微信干预对青光眼患者体力活动量的影响

Effect of WeChat Intervention on Physical Activity in Patients with Glaucoma

目的:观察利用微信干预增加青光眼患者体力活动的效果。方法:前瞻性随机对照研究。选择2018年6-12月于温州医科大学附属眼视光医院门诊确诊的青光眼患者102例作为研究对象。利用Excel生成的随机数随机分为对照组和干预组。对照组患者仅在门诊入组时进行运动宣教,并告知其可增加每天的运动步数;干预组患者入组时进行运动宣教,告知其可增加每天的运动步数的同时,加入微信群进行运动提醒干预。所有患者均需利用运动监测仪器完成基线1周和随访1个月的体力活动监测。采用卡方检验、独立样本t检验、Mann-Whitney U检验、配对t检验及Wilcoxon符号秩检验进行数据分析。结果:排除30例基线运动量较大(步数>12000步/d)、依从性不好及其他原因失访的患者,最终纳入72例(对照组42例,干预组30例)。干预组患者干预后的步数(t=4.94,P<0.001),运动消耗的卡路里(Z=-2.87,P=0.004),代谢当量(Z=-3.30,P=0.001),中等强度体力活动时间(Z=-2.89,P=0.004),高强度体力活动时间(t=2.57,P=0.016)及中高强度体力活动时间(Z=-3.01,P=0.003)均较基线增加;轻度体力活动时间(t=-2.14,P=0.041)和久坐静止不动次数较干预前减少(t=-2.76,P=0.022)。对照组随访的步数也较基线增加(t=3.29,P<0.001),轻度体力活动时间较基线减少(t=-2.57,P=0.014)。另外,干预组的高强度体力活动时间增加量(随访-基线)(Z=-3.04,P=0.002)和超高强度体力活动时间增加量(Z=-2.06,P=0.040)明显高于对照组,差异均有统计学意义。结论:微信干预可以增加青光眼患者的每天运动步数和中高强度体力活动时间,减少患者的轻度体力活动时间和久坐静止次数。

Objective:To study the effect of WeChat reminder intervention for increasing physical activity(PA)in glaucoma patients.Methods:In this prospective,randomized,controlled study,102 glaucoma patients were enrolled from the outpatient department of the Eye Hospital,Wenzhou Medical University from June 2018 to December 2018.Participants were randomly divided into a control group and an intervention group using random numbers generated by Excel.All the participants were taught the benefit of exercise and were advised to increase their daily steps when they were enrolled in the outpatient department.Only patients in the intervention group were invited to join the WeChat group for a reminder of exercise intervention.The PA of all patients was monitored by ActiGraph(WGT3X-BT)for a 1-week baseline and 1-month follow-up during the intervention period.Statistical analyses were performed using a Chi-square test,independent samples t test,Mann-Whitney U test,paired samples t test and Wilcoxon signed-rank test.Results:Thirty patients with high daily exercise levels at baseline(>12000 steps/day),poor compliance or other reasons during the follow-up were excluded.Seventy-two patients finally met all requirements,including 42 patients in the control group and 30 patients in the intervention group.For the intervention group,the mean amount of PA during the 1-month follow-up was significantly higher than that at the 1-week baseline,in which the mean daily steps(t=4.94,P<0.001),calories consumed during exercise(Z=-2.87,P=0.004),metabolism equivalents(METs)(Z=-3.30,P=0.001),moderate physical activity(MPA)(Z=-2.89,P=0.004),vigorous physical activity(VPA)(t=2.57,P=0.016)and moderate-to-vigorous physical activity(MVPA)times(Z=-3.01,P=0.003)had significant differences.Light physical activity(LPA)and the number of sedentary breaks were reduced compared with those before intervention(t=-2.14,P=0.041;t=-2.76,P=0.022).For the control group,the average daily steps in the 1-month follow-up were also higher after intervention than the average at baseline(t=3.29,P<0.001).LPA time was also reduced compared to baseline(t=-2.57,P=0.014).In addition,in the intervention group,the increase in VPA time(follow-up-baseline)(Z=-3.04,P=0.002)and very vigorous physical activity(VVPA)time(Z=-2.06,P=0.040)were significantly higher than those in the control group.Conclusions:WeChat intervention can increase the daily steps and MVPA time of glaucoma patients and decrease the LPA time and the number of sedentary breaks.