Boström C, Elfving B, Dupré B, Opava C H, Lundberg I E, Jansson E
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Lupus. 2016 May;25(6):602-16. doi: 10.1177/0961203315622817. Epub 2016 Jan 13.
To study the effects of a one-year physical activity programme on aerobic capacity, physical activity and health-related quality of life (HRQL) in patients with systemic lupus erythematosus (SLE) by a randomized control design.
Thirty-five women with low or moderate disease activity and organ damage were randomized to intervention (I) or control (C) group. The intervention during months 0-3 consisted of education, supervised aerobic exercise at high intensity and individual coaching, as well as self-managed physical activity at low-to-moderate intensity. During months 4-12, the physical activity was self-managed and the coaching was successively reduced over time. Outcome measures included: maximal oxygen uptake (VO2 max) from a bicycle ergometer test, self-reported physical activity and HRQL (SF-36).
VO2 at sub-max. and max. increased, independent of group, during the one-year study period (main effect of time p < 0.0001). VO2 max. increased between baseline and month 3 (p < 0.0001), between months 3 and 6 (p = 0.01) and the increase was sustained at month 12 (ns). Frequency of physical activity at high intensity also increased, independent of group, during the study period. It was increased at months 3, 6 and 12 compared to baseline (p = 0.02, p < 0.001, p = 0.03). Improvement in mental health between baseline and month 6 (p = 0.002) was seen for the I-group, not the C-group (p = 0.03). Disease activity and organ damage did not change.
Physical activity and aerobic capacity increased after supervised exercise and coaching, and the improvement was sustained during the one-year programme. However, no interactions between the group differences were seen, which suggests that repeated measurements could motivate to increased physical activity and thereby to increased aerobic capacity. As sub-max. VO2 increased over time, training-induced changes in VO2 on-kinetics could be another explanation. Little influence on HRQL was seen after the programme. The study indicates that physical activity at high intensity over one year is tolerated by patients with mild to moderate SLE.
采用随机对照设计,研究为期一年的体育活动计划对系统性红斑狼疮(SLE)患者有氧能力、身体活动及健康相关生活质量(HRQL)的影响。
35名疾病活动度低或中度且有器官损害的女性被随机分为干预组(I)或对照组(C)。0至3个月期间的干预包括教育、高强度的有监督有氧运动和个人指导,以及低至中度强度的自我管理体育活动。在4至12个月期间,体育活动由自我管理,且指导随着时间的推移逐渐减少。结果指标包括:自行车测力计测试中的最大摄氧量(VO2 max)、自我报告的身体活动及HRQL(SF - 36)。
在为期一年的研究期间,次最大和最大VO2均增加,与组别无关(时间的主效应p < 0.0001)。VO2 max在基线至3个月之间增加(p < 0.0001),在3至6个月之间增加(p = 0.01),且在12个月时保持增加(无显著性差异)。在研究期间,高强度身体活动的频率也增加,与组别无关。与基线相比,在3、6和12个月时增加(p = 0.02,p < 0.001,p = 0.03)。I组在基线至6个月之间心理健康有所改善(p = 0.002),而C组未改善(p = 0.03)。疾病活动度和器官损害未改变。
在有监督的运动和指导后,身体活动和有氧能力增加,且在为期一年的计划中这种改善得以持续。然而,未观察到组间差异的相互作用,这表明重复测量可能促使身体活动增加,从而使有氧能力增加。由于次最大VO2随时间增加,训练引起的VO2动力学变化可能是另一种解释。该计划对HRQL影响较小。该研究表明,轻度至中度SLE患者能够耐受为期一年的高强度身体活动。