Garshick Eric, Mulroy Sara, Graves Daniel E, Greenwald Karen, Horton John A, Morse Leslie R
Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Veterans Affairs Boston Healthcare System, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Rancho Los Amigos National Rehabilitation Center, Downey, CA.
Arch Phys Med Rehabil. 2016 Oct;97(10):1721-7. doi: 10.1016/j.apmr.2016.02.010. Epub 2016 Mar 4.
To assess the relations between measures of activity with dyspnea and satisfaction with life in chronic spinal cord injury (SCI).
Cross-sectional survey.
Five SCI centers.
Between July 2012 and March 2015, subjects (N=347) with traumatic SCI ≥1 year after injury who used a manual wheelchair or walked with or without an assistive device reported hours spent away from home or yard on the previous 3 days, sports participation, and planned exercise.
Not applicable.
Satisfaction with Life Scale (SWLS) and dyspnea. Dyspnea was defined as shortness of breath when hurrying on the level or going up a slight hill, going slower than people the same age on the level because of breathlessness, or stopping for breath when going at your own pace, or after about 100yd (or after a few minutes) on the level.
Dyspnea prevalence was 30%. Adjusting for asthma or chronic obstructive pulmonary disease, mobility mode, race, and season, there was a significant linear trend between greater SWLS scores and quartiles of time spent away from the home or yard (P=.0002). SWLS score was greater if participating in organized sports (P=.01), although was not significantly greater with planned exercise (P=.093). Planned exercise was associated with a reduced odds ratio (OR) of dyspnea (.57; 95% confidence interval [CI], .34-.95; P=.032), but organized sports was not (P=.265). Dyspnea was not significantly increased in persons who spent the fewest hours outside their home or yard (≤7h) compared with people who spent the most hours outside their home or yard (>23h) (OR=1.69; 95% CI, 0.83-3.44; P=.145).
In SCI, a planned exercise program is associated with less dyspnea. An active lifestyle characterized by greater time spent away from home or yard and sports participation is associated with greater SWLS scores.
评估慢性脊髓损伤(SCI)患者的活动量与呼吸困难及生活满意度之间的关系。
横断面调查。
五个SCI中心。
在2012年7月至2015年3月期间,受伤≥1年的创伤性SCI患者(N = 347),他们使用手动轮椅或借助或不借助辅助设备行走,报告了前3天离开家或院子的时间、体育活动参与情况和计划锻炼情况。
不适用。
生活满意度量表(SWLS)和呼吸困难情况。呼吸困难定义为在平地上快走或爬小坡时呼吸急促、因气喘而比同龄人走得慢、按自己的速度行走时或在平地上行走约100码(或几分钟后)需要停下来喘气。
呼吸困难患病率为30%。在对哮喘或慢性阻塞性肺疾病、移动方式、种族和季节进行校正后,SWLS得分越高与离开家或院子的时间四分位数之间存在显著的线性趋势(P = .0002)。参加有组织的体育活动时SWLS得分更高(P = .01),不过计划锻炼时SWLS得分虽有升高但无显著差异(P = .093)。计划锻炼与呼吸困难的比值比(OR)降低相关(.57;95%置信区间[CI],.34 -.95;P = .032), 但有组织的体育活动与呼吸困难无关(P = .265)。与在家或院子外停留时间最长(>23小时)的人相比,在家或院子外停留时间最短(≤7小时)的人呼吸困难并未显著增加(OR = 1.69;95%CI,0.83 - 3.44;P = .145)。
在脊髓损伤患者中,计划锻炼项目与较少的呼吸困难相关。以更多时间离开家或院子及参与体育活动为特征的积极生活方式与更高的SWLS得分相关。