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中高强度体力活动对纤维肌痛患者长期临床结局和疼痛严重程度的影响。

Effect of moderate to vigorous physical activity on long-term clinical outcomes and pain severity in fibromyalgia.

机构信息

Department of Kinesiology, Indiana University-Purdue University Indianapolis, 901 West New York Street, Indianapolis, IN 46202-5193, USA.

出版信息

Arthritis Care Res (Hoboken). 2013 Aug;65(8):1211-8. doi: 10.1002/acr.21980.

Abstract

OBJECTIVE

To evaluate the relationship between long-term maintenance of moderate to vigorous physical activity (MVPA) and clinical outcomes in fibromyalgia (FM).

METHODS

Patients with FM (n = 170) received individualized exercise prescriptions and completed baseline and followup physical activity assessments using the Community Health Activities Model Program for Seniors questionnaire at weeks 12, 24, and 36. The primary outcome was the change in the Fibromyalgia Impact Questionnaire-Physical Impairment (FIQ-PI) score. The secondary outcomes included improvements in overall well-being (FIQ total score), pain severity ratings, and depression.

RESULTS

Using a threshold increase in MVPA of ≥10 metabolic equivalent hours/week above usual activities, 27 subjects (15.9%) increased and sustained (SUS-PA), 68 (40%) increased but then declined (UNSUS-PA), and 75 (44.1%) did not achieve (LO-PA) this benchmark. Compared to LO-PA subjects, both SUS-PA and UNSUS-PA subjects reported greater improvement in FIQ-PI (P < 0.01) and FIQ total score (P < 0.05). Additionally, the SUS-PA group reported greater improvement in pain severity compared to the LO-PA group (P < 0.05). However, there were no significant group differences between SUS-PA and UNSUS-PA for any primary or secondary outcome measure.

CONCLUSION

Increased participation in MVPA for at least 12 weeks improved physical function and overall well-being in patients with FM. Although sustained physical activity was not associated with greater clinical benefit compared with unsustained physical activity, these findings also suggest that performing greater volumes of physical activity is not associated with worsening pain in FM. Future research is needed to determine the relationship between sustained MVPA participation and subsequent improvement in patient outcomes.

摘要

目的

评估纤维肌痛(FM)患者长期保持中等至剧烈体力活动(MVPA)与临床结局的关系。

方法

170 例 FM 患者接受个体化运动处方,并在第 12、24 和 36 周时使用社区健康活动模型计划老年人问卷进行基线和随访体力活动评估。主要结局为纤维肌痛影响问卷-身体损伤(FIQ-PI)评分的变化。次要结局包括整体健康状况(FIQ 总分)、疼痛严重程度评分和抑郁的改善。

结果

使用 MVPA 阈值增加≥10 个代谢当量小时/周高于日常活动,27 例(15.9%)增加并持续(SUS-PA),68 例(40%)增加但随后下降(UNSUS-PA),75 例(44.1%)未达到(LO-PA)该基准。与 LO-PA 受试者相比,SUS-PA 和 UNSUS-PA 受试者的 FIQ-PI(P < 0.01)和 FIQ 总分(P < 0.05)改善更大。此外,SUS-PA 组报告的疼痛严重程度改善大于 LO-PA 组(P < 0.05)。然而,在任何主要或次要结局指标上,SUS-PA 和 UNSUS-PA 组之间均无显著差异。

结论

至少 12 周增加 MVPA 参与可改善 FM 患者的身体功能和整体健康状况。尽管与持续的体力活动相比,不持续的体力活动与更大的临床获益无关,但这些发现还表明,在 FM 中,进行更大体积的体力活动与疼痛恶化无关。需要进一步研究来确定持续的 MVPA 参与与患者后续结局改善之间的关系。

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