Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI.
Ann Behav Med. 2019 Jan 1;53(1):98-108. doi: 10.1093/abm/kay018.
Symptom severity is negatively associated with physical activity in multiple sclerosis (MS). However, it is unclear how physical activity and symptoms correlate on a day-to-day basis in persons with MS.
To determine the temporal within-person associations of pain, fatigue, depressed mood, and perceived cognitive function with physical activity in MS.
Ambulatory adults with MS (N = 107) completed 7 days of home monitoring. Continuous physical activity data (assessed via wrist-worn accelerometer) and concurrent ecological momentary assessment (5X/day) of pain, fatigue, depressed mood, and perceived cognitive function were collected. Data were analyzed using multilevel mixed modeling.
Fatigue and depressed mood demonstrated bidirectional associations with physical activity, whereas pain and cognitive function did not. Higher than usual fatigue (B = -5.83, p = .001) and depressed mood (B = -4.12, p = .03) were followed by decreased physical activity. In contrast, higher than usual physical activity was associated with subsequent decline in fatigue (B = -0.001, p = .02) and depressed mood (B = -0.0007, p = .02); however, the association between physical activity and fatigue varied across the day.
Physical activity is dynamically related to fatigue and mood on a moment-to-moment basis in MS. Efforts to increase physical activity in MS must incorporate a focus on how symptoms affect and are affected by activity.
在多发性硬化症（MS）中，症状严重程度与身体活动呈负相关。然而，目前尚不清楚 MS 患者的身体活动和症状在日常基础上是如何相互关联的。
确定疼痛、疲劳、抑郁情绪和感知认知功能与 MS 患者身体活动的日内个体内关联。
107 名有活动能力的 MS 成年人完成了 7 天的家庭监测。连续的身体活动数据（通过手腕佩戴的加速度计评估）和同时进行的生态瞬时评估（每天 5 次）评估疼痛、疲劳、抑郁情绪和感知认知功能。使用多层次混合模型进行数据分析。
疲劳和抑郁情绪与身体活动呈双向关联，而疼痛和认知功能则没有。高于平常的疲劳（B = -5.83，p =.001）和抑郁情绪（B = -4.12，p =.03）后，身体活动减少。相比之下，高于平常的身体活动与随后的疲劳（B = -0.001，p =.02）和抑郁情绪（B = -0.0007，p =.02）下降有关；然而，身体活动与疲劳之间的关联在一天中有所不同。
在 MS 中，身体活动与疲劳和情绪在瞬间到瞬间的基础上是动态相关的。在 MS 中增加身体活动的努力必须将重点放在症状如何影响和被活动影响上。
