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光强度体力活动对膝骨关节炎的潜在功能益处。

Potential Functional Benefit From Light Intensity Physical Activity in Knee Osteoarthritis.

机构信息

Department of Physical Therapy, University of Delaware, Newark, Delaware.

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

Am J Prev Med. 2017 Nov;53(5):689-696. doi: 10.1016/j.amepre.2017.07.008. Epub 2017 Aug 30.

Abstract

INTRODUCTION

Knee pain may preclude participation in higher intensity physical activity in people with knee osteoarthritis and benefits of light activity are unclear. The effect of replacing sedentary time with light intensity activity on incident functional limitation 2 years later was investigated.

METHODS

Included were people with or at high risk of knee osteoarthritis without baseline functional limitation using data from the Osteoarthritis Initiative collected between August 2008 and July 2010. Data were analyzed between May 2016 and August 2016 for time in sedentary, light, and moderate to vigorous physical activity from accelerometer monitoring. Incident functional limitation was defined as (1) slow gait speed <1.0 meters/second during a 20-meter walk, (2) Western Ontario and McMasters University Osteoarthritis Index physical function ≥28, or (3) Short Form 12 Physical Component scale <40.

RESULTS

Inclusion criteria were met by 1,873 people (mean age=65.0 [SD=9.0] years, mean BMI=28.4 [SD=4.7] kg/m). Replacing 60 minutes/day of sedentary time with 60 minutes/day of light activity was associated with a 17% reduced risk for incident slow gait speed 2 years later (Hazard Ratio=0.83, 95% CI=0.70, 0.99) after adjustment. Approximately 5 minutes/day of moderate to vigorous physical activity would be necessary to receive the equivalent benefit of 60 minutes/day of light activity. Effects in secondary patient-reported outcomes did not reach statistical significance.

CONCLUSIONS

Replacing sedentary time with light activity may reduce the risk of performance-based functional limitation. As expected, moderate to vigorous physical activity rather than light provided stronger risk reduction. When moderate to vigorous physical activity is not an option, pursuing light activity may be a beneficial alternative to being sedentary.

摘要

简介

膝关节疼痛可能会使膝骨关节炎患者无法参与高强度的体育活动,而轻度活动的益处尚不清楚。本研究旨在探讨用低强度活动替代久坐时间对 2 年后新发功能障碍的影响。

方法

本研究纳入了来自 Osteoarthritis Initiative 的数据,这些数据是在 2008 年 8 月至 2010 年 7 月间收集的,参与者患有膝骨关节炎或处于膝骨关节炎高危状态,且基线时无功能障碍。本研究于 2016 年 5 月至 2016 年 8 月间对参与者进行分析,使用加速度计监测数据来评估他们的久坐时间、轻体力活动时间和中高强度体力活动时间。新发功能障碍定义为:(1)20 米步行速度<1.0 米/秒;(2)Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 量表的身体功能评分≥28 分;(3)Short Form 12 健康调查量表 (SF-12) 物理成分评分<40 分。

结果

共有 1873 名参与者符合纳入标准(平均年龄 65.0[9.0]岁,平均 BMI 28.4[4.7]kg/m2)。与每天久坐 60 分钟相比,每天用 60 分钟的低强度活动替代久坐时间与 2 年后新发 20 米步行速度较慢的风险降低 17%相关(风险比=0.83,95%可信区间=0.70,0.99),校正后仍具有统计学意义。每天需要进行大约 5 分钟的中高强度体力活动才能获得与每天 60 分钟低强度体力活动相当的益处。次要患者报告结局指标的结果无统计学意义。

结论

用低强度活动替代久坐时间可能会降低出现基于表现的功能障碍的风险。与预期一致的是,中高强度体力活动而非低强度体力活动提供了更强的风险降低作用。当无法进行中高强度体力活动时,进行低强度体力活动可能是避免久坐的有益替代方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c93d/5650918/04c3a7195892/nihms902632f1.jpg

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