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特发性远端轴索性多发性神经病患者运动与疼痛的关系。

Relation of exercise and pain in patients with idiopathic distal axonal polyneuropathies.

机构信息

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

J Peripher Nerv Syst. 2020 Dec;25(4):388-394. doi: 10.1111/jns.12415. Epub 2020 Oct 13.

Abstract

Although exercise is associated with better outcomes in patients with some peripheral neuropathies, data in idiopathic peripheral neuropathies is lacking. This study was completed to do a comprehensive data analysis about the benefits of regular exercise in a well-characterized cohort of patients with idiopathic distal, symmetrical, axonal polyneuropathy enrolled in the Peripheral Neuropathy Research Registry (PNRR) at Johns Hopkins University School of Medicine. From the patient-reported exercise habits, metabolic equivalents (METs) were calculated and the patient information was grouped into four categories. The PNRR data set, including patient reported pain, numbness, and weakness, was analyzed using the METs categories to evaluate for the benefits of exercise. We controlled for the components of metabolic syndrome including Hemoglobin A1c (HbA1c), systolic and diastolic blood pressure (BP), high density lipids (HDL) and triglyceride level, and body mass index (BMI) as defined by the Adult Treatment Panel III Guidelines. Lower METs were associated with neuropathic pain, but not with other peripheral neuropathy symptoms. Patients with IPN who exercised were less likely to have painful neuropathy independent of the average METs per week (P < .01). No significant differences were seen for patient reported numbness, weakness, or balance issues. The data suggests that patients with idiopathic neuropathy benefit from exercises even if performed on a low intensity level or less frequently, and patients are less likely to have severe pain symptoms when exercising on a regular basis.

摘要

虽然运动与一些周围神经病患者的更好结果相关,但在特发性周围神经病中缺乏数据。本研究旨在对约翰霍普金斯大学医学院周围神经病研究登记处(PNRR)中纳入的特发性远端、对称、轴索性多发性神经病患者进行全面数据分析,以了解定期运动的益处。从患者报告的运动习惯中计算出代谢当量(METs),并将患者信息分为四组。使用 METs 类别分析 PNRR 数据集,包括患者报告的疼痛、麻木和无力,以评估运动的益处。我们控制了代谢综合征的成分,包括糖化血红蛋白(HbA1c)、收缩压和舒张压(BP)、高密度脂蛋白(HDL)和甘油三酯水平以及体重指数(BMI),这些都是根据成人治疗小组 III 指南定义的。较低的 METs 与神经病理性疼痛相关,但与其他周围神经病症状无关。独立于每周平均 METs(P <.01),每周进行运动的 IPN 患者发生疼痛性神经病的可能性较小。对于患者报告的麻木、无力或平衡问题,没有观察到显著差异。数据表明,即使运动强度较低或频率较低,特发性神经病患者也能从运动中受益,而且患者定期运动时发生严重疼痛症状的可能性较小。

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