A cardiac-rehab behaviour intervention to reduce sedentary time in coronary artery disease patients: the SIT LESS study

This data sharing collection contains materials used and data collected as part of the ‘SIT LESS (Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy) study’.

Background: As high sedentary times (ST) are highly prevalent in patients with coronary artery disease (CAD), we developed and evaluated the 12-week, hybrid behavioural change intervention SIT LESS. We examined the immediate and medium-term effect of the SIT LESS intervention on changes in ST among CAD patients enrolled in cardiac rehabilitation (CR).

Methods: CAD patients participating in CR at 2 regional hospitals were included in this randomized controlled trial (1:1, stratified for gender and hospital). The control group received CR, whereas SIT LESS participants additionally received a 12-week hybrid behaviour change intervention. The primary outcome was the change in accelerometer-derived ST from pre-CR to post-CR and 3 months post-CR. Secondary outcomes included changes in ST and physical activity characteristics, subjective outcomes, and cardiovascular risk factors. A baseline constrained linear mixed-model was used.

Results: Participants (23% female; SIT LESS: n = 108, control: n = 104) were 63 ± 10 years. Greater ST reductions were found for SIT LESS compared to control post-CR (-1.7 (95% confidence interval (CI): -2.0; -1.4) versus - 1.1 (95% CI: -1.4; -0.8) h/day, pinteraction=0.009), but not at 3 months post-CR (pinteraction=0.61). Besides, larger light-intensity physical activity (LIPA) increases were found for SIT LESS compared to control post-CR (+ 1.4 (95% CI: +1.2; +1.6) versus + 1.0 (95% CI: +0.8; +1.3) h/day, pinteraction=0.020). Changes in other secondary outcomes did not differ among groups.

Conclusion: SIT LESS transiently reduced ST and increased LIPA, but group differences were no longer significant 3 months post-CR. These findings highlight the challenge to induce sustainable behaviour changes in CAD patients without any continued support.

本数据共享合集包含「少坐：久坐行为个性化二级预防干预研究（SIT LESS, Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy）」相关的使用材料与采集数据。
背景：冠状动脉疾病（coronary artery disease, CAD）患者久坐时长（sedentary time, ST）普遍偏高，为此我们研发并评估了为期12周的混合行为改变干预方案SIT LESS。本研究旨在探究SIT LESS干预对纳入心脏康复（cardiac rehabilitation, CR）队列的CAD患者久坐时长变化的即时与中期影响。
方法：本随机对照试验纳入于2家区域医院参与心脏康复的CAD患者，按1:1比例随机分组，并以性别与医院作为分层因素。对照组仅接受常规心脏康复，SIT LESS组则额外接受为期12周的混合行为改变干预。主要结局指标为从心脏康复前、心脏康复后至心脏康复后3个月，通过加速度计测得的ST变化。次要结局指标包括ST与身体活动特征变化、主观结局指标及心血管危险因素。分析采用基线约束线性混合模型。
结果：本研究共纳入受试者（女性占比23%；SIT LESS组n=108，对照组n=104），受试者平均年龄为63±10岁。心脏康复后，SIT LESS组的ST降幅显著大于对照组：SIT LESS组为-1.7小时/天（95%置信区间CI：-2.0~-1.4），对照组为-1.1小时/天（95%置信区间CI：-1.4~-0.8），交互作用p=0.009；但该组间差异在心脏康复后3个月不再显著（交互作用p=0.61）。此外，心脏康复后，SIT LESS组的轻强度身体活动（light-intensity physical activity, LIPA）增幅显著大于对照组：SIT LESS组为+1.4小时/天（95%置信区间CI：+1.2~+1.6），对照组为+1.0小时/天（95%置信区间CI：+0.8~+1.3），交互作用p=0.020。其余次要结局指标的组间变化无显著差异。
结论：SIT LESS可暂时性降低受试者ST并提升LIPA，但该组间差异在心脏康复后3个月不再显著。本研究结果凸显了在无持续支持的情况下，诱导CAD患者实现可持续行为改变所面临的挑战。