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多发性硬化症中的饮食和运动干预(MoDEMS):一项针对肥胖多发性硬化症成人行为性体重减轻的随机对照试验。

Modifying diet and exercise in multiple sclerosis (MoDEMS): A randomized controlled trial for behavioral weight loss in adults with multiple sclerosis and obesity.

机构信息

Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.

Departments of Neurology and Psychiatry, University Health, Kansas City, MO, USA.

出版信息

Mult Scler. 2023 Dec;29(14):1860-1871. doi: 10.1177/13524585231213241. Epub 2023 Nov 24.

Abstract

BACKGROUND

Obesity is a risk factor for developing multiple sclerosis (MS) and MS-related disability. The efficacy of behavioral weight loss interventions among people with MS (pwMS) remains largely unknown.

OBJECTIVE

Examine whether a group-based telehealth weight loss intervention produces clinically significant weight loss in pwMS and obesity.

METHODS

Seventy-one pwMS were randomized to the weight loss intervention or treatment-as-usual (TAU). The 6-month program promoted established guidelines for calorie reduction and increased physical activity. Anthropometric measurements, mobility tasks, self-report questionnaires, and accelerometry were used to assess changes at follow-up.

RESULTS

Mean percent weight loss in the treatment group was 8.6% compared to 0.7% in the TAU group ( < .001). Sixty-five percent of participants in the intervention achieved clinically meaningful weight loss (⩾ 5%). Participants in the treatment group engaged in 46.2 minutes/week more moderate-to-vigorous physical activity than TAU participants ( = .017) and showed improvements in quality of life ( = .012). Weight loss was associated with improved mobility ( = .003) and reduced fatiguability ( = .008).

CONCLUSION

Findings demonstrate the efficacy of a behavioral intervention for pwMS and obesity, with clinically significant weight loss for two-thirds of participants in the treatment condition. Weight loss may also lead to improved mobility and quality of life.

摘要

背景

肥胖是多发性硬化症(MS)和 MS 相关残疾的一个风险因素。针对 MS 患者(pwMS)的行为体重减轻干预措施的疗效在很大程度上尚不清楚。

目的

研究基于小组的远程医疗体重减轻干预措施是否能在 pwMS 和肥胖患者中产生临床显著的体重减轻效果。

方法

71 名 pwMS 被随机分配到体重减轻干预组或常规治疗组(TAU)。为期 6 个月的计划促进了减少卡路里和增加身体活动的既定指南。采用人体测量学测量、移动任务、自我报告问卷和加速度计来评估随访时的变化。

结果

治疗组的体重减轻百分比平均为 8.6%,而 TAU 组为 0.7%(<0.001)。干预组中有 65%的参与者实现了临床意义上的体重减轻(≥5%)。与 TAU 组相比,治疗组的参与者每周多进行 46.2 分钟的中等到剧烈身体活动(=0.017),并且生活质量得到改善(=0.012)。体重减轻与移动能力的提高(=0.003)和疲劳感的减少(=0.008)有关。

结论

研究结果表明,针对 pwMS 和肥胖的行为干预措施是有效的,治疗组中有三分之二的参与者实现了临床显著的体重减轻。体重减轻也可能导致移动能力和生活质量的提高。

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