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多发性硬化症患者中与跌倒相关的恐惧和跌倒与久坐行为的关联。

The association of fear of falling and falls with sedentary behavior in people with multiple sclerosis.

机构信息

Department of Physical Therapy, School of Health Professions, Faculty of Medicine and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.

Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel.

出版信息

J Psychosom Res. 2024 Jun;181:111675. doi: 10.1016/j.jpsychores.2024.111675. Epub 2024 Apr 18.

Abstract

OBJECTIVE

Sedentary behavior, falls, and fear of falling (FoF) are specific concerns for people with MS (pwMS). Considering the relatively high incidence and potential linkage, it is surprising that this triple relationship has as yet not been extensively investigated in pwMS. Thus, the present study aimed to examine the correlates of sedentary behavior with FoF and falls in pwMS.

METHODS

Fifty pwMS, 30 women, were admitted to this cross-sectional study. Primary outcome measures included physical activity and sedentary behavior metrics measured by accelerometry, fall status, and FoF. Additional measures included mobility clinical tests, cognition, perceived fatigue, depression, and anxiety. The sample was divided into two subgroups according to the daily Metabolic Equivalent of Task (MET) rate scores; <1.5 was defined as sedentary, ≥1.5 were defined as non-sedentary. Multivariate analysis of variance and linear regression analyses assessed the relationships by using an alpha of 0.05.

RESULTS

Sixty-four percent of the sample were classified as sedentary. The sedentary subgroup reported more FoF than the non-sedentary subgroup (32.5 (S·D. = 11.3) vs. 29.9 (S.D. = 9.5); however, no differences were found in fall status between the subgroups. No differences were found for depression, anxiety, cognition, and perceived fatigue between the subgroups. Furthermore, according to the linear regression analysis, FoF explained 23.9% of the variance pertaining to the daily MET rate when controlling for age, gender, disease duration, and disability.

CONCLUSIONS

Clinicians are encouraged to incorporate the issue of FoF during standard management, which may represent an opportunity to improve care and reduce sedentary behavior in pwMS.

摘要

目的

久坐行为、跌倒和跌倒恐惧(Fear of Falling,FoF)是多发性硬化症(Multiple Sclerosis,MS)患者的特殊关注点。鉴于发病率较高且潜在关联性,令人惊讶的是,这三重关系在 MS 患者中尚未得到广泛研究。因此,本研究旨在探讨 MS 患者久坐行为与 FoF 和跌倒的相关性。

方法

本横断面研究纳入了 50 名 MS 患者,其中 30 名为女性。主要结局指标包括通过加速度计测量的身体活动和久坐行为指标、跌倒状态和 FoF。此外的测量指标包括移动能力临床测试、认知、感知疲劳、抑郁和焦虑。根据每日代谢当量(Metabolic Equivalent of Task,MET)率评分,将样本分为两个亚组;<1.5 定义为久坐,≥1.5 定义为非久坐。使用 0.05 的 α 值进行多元方差分析和线性回归分析,以评估相关性。

结果

样本中有 64%的人被归类为久坐。与非久坐亚组相比,久坐亚组报告的 FoF 更多(32.5(S.D. = 11.3)比 29.9(S.D. = 9.5);然而,亚组之间的跌倒状态没有差异。亚组之间在抑郁、焦虑、认知和感知疲劳方面没有差异。此外,根据线性回归分析,在控制年龄、性别、疾病持续时间和残疾后,FoF 解释了每日 MET 率差异的 23.9%。

结论

鼓励临床医生在标准管理中纳入 FoF 问题,这可能为改善 MS 患者的护理和减少久坐行为提供机会。

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