Applied Physiology and Nutrition Research Group, Universidade de Sao Paulo, Av. Professor Mello Moraes, 65 - Cidade Universitaria, Sao Paulo/SP 05508-030, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 225 - Cerqueira Cesar, Sao Paulo/SP 05403-010, Brazil.
Autoimmun Rev. 2017 Jul;16(7):667-674. doi: 10.1016/j.autrev.2017.05.001. Epub 2017 May 4.
This review aims to (1) summarize the estimates of physical inactivity and sedentary behavior in autoimmune rheumatic diseases; (2) describe the relationship between physical (in)activity levels and disease-related outcomes; (3) contextualize the estimates and impact of physical inactivity and sedentary behavior in autoimmune diseases compared to other rheumatic diseases and chronic conditions; and (4) discuss scientific perspectives around this theme and potential clinical interventions to attenuate these preventable risk factors. We compiled evidence to show that estimates of physical inactivity and sedentary behavior in autoimmune rheumatic diseases are generally comparable to other rheumatic diseases as well as to other chronic conditions (e.g., type 2 diabetes, cardiovascular diseases, and obesity), in which a lack of physical activity and excess of sedentary behavior are well-known predictors of morbimortality. In addition, we also showed evidence that both physical inactivity and sedentary behavior may be associated with poor health-related outcomes (e.g., worse disease symptoms and low functionality) in autoimmune rheumatic diseases. Thus, putting into practice interventions to make the patients "sit less and move more", particularly light-intensity activities and/or breaking-up sedentary time, is a simple and prudent therapeutic approach to minimize physical inactivity and sedentary behavior, which are overlooked yet modifiable risk factors in the field of autoimmune rheumatic diseases.
(1) 总结自身免疫性风湿病中身体活动不足和久坐行为的估计；(2) 描述身体（活动）水平与疾病相关结局之间的关系；(3) 将自身免疫性疾病中身体活动不足和久坐行为的估计和影响与其他风湿性疾病和慢性疾病进行对比；(4) 讨论这一主题的科学观点以及减轻这些可预防风险因素的潜在临床干预措施。我们综合证据表明，自身免疫性风湿病中身体活动不足和久坐行为的估计与其他风湿性疾病以及其他慢性疾病（例如 2 型糖尿病、心血管疾病和肥胖症）相当，在这些疾病中，身体活动不足和久坐行为过多是发病率和死亡率的众所周知的预测因素。此外，我们还表明，身体活动不足和久坐行为可能与自身免疫性风湿病中的不良健康相关结局（例如，疾病症状恶化和功能降低）有关。因此，实施干预措施让患者“少坐多动”，特别是进行低强度活动和/或打破久坐时间，是一种简单而谨慎的治疗方法，可以最大程度地减少身体活动不足和久坐行为这两个在自身免疫性风湿病领域被忽视但可改变的风险因素。
