Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Arthritis Care Res (Hoboken). 2014 Jul;66(7):1041-7. doi: 10.1002/acr.22262.
Health-related utility measures overall health status and quality of life and is commonly incorporated into cost-effectiveness analyses. This study investigates whether attainment of federal physical activity guidelines translates into better health-related utility in adults with or at risk for knee osteoarthritis (OA).
Cross-sectional data from 1,908 adults with or at risk for knee OA participating in the accelerometer ancillary study of the Osteoarthritis Initiative were assessed. Physical activity was measured using 7 days of accelerometer monitoring and was classified as 1) meeting guidelines (≥150 bouted moderate-to-vigorous [MV] minutes per week); 2) insufficiently active (≥1 MV bout[s] per week but below guidelines); or 3) inactive (zero MV bouts per week). A Short Form 6D health-related utility score was derived from patient-reported health status. Relationship of physical activity levels to median health-related utility adjusted for socioeconomic and health factors was tested using quantile regression.
Only 13% of participants met physical activity guidelines, and 45% were inactive. Relative to the inactive group, median health-related utility scores were significantly greater for the meeting guidelines group (0.063; 95% confidence interval [95% CI] 0.055, 0.071) and the insufficiently active group (0.059; 95% CI 0.054, 0.064). These differences showed a statistically significant linear trend and strong cross-sectional relationship with physical activity level even after adjusting for socioeconomic and health factors.
We found a significant positive relationship between physical activity level and health-related utility. Interventions that encourage adults, including persons with knee OA, to increase physical activity even if recommended levels are not attained may improve their quality of life.
健康相关效用衡量整体健康状况和生活质量,通常纳入成本效益分析。本研究旨在调查对于存在或有膝关节骨关节炎(OA)风险的成年人而言,达到联邦体力活动指南标准是否会转化为更好的健康相关效用。
使用加速度计对 1908 名存在或有膝关节 OA 风险的成年人进行了加速计辅助研究的横断面数据分析。通过 7 天的加速度计监测来衡量体力活动,并将其分类为 1)符合指南(每周≥150 分钟有节奏的剧烈运动);2)活动不足(每周有≥1 次有节奏的剧烈运动但未达到指南标准);或 3)不活动(每周无有节奏的剧烈运动)。通过患者报告的健康状况得出简短 6D 健康相关效用评分。使用分位数回归检验体力活动水平与调整社会经济和健康因素后的中位数健康相关效用的关系。
仅有 13%的参与者符合体力活动指南,45%的参与者不活动。与不活动组相比,符合指南组的中位数健康相关效用评分显著更高(0.063;95%置信区间[95%CI]:0.055,0.071),活动不足组的评分也更高(0.059;95%CI:0.054,0.064)。即使在调整了社会经济和健康因素后,这些差异仍表现出显著的线性趋势和与体力活动水平的强横断面关系。
我们发现体力活动水平与健康相关效用之间存在显著的正相关关系。鼓励成年人(包括膝关节 OA 患者)增加体力活动的干预措施,即使未达到推荐水平,也可能提高他们的生活质量。