IRCCS Fondazione Don Carlo Gnocchi, Via Capecelatro 66, 20148 Milano, Italy.
Rehabilitation Department, CRRF Mons L Novarese, 13040 Loc. Trompone, Moncrivello (VC), Italy.
Mult Scler Relat Disord. 2022 Aug;64:103941. doi: 10.1016/j.msard.2022.103941. Epub 2022 Jun 6.
People with Multiple Sclerosis (PwMS) show low levels of physical activity (PA), however there has been limited research on PA in early diagnosed and no/minimally impaired (<5 years, EDSS≤ 2.5) PwMS. The aims of the study were to objectively quantify PA levels in non-disabled PwMS, to compare the time spent daily at different PA levels (No activity (NPA), Light PA (LPA), Moderate PA (MPA), and Vigorous PA (VPA)) with healthy subjects (HS), and to examine the association of PA with disability, and clinical measures in PwMS.
We assessed 58 PwMS (mean age±standard deviation, SD 39.1 ± 10.6years) and 20 HS (mean age±SD 39.3 ± 8.9 years). Demographic and clinical data were recorded at the hospital during the baseline assessment. Subjects wore the wrist GENEActiv accelerometer for 7-days. Data were collected at 100 Hz and summarized into a motor activity (MA) index using 60 s epochs with the following thresholds: MA 10mG, MA: 100mG, MA: 350mG.
PwMS show higher NPA and lower VPA compared to matched healthy subjects (NPA: Mean±SD, HS: 7.2 ± 0.9 h/day; PwMS: 8.1 ± 1.2 h/day, p<0.01; VPA: HS: 0.78± 0.42 h/day; PwMS: 0.50± 0.40 h/day, p = 0.01), while no between group differences were observed for LPA and MPA (p>0.05). Bivariate analysis showed that higher NPA was associated with fatigue (Fatigue Severity Scale, FSS score) in PwMS with EDSS 0-1.5 (r = 0.34, p = 0.05). In PwMS with EDSS 2-2.5, NPA was correlated with Six Minute Walk Test (6MWT, r=-0.45, p = 0.02) and CIQ (r=-0.41, p = 0.04), while VPA was more associated with FSS (R= -0.38, p = 0.06).
The PA level of PwMS differs from that of healthy subjects even in early diagnosed subjects. In PwMS with EDSS 0-1.5 only, fatigue is associated to prolonged inactive behavior. Conversely, in PwMS with EDSS 2-2.5 both inactivity and vigorous activities are modulated by fatigue, endurance and associated with different level of social participation.
多发性硬化症患者（PwMS）的身体活动水平较低，然而，对于早期诊断和无/轻度受损（<5 年，EDSS≤2.5）的 PwMS 的身体活动的研究有限。本研究的目的是客观地量化非残疾 PwMS 的身体活动水平，比较不同身体活动水平（无活动（NPA）、低强度身体活动（LPA）、中强度身体活动（MPA）和高强度身体活动（VPA））的每日时间分配与健康受试者（HS），并检查 PwMS 中身体活动与残疾和临床指标的关系。
我们评估了 58 名 PwMS（平均年龄±标准差，39.1±10.6 岁）和 20 名 HS（平均年龄±SD，39.3±8.9 岁）。在基线评估期间在医院记录人口统计学和临床数据。受试者佩戴腕部 GENEActiv 加速度计 7 天。数据以 100Hz 的频率采集，并使用 60s 时窗的运动活动（MA）指数进行汇总，使用以下阈值：MA 10mG、MA：100mG、MA：350mG。
与匹配的健康受试者相比，PwMS 显示出更高的 NPA 和更低的 VPA（NPA：均值±标准差，HS：7.2±0.9h/天；PwMS：8.1±1.2h/天，p<0.01；VPA：HS：0.78±0.42h/天；PwMS：0.50±0.40h/天，p=0.01），而 LPA 和 MPA 之间没有组间差异（p>0.05）。双变量分析显示，在 EDSS 0-1.5 的 PwMS 中，较高的 NPA 与疲劳（疲劳严重程度量表，FSS 评分）相关（r=0.34，p=0.05）。在 EDSS 2-2.5 的 PwMS 中，NPA 与 6 分钟步行测试（6MWT，r=-0.45，p=0.02）和 CIQ（r=-0.41，p=0.04）相关，而 VPA 与 FSS（r=-0.38，p=0.06）更相关。
即使在早期诊断的患者中，PwMS 的身体活动水平也不同于健康受试者。仅在 EDSS 0-1.5 的 PwMS 中，疲劳与长时间的不活动行为有关。相反，在 EDSS 2-2.5 的 PwMS 中，无活动和剧烈活动都受到疲劳、耐力的调节，并与不同程度的社会参与有关。
