Da Costa Deborah, Dritsa Maria, Ring Angela, Fitzcharles Mary-Ann
Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Arthritis Rheum. 2004 Dec 15;51(6):1004-8. doi: 10.1002/art.20841.
To examine the relationship between disease-related variables, leisure-time physical activity (LTPA), and mental health status with fatigue severity in patients with spondylarthropathy (SpA).
Sixty-six SpA patients completed questionnaires assessing disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), functional ability (Bath Ankylosing Spondylitis Functional Index), and health-related quality of life (Short Form 36). LTPA patterns, demographics, and disease-related data were obtained by interview. A clinical examination determined tender point count. Fatigue was assessed with the BASDAI fatigue item.
The mean BASDAI fatigue score was 5.5 (SD=2.7) with 59% of the sample obtaining a score > or =5. Disease activity, functional disability, and worse mental health contributed to greater fatigue (R2=0.56). The relationship between exercise duration and fatigue intensity was moderated by mental health status. For patients with poorer mental health scores, exercise did not influence fatigue severity. However, for patients reporting better mental health status, engaging in more LTPA decreased fatigue severity.
In addition to increased disease activity and functional disability, greater fatigue severity in SpA is associated with poorer mental health status. Integrating regular leisure physical activity into the comprehensive treatment of SpA may be useful for modulating fatigue.
探讨脊柱关节炎（SpA）患者中疾病相关变量、休闲时间体力活动（LTPA）和心理健康状况与疲劳严重程度之间的关系。
66例SpA患者完成了评估疾病活动度（巴斯强直性脊柱炎疾病活动指数[BASDAI]）、功能能力（巴斯强直性脊柱炎功能指数）和健康相关生活质量（简明健康状况调查量表36项）的问卷。通过访谈获取LTPA模式、人口统计学和疾病相关数据。临床检查确定压痛点计数。使用BASDAI疲劳项目评估疲劳。
BASDAI疲劳评分的平均值为5.5（标准差=2.7），59%的样本得分≥5。疾病活动度、功能残疾和较差的心理健康导致更严重的疲劳（R2=0.56）。运动持续时间与疲劳强度之间的关系受心理健康状况的调节。对于心理健康评分较差的患者，运动对疲劳严重程度没有影响。然而，对于心理健康状况较好的患者，进行更多的LTPA可降低疲劳严重程度。
除了疾病活动度增加和功能残疾外，SpA患者中更严重的疲劳严重程度还与较差的心理健康状况相关。将定期休闲体育活动纳入SpA的综合治疗可能有助于调节疲劳。
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