Macdonald Eilidh, Buchan Duncan, Cerexhe Luke, Renfrew Linda, Sculthorpe Nicholas
Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom.
Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Stephenson Place, Hamilton International Technology Park, South Lanarkshire, Scotland G72 0HL, United Kingdom.
Mult Scler Relat Disord. 2023 Jan;69:104462. doi: 10.1016/j.msard.2022.104462. Epub 2022 Dec 9.
People with Multiple Sclerosis (PwMS) find it more difficult to engage in physical activity (PA) than healthy controls. Accelerometers can be used to measure sedentary time and free-living physical activity, understanding the differences between PwMS and controls can help inform changes such as interventions to promote a more active lifestyle. This in turn will help prevent secondary conditions and reduce symptom progression.
To conduct a systematic review and meta-analysis on accelerometer measured sedentary behavior and physical activity between PwMS and healthy controls.
A systematic search of five databases (PubMed, Web of Science, Ovid, Science Direct and CINAHIL) from inception until 22nd November 2019. Inclusion criteria was (1) included a group of participants with a definite diagnosis of multiple sclerosis of any type; (2) have 3 or more days of PA monitoring using accelerometers during free living conditions; (3) include age matched healthy controls; (4) assess adults over the age of 18; (5) reported data had to have been reported in a manner suitable for quantitative pooling including: percent of time spent sedentary, minutes per day of sedentary, light, moderate, vigorous activity (moderate and vigorous totaled together), steps per day or counts per day.
Initial search produced 9021 papers, after applying inclusion criteria 21 eligible papers were included in the study. One paper was a longitudinal study from which only baseline data was included. One paper was a reliability and validity study, with data for PwMS versus controls in the validity section. All other papers are cross sectional, with one being a pilot study and another a random control study. One paper used two devices in unison, only one set of data is included in the statistics. Outcome data was available for 1098 participants, 579 PwMS and 519 healthy controls. Significant differences were seen in all categories tested: (1) sedentary time (min/day), standard mean difference -0.286, P = 0.044, n = 4 studies; (2) relative sedentary time (%/day), standard mean difference -0.646, P = 0.000, n = 5 studies; (3) LPA (min/day), standard mean difference 0.337, P = 0.039, n = 5 studies; (4) relative LPA (%/day), standard mean difference 0.211, P = 0.152, n = studies; (5) MVPA (min/day), standard mean difference 0.801, P = 0.000, n = 8 studies; (6) relative MVPA (%/day), mean difference 0.914, P = 0.000, n = 5 studies; (7) step count, standard mean difference 0.894, P = 0.000, n = 8 studies; (8) activity count, standard mean difference 0.693, P = 0.000, n = 13 studies.
PwMS are more sedentary and engage in less LPA, MVPA, steps per day and accelerometer counts per day than healthy controls when measured using accelerometers during free-living conditions.
与健康对照组相比，多发性硬化症患者（PwMS）进行体育活动（PA）更加困难。加速度计可用于测量久坐时间和日常体育活动，了解PwMS与对照组之间的差异有助于为促进更积极生活方式的干预措施等变化提供依据。这反过来将有助于预防继发性疾病并减少症状进展。
对加速度计测量的PwMS与健康对照组的久坐行为和体育活动进行系统评价和荟萃分析。
对5个数据库（PubMed、科学网、Ovid、科学Direct和CINAHIL）从创建到2019年11月22日进行系统检索。纳入标准为：（1）纳入一组确诊为任何类型多发性硬化症的参与者；（2）在自由生活条件下使用加速度计进行3天或更长时间的PA监测；（3）包括年龄匹配的健康对照组；（4）评估18岁以上的成年人；（5）报告的数据必须以适合定量汇总的方式报告，包括：久坐时间百分比、每天久坐分钟数、轻度、中度、剧烈活动（中度和剧烈活动合计）、每天步数或每天计数。
初步检索产生9021篇论文，应用纳入标准后，21篇符合条件的论文纳入研究。一篇论文是纵向研究，仅纳入基线数据。一篇论文是可靠性和有效性研究，在有效性部分有PwMS与对照组的数据。所有其他论文均为横断面研究，一篇为试点研究，另一篇为随机对照研究。一篇论文同时使用了两种设备，统计中仅纳入一组数据。1098名参与者有结果数据，579名PwMS和519名健康对照组。在所有测试类别中均观察到显著差异：（1）久坐时间（分钟/天），标准平均差-0.286，P = 0.044，n = 4项研究；（2）相对久坐时间（%/天），标准平均差-0.646，P = 0.000，n = 5项研究；（3）轻度身体活动（LPA，分钟/天），标准平均差0.337，P = 0.039，n = 5项研究；（4）相对LPA（%/天），标准平均差0.211，P = 0.152，n = 研究；（5）中度至剧烈身体活动（MVPA，分钟/天），标准平均差0.801，P = 0.000，n = 8项研究；（6）相对MVPA（%/天），平均差0.914，P = 0.000，n = 5项研究；（7）步数，标准平均差0.894，P = 0.000，n = 8项研究；（8）活动计数，标准平均差0.693，P = 0.000，n = 13项研究。
在自由生活条件下使用加速度计测量时，PwMS比健康对照组久坐时间更长，且每天的轻度身体活动、中度至剧烈身体活动、步数和加速度计计数更少。
