Krüger Theresa, Behrens Janina R, Grobelny Anuschka, Otte Karen, Mansow-Model Sebastian, Kayser Bastian, Bellmann-Strobl Judith, Brandt Alexander U, Paul Friedemann, Schmitz-Hübsch Tanja
NeuroCure Clinical Research Center, Clinical Neuroimmunology Group, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
BMC Neurol. 2017 Jan 13;17(1):10. doi: 10.1186/s12883-016-0783-0.
Physical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL).
PA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5-6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities. Measures of EE were also derived from self-assessment with IPAQ (International Physical Activity Questionnaire) long version, which additionally yielded information on the context of PA and a classification into subjects' PA levels. To explore the convergence between both types of assessment, IPAQ categories (low, moderate, high) were related to selected PA parameters from objective assessment using ANOVA. Group differences and associated effect sizes for all PA parameters as well as their relation to clinical and hrQoL measures were determined.
Both, SWAmini and IPAQ assessment, captured differences in PA between PwMS and HC. IPAQ categories fit well with common cut-offs for step count (p = 0.002) and mean METs (p = 0.004) to determine PA levels with objective devices. Correlations between specifically matched pairs of IPAQ and SWAmini parameters ranged between r .288 and r .507. Concerning hrQoL, the lower limb mobility subscore was related to four PA measures, while a relation with patients' report of general contentment was only seen for one.
Both methods of assessment seem applicable in PwMS and able to describe reductions in daily PA at group level. Whether they can be used to track individual effects of interventions to enhance PA levels needs further exploration. The relation of PA measures with hrQoL seen with lower limb mobility suggests lower limb function not only as a major target for intervention to increase PA but also as a possible surrogate for PA changes.
多发性硬化症患者（PwMS）的身体活动（PA）常常受到限制，提高PA水平被认为对这一人群有益。我们旨在探索两种标准方法（主观加客观）来评估PwMS中PA的减少情况，并描述PA与健康相关生活质量（hrQoL）的关系。
使用SenseWear mini®臂带（SWAmini）对26例PwMS（扩展残疾状态量表评分1.5 - 6.0）和30例匹配的健康对照者（HC）进行为期7天的PA客观测量，并报告步数、平均总能量消耗和与活动相关的能量消耗（EE）以及不同强度PA所花费的时间。EE测量值也来自国际体力活动问卷（IPAQ）长版的自我评估，该问卷还提供了PA背景信息以及受试者PA水平分类。为了探索两种评估类型之间的一致性，使用方差分析将IPAQ类别（低、中、高）与客观评估中选定的PA参数相关联。确定所有PA参数的组间差异和相关效应大小，以及它们与临床和hrQoL测量值的关系。
SWAmini和IPAQ评估均捕捉到了PwMS和HC之间PA的差异。IPAQ类别与使用客观设备确定PA水平的步数（p = 0.002）和平均代谢当量（p = 0.004）的常见临界值拟合良好。IPAQ和SWAmini特定匹配参数对之间的相关性在r = 0.288至r = 0.50之间。关于hrQoL，下肢活动度子评分与四项PA测量相关，而仅在一项测量中发现与患者总体满意度报告相关。
两种评估方法似乎都适用于PwMS，并且能够在组水平上描述每日PA的减少情况。它们是否可用于跟踪提高PA水平干预措施的个体效果需要进一步探索。PA测量与下肢活动度hrQoL之间的关系表明，下肢功能不仅是增加PA干预的主要目标，也是PA变化的可能替代指标。
