Samenvatting

Abstract
Problem definition.
Chronic diseases are accountable for the leading cause of mortality on the globe.
Non-communicable disease (NCD) – a type of chronic illness – causes burden on multiple levels,
ranging from personal to economical strain, resulting in immense number deaths annually. Dominant
causes of NCD are physical inactivity as well as the execution of sedentary behavior (SB). Patients with
chronic illnesses often live a sedentary lifestyle. Given the impact of this demeanor, research for
effective interventions is of considerable public significance. Objective. This study aimed to unfold the
effectiveness of interventions focusing to reduce sedentary behavior in patients with a noncommunicable
disease.
Method.
This literature study searched for randomized controlled trials and
controlled clinical trials on scientific database PubMed. Studies were only included when subjects had
a certain type of NCD, aimed to reduce SB, written in English and Dutch, if they were published between
2006 and 2016. Medical Subject Headings (MeSH-terms) and keywords, including synonyms were used
for inquiry. The Physiotherapy Evidence Database Scale (PEDro-scale) was used to assess the
methodological quality. The results were valued by the use of a best evidence synthesis (BES). The
BES was applied three times, once for each type of NCD of the involved articles.
Results.
This systematic review included six randomized controlled trials. Sedentary behavior was objectively
measured in every study. The studies included the following NCDs: DM type II, Chronic Obstructive
Pulmonary Disease (COPD), stroke patients. In all studies but one, the amount of time sitting was
measured as a primary outcome. Altogether, 324 participants were included. The interventions applied
to different kinds of NCDs were evaluated. Best-evidence synthesis results provided most effectiveness
concerning interventions applied to Diabetes Mellitus type II (DM type II) patients. No or insufficient
evidence of the effectiveness was found for the interventions that were implemented in literature
investigating reduction in SB time in COPD and stroke. Conclusion. Interventions applied into studies
investigating SB in DM type II patients are most effective. The interventions include counseling together
with an objective motivational tool, pedometer. In the future, multiple randomized controlled trials with
larger populations are needed. Additionally, studies of high quality are needed to provide high quality
evidence on the most effective intervention to reduce SB in patients with a NCD, preferably including a
greater variety in types of NCDs, aiming to sustain long term positive effects on reduced sedentary
behavior.