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症状性膝骨关节炎患者全身性疲劳的决定因素:MOST 研究。

Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: The MOST Study.

机构信息

Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.

Department of Physiotherapy, College of Medical Sciences, University of Benin, Edo State, Nigeria.

出版信息

Int J Rheum Dis. 2020 Apr;23(4):559-568. doi: 10.1111/1756-185X.13797. Epub 2020 Jan 28.

Abstract

AIM

The aim of the study was to identify sociodemographic, disease-related, physical and mental health-related determinants of fatigue at 2-year follow-up in individuals with symptomatic knee osteoarthritis (OA).

METHODS

A longitudinal analysis of participants with symptomatic knee OA from the Multicenter Osteoarthritis Study (MOST) was conducted to identify predictors of fatigue at 2-year follow-up. Participants self-reported fatigue at baseline for the first time in the MOST cohort and at follow-up using a 0-10 visual analog scale. At baseline, questionnaires on sociodemographics, disease-related symptoms, physical and mental health factors were completed. Data were analyzed using linear regressions with a backwards elimination approach.

RESULTS

Of the 2330 individuals in the MOST cohort at baseline, 576 had symptomatic knee OA and of these, 449 with complete fatigue values at baseline and follow-up were included in this analysis. Minimally important fatigue change (ie, worsening [≥1.13], no change [<0.82 or <1.13] and improvement [≥-0.82]) from baseline to follow-up were unequal within the population (34.5%, 26.9%, 38.5%; χ [2, N = 449] = 9.32, P = .009). The multiple linear regression showed that baseline fatigue (unstandardized coefficient [Β] = 0.435; 95% confidence interval [CI] 0.348-0.523, P < .001), slow gait speed (Β = -1.124; 95% CI -1.962 to -0.285, P = .009), depressive symptoms (Β = 0.049; 95% CI 0.024-0.075, P < .001) and higher numbers of comorbidities (Β = 0.242; 95% CI 0.045-0.439, P = .016) were significant predictors of greater fatigue at follow-up.

CONCLUSION

Fatigue is strongly associated with physical- and mental-related health factors. Individualized treatments that include combined psychological and physical function rehabilitation might be modalities for fatigue management.

摘要

目的

本研究旨在确定膝关节骨关节炎(OA)患者在 2 年随访时出现乏力的社会人口学、疾病相关、身心健康相关决定因素。

方法

对多中心骨关节炎研究(MOST)中患有膝关节 OA 的患者进行纵向分析,以确定 2 年随访时乏力的预测因素。参与者在 MOST 队列中首次自我报告基线时的乏力,并在随访时使用 0-10 视觉模拟量表进行报告。基线时,参与者完成了关于社会人口统计学、疾病相关症状、身心健康因素的问卷。使用向后消除方法的线性回归分析数据。

结果

在 MOST 队列的 2330 名参与者中,有 576 名患有膝关节 OA,其中有 449 名在基线和随访时具有完整的乏力值,被纳入本分析。从基线到随访,人群内最小重要变化(即恶化[≥1.13]、无变化[<0.82 或 <1.13]和改善[≥-0.82])不均衡(34.5%、26.9%、38.5%;χ[2,N=449]=9.32,P=0.009)。多元线性回归显示,基线乏力(未标准化系数[B]=0.435;95%置信区间[CI]0.348-0.523,P<0.001)、缓慢的步行速度(B=-1.124;95%CI-1.962 至-0.285,P=0.009)、抑郁症状(B=0.049;95%CI0.024-0.075,P<0.001)和更多的合并症(B=0.242;95%CI0.045-0.439,P=0.016)是随访时乏力程度增加的显著预测因素。

结论

乏力与身心健康相关因素密切相关。包含心理和身体功能康复的个体化治疗可能是乏力管理的一种方式。

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