使用加速度计评估青光眼患者的身体活动。
Real-world assessment of physical activity in glaucoma using an accelerometer.
机构信息
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21287, USA.
出版信息
Ophthalmology. 2012 Jun;119(6):1159-66. doi: 10.1016/j.ophtha.2012.01.013. Epub 2012 Mar 2.
OBJECTIVE
To determine the association between glaucomatous visual field (VF) loss and the amount of physical activity and walking in normal life.
DESIGN
Prospective, observational study.
PARTICIPANTS
Glaucoma suspects without significant VF or visual acuity loss (controls) and glaucoma subjects with bilateral VF loss between 60 and 80 years of age.
METHODS
Participants wore an accelerometer over 7 days of normal activity.
MAIN OUTCOME MEASURES
Daily minutes of moderate or vigorous physical activity (MVPA) was the primary measure. Steps per day was a secondary measure.
RESULTS
Fifty-eight controls and 83 glaucoma subjects provided sufficient study days for analysis. Control and glaucoma subjects were similar in age, race, gender, employment status, cognitive ability, and comorbid illness (P>0.1 for all). Better-eye VF mean deviation (MD) averaged 0.0 decibels (dB) in controls and -11.1 dB in glaucoma subjects. The median control subject engaged in 16.1 minutes of MVPA daily and walked 5891 steps/day, as compared with 12.9 minutes of MVPA daily (P = 0.25) and 5004 steps/day (P = 0.05) for the median glaucoma subject. In multivariate models, glaucoma was associated with 21% less MVPA (95% confidence interval [CI], -53% to 32%; P = 0.37) and 12% fewer steps per day (95% CI, -22% to 9%; P = 0.21) than controls, although differences were not statistically significant. There was a significant dose response relating VF loss to decreased activity, with each 5 dB decrement in the better-eye VF associated with 17% less MVPA (95% CI, -30% to -2%; P = 0.03) and 10% fewer steps per day (95% CI, -16% to -5%; P = 0.001). Glaucoma subjects in the most severe tertile of VF damage (better-eye VF MD worse than -13.5 dB) engaged in 66% less MVPA than controls (95% CI, -82% to -37%; P = 0.001) and took 31% fewer steps per day (95% CI, -44% to -15%; P = 0.001). Other significant predictors of decreased physical activity included older age, comorbid illness, depressive symptoms, and higher body mass index.
CONCLUSIONS
Overall, no significant difference in physical activity was found between individuals with and without glaucoma, although substantial reductions in physical activity and walking were noted with greater levels of VF loss. Further study is needed to characterize better the relationship between glaucoma and physical activity.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
确定青光眼视野（VF）损失与日常生活中体力活动和步行量之间的关系。
设计
前瞻性、观察性研究。
参与者
无明显 VF 或视力丧失的青光眼疑似患者（对照组）和双侧 VF 丧失 60 至 80 岁的青光眼患者。
方法
参与者在 7 天的正常活动中佩戴加速度计。
主要观察指标
日常中等强度或剧烈体力活动（MVPA）分钟数为主要指标。每天的步数为次要指标。
结果
58 名对照组和 83 名青光眼患者提供了足够的研究天数进行分析。对照组和青光眼患者在年龄、种族、性别、就业状况、认知能力和合并症方面相似（所有 P 值均>0.1）。对照组的平均最佳眼 VF 平均偏差（MD）为 0.0 分贝（dB），而青光眼患者为-11.1 dB。中位数对照组每天进行 16.1 分钟的 MVPA，每天走 5891 步，而中位数青光眼患者每天进行 12.9 分钟的 MVPA（P=0.25）和 5004 步（P=0.05）。在多变量模型中，与对照组相比，青光眼患者的 MVPA 少 21%（95%置信区间，-53%至 32%；P=0.37），每天的步数少 12%（95%置信区间，-22%至 9%；P=0.21），尽管差异无统计学意义。VF 损失与活动减少之间存在显著的剂量反应关系，最佳眼 VF 每降低 5 dB，MVPA 减少 17%（95%置信区间，-30%至-2%；P=0.03），每天的步数减少 10%（95%置信区间，-16%至-5%；P=0.001）。VF 损害最严重的三分之一（最佳眼 VF MD 差于-13.5 dB）的青光眼患者的 MVPA 比对照组少 66%（95%置信区间，-82%至-37%；P=0.001），每天的步数少 31%（95%置信区间，-44%至-15%；P=0.001）。体力活动减少的其他显著预测因素包括年龄较大、合并症、抑郁症状和较高的体重指数。
结论
总体而言，青光眼患者与无青光眼患者之间的体力活动无显著差异，但随着 VF 损失程度的增加，体力活动和步行量明显减少。需要进一步研究以更好地描述青光眼与体力活动之间的关系。
金融披露
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