陳俊帆翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

缺乏足夠的體力活動導致增加許多慢性疾病的危險性，包括冠狀動脈心臟疾病。規律的體力活動可以減少這些危險性，並且提供其他身體上及可能在心理健康上的益處。大多數的成人並沒有達到建議等級的體力活動。這篇回顧的發現指出專業的勸告及指導協同連續的支持可以鼓勵人們在短中期增加體力活動性。我們需要更多的研究來決定針對某些特定族群，什麼是鼓勵長期體力活動的最佳運動促進方法。