Panisset M G, Galea M P
Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC 3050, Australia.
Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC 3050, Australia; Australian Rehabilitation Research Centre, Parkville, Australia.
Mult Scler Relat Disord. 2023 Oct;78:104901. doi: 10.1016/j.msard.2023.104901. Epub 2023 Aug 1.
Regular exercise is beneficial for people with Multiple Sclerosis (MS), regardless of disability level. The previously reported differential effect of COVID-19-related lockdowns on exercise levels in this population remains unexplained. We examined effects of lockdowns on exercise in Australians with MS according to disability levels, lockdown severity and health technology use.
A cross-sectional survey of people with MS in Australia (22 April-23 September 2021) collected demographic and clinical information as well as exercise patterns before and during lockdowns. Mann-Whitney was used to compare ordinal data and Likelihood Ratio to compare dichotomous data.
151 people completed the survey. 72.2% had mild disability and 25.2% moderate disability. Extended lockdowns were associated with significantly decreased sedentary behaviour (31.5% to 25.9%) but also with decreased exercise frequency in frequent exercisers (≥3 times/week; 53.7% to 22.2%). The latter occurred significantly more in those with mild disability (-22.7%) than with moderate disability (-3.5%). More people with mild disability walked for exercise pre-pandemic (LR 8.6, p=.004) and during lockdowns (LR 6.6, p=.010). Walking during lockdowns was positively associated with working from home. People with moderate disability were more likely to engage in home exercise both pre-pandemic (LR 5.5, p=.019) and during lockdown (LR 5.2, p=.023). Engagement in home exercise rose for both groups during lockdowns and was facilitated by on-line exercise classes.
Lockdowns differentially affected exercise patterns according to disability level. The proportion of people achieving exercise recommendations decreased more in those with mild but not moderate disability. Incidental physical activity was disproportionately impacted in people with moderate disability.
规律运动对多发性硬化症（MS）患者有益，无论其残疾程度如何。此前报道的新冠疫情相关封锁措施对该人群运动水平的不同影响仍未得到解释。我们根据残疾程度、封锁强度和健康技术使用情况，研究了封锁措施对澳大利亚MS患者运动的影响。
对澳大利亚的MS患者进行横断面调查（2021年4月22日至9月23日），收集人口统计学和临床信息以及封锁前和封锁期间的运动模式。采用曼-惠特尼检验比较有序数据，采用似然比检验比较二分数据。
151人完成了调查。72.2%为轻度残疾，25.2%为中度残疾。延长封锁与久坐行为显著减少相关（从31.5%降至25.9%），但也与频繁锻炼者（每周≥3次）的运动频率降低相关（从53.7%降至22.2%）。后者在轻度残疾患者中（-22.7%）比中度残疾患者中（-3.5%）更为显著。更多轻度残疾患者在疫情前（似然比8.6，p = 0.004）和封锁期间（似然比6.6，p = 0.010）通过步行进行锻炼。封锁期间步行与在家工作呈正相关。中度残疾患者在疫情前（似然比5.5，p = 0.019）和封锁期间（似然比5.2，p = 0.023）更有可能进行家庭锻炼。在封锁期间，两组进行家庭锻炼的比例均有所上升，且在线运动课程对此起到了促进作用。
封锁措施根据残疾程度对运动模式产生了不同影响。达到运动建议的人群比例在轻度而非中度残疾患者中下降得更多。中度残疾患者的偶然身体活动受到的影响尤为严重。
