Song Jing, Gilbert Abigail L, Chang Rowland W, Pellegrini Christine A, Ehrlich-Jones Linda S, Lee Jungwha, Pinto Daniel, Semanik Pamela A, Sharma Leena, Kwoh C Kent, Jackson Rebecca D, Dunlop Dorothy D
From *Northwestern University Feinberg School of Medicine; †Rehabilitation Institute of Chicago; and ‡Rush University Medical Center, Chicago, IL; §University of Arizona Arthritis Center, Tucson, AZ; and ∥Department of Internal Medicine, Ohio State University, Columbus, OH.
J Clin Rheumatol. 2017 Jan;23(1):26-32. doi: 10.1097/RHU.0000000000000473.
Physical inactivity is a leading risk factor for developing disability. Although randomized clinical trials have demonstrated improving physical activity can reduce this risk in older adults with arthritis, these studies did not specifically evaluate inactive adults.
The aim of this study was to evaluate the relationship of changes in physical activity with disability changes among initially inactive adults with or at high risk of knee osteoarthritis from Osteoarthritis Initiative.
Inactive persons were identified at baseline based on the US Department of Health and Human Services classification (no [zero] 10-minute session of moderate-to-vigorous [MV] activity over 1 week) from objective accelerometer monitoring. Two years later, physical activity change status was classified as follows: (1) met Federal physical activity guidelines (≥150 MV minutes/week acquired in bouts ≥10 minutes), (2) insufficiently increased activity (some but <150 MV bout minutes/week), or (3) remained inactive. Disability at baseline and 2 years was assessed by Late Life Disability Instrument limitation and frequency scores. Multiple regression evaluated the relationship of physical activity change status with baseline-to-2-year changes in disability scores adjusting for socioeconomics, health factors, and baseline disability score.
Increased physical activity showed a graded relationship with improved disability scores in Late Life Disability Instrument limitation (P < 0.001) and frequency scores (P = 0.027). While increasing MV activity to guideline levels showed the greatest reduction, even insufficiently increased physical activity was related to reduced disability.
Findings support advice to increase MV physical activity to reduce disability among inactive adults with or at high risk of knee osteoarthritis, even when guidelines are not met.
缺乏身体活动是导致残疾的主要风险因素。尽管随机临床试验表明，增加身体活动可以降低患有关节炎的老年人的这种风险，但这些研究并未专门评估缺乏运动的成年人。
本研究旨在评估来自骨关节炎倡议组织的最初缺乏运动或有膝关节骨关节炎高风险的成年人中，身体活动变化与残疾变化之间的关系。
根据美国卫生与公众服务部的分类标准（在1周内没有[零]10分钟的中度至剧烈[MV]活动），通过客观的加速度计监测在基线时识别出缺乏运动的人。两年后，身体活动变化状态分类如下：（1）达到联邦身体活动指南（每周通过≥10分钟的运动获得≥150分钟的MV活动），（2）活动增加不足（有一些但<150分钟的MV运动分钟/周），或（3）仍然缺乏运动。通过晚年残疾工具限制和频率评分评估基线和2年时的残疾情况。多元回归分析评估了身体活动变化状态与残疾评分从基线到2年变化之间的关系，并对社会经济因素、健康因素和基线残疾评分进行了调整。
身体活动增加与晚年残疾工具限制评分（P<0.001）和频率评分（P = 0.027）改善之间呈现分级关系。虽然将MV活动增加到指南水平显示出最大程度的降低，但即使是活动增加不足也与残疾减少有关。
研究结果支持增加MV身体活动以减少患有或有膝关节骨关节炎高风险的缺乏运动成年人残疾的建议，即使未达到指南要求。
