Paediatric Department, University Hospitals Würzburg, Würzburg, Germany.
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Am J Respir Crit Care Med. 2022 Feb 1;205(3):330-339. doi: 10.1164/rccm.202106-1419OC.
The long-term effects of vigorous physical activity (PA) on lung function in cystic fibrosis are unclear. To evaluate effects of a 12-month partially supervised PA intervention using motivational feedback. In a parallel-arm multicenter randomized controlled trial (ACTIVATE-CF), relatively inactive patients aged at least 12 years were randomly assigned (1:1 ratio) to an intervention group or control group. The intervention group consented to add 3 hours of vigorous PA per week, whereas the control group was asked not to change their PA behavior. Primary endpoint was change in percent predicted FEV (ΔFEV) at 6 months. Secondary endpoints included PA, exercise capacity, exercise motives, time to first exacerbation and exacerbation rates, quality of life, anxiety, depression, stress, and blood glucose control. Data were analyzed using mixed linear models. A total of 117 patients (40% of target sample size) were randomized to an intervention (n = 60) or control group (n = 57). After 6 months, ΔFEV was significantly higher in the control group compared with the intervention group (2.70% predicted [95% confidence interval, 0.13-5.26]; = 0.04). The intervention group reported increased vigorous PA compared with the control group at each study visit, had higher exercise capacity at 6 and 12 months, and higher PA at 12 months. No effects were seen in other secondary outcomes. ACTIVATE-CF increased vigorous PA and exercise capacity, with effects carried over for the subsequent 6 months, but resulted in better FEV in the control group.
剧烈身体活动对囊性纤维化患者肺功能的长期影响尚不清楚。本研究旨在评估为期 12 个月、采用动机反馈的部分监督身体活动干预对肺功能的影响。在一项平行臂、多中心随机对照试验(ACTIVATE-CF)中,将年龄至少 12 岁、活动度较低的患者按 1:1 的比例随机分配到干预组或对照组。干预组同意每周增加 3 小时剧烈身体活动,而对照组则要求不改变其身体活动行为。主要终点为 6 个月时预测的 FEV 百分比变化(ΔFEV)。次要终点包括身体活动、运动能力、运动动机、首次加重时间和加重率、生活质量、焦虑、抑郁、压力以及血糖控制。采用混合线性模型对数据进行分析。共 117 例患者(目标样本量的 40%)被随机分配到干预组(n=60)或对照组(n=57)。6 个月后,对照组的 ΔFEV 明显高于干预组(2.70%预测值[95%置信区间,0.13-5.26];=0.04)。与对照组相比,干预组在每次研究访视时的剧烈身体活动量均有所增加,6 个月和 12 个月时的运动能力更高,12 个月时的身体活动量更高。其他次要结局未见效果。ACTIVATE-CF 增加了剧烈身体活动和运动能力,且效果持续到随后的 6 个月,但对照组的 FEV 更好。