功能和心理变量均影响慢性阻塞性肺疾病患者的日常身体活动：一种结构方程模型
Functional and psychological variables both affect daily physical activity in COPD: a structural equations model.
作者信息
Altenburg Wytske A, Bossenbroek Linda, de Greef Mathieu H G, Kerstjens Huib A M, ten Hacken Nick H T, Wempe Johan B
机构信息
University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, P.O. Box 30001, Internal Mail Address AA11, 9700 RB Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, P.O. Box 30002, Internal Mail Address CD24, 9750 RA Haren, The Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, P.O. Box 30001, Internal Mail Address FA40, 9700RB Groningen, The Netherlands.
出版信息
Respir Med. 2013 Nov;107(11):1740-7. doi: 10.1016/j.rmed.2013.06.002. Epub 2013 Jun 28.
BACKGROUND
Daily physical activity (DPA) level is reduced in patients with COPD. The aim of this study was to investigate the association of DPA with functional and psychological variables in these patients.
METHODS
155 COPD patients (102 males, median (IQR) age 62 years (54-69 years), predicted FEV1 60% (40-75%) were included. We assessed DPA (DigiWalker SW-200), functional capacity and psychological factors.
RESULTS
DPA level was significantly associated with all functional capacity variables and two psychological variables (Perceived Physical Ability Subscale, depression subscale of the Hospital Anxiety and Depression Scale). The six-minute walking distance and St. George Respiratory Questionnaire activity score explained 37% of the variance of DPA in a regression analysis. A structural equations model revealed that psychological variables indirectly explained DPA through functional capacity variables. DPA was stronger associated with functional capacity variables and weaker with psychological variables in patients with lower functional status than in patients with higher functional status.
CONCLUSIONS
Higher levels of DPA are associated with better functional capacity, but interestingly, DPA is also affected by psychological factors, though only indirectly, via functional capacity. The effect of specific treatment addressing psychological factors on DPA level and exercise tolerance needs further investigation.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, NCT00614796.
背景
慢性阻塞性肺疾病（COPD）患者的日常身体活动（DPA）水平降低。本研究旨在调查这些患者中DPA与功能和心理变量之间的关联。
方法
纳入155例COPD患者（102例男性，年龄中位数（四分位间距）为62岁（54 - 69岁），预计第一秒用力呼气容积（FEV1）为60%（40 - 75%））。我们评估了DPA（计步器SW - 200）、功能能力和心理因素。
结果
DPA水平与所有功能能力变量以及两个心理变量（感知身体能力子量表、医院焦虑抑郁量表的抑郁子量表）显著相关。在回归分析中，六分钟步行距离和圣乔治呼吸问卷活动得分解释了DPA变异的37%。结构方程模型显示，心理变量通过功能能力变量间接解释DPA。与功能状态较高的患者相比，功能状态较低的患者中DPA与功能能力变量的关联更强，与心理变量的关联较弱。
结论
较高水平的DPA与更好的功能能力相关，但有趣的是，DPA也受心理因素影响，尽管只是通过功能能力间接影响。针对心理因素的特定治疗对DPA水平和运动耐力的影响需要进一步研究。
临床试验注册
ClinicalTrials.gov，NCT00614796。
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