更高水平的身体活动与轴性脊柱关节炎患者逃避应对的行为减少、更好的身体功能和生活质量相关。
Higher levels of physical activity are associated with less evasive coping, better physical function and quality of life in patients with axial spondyloarthritis.
机构信息
Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Physical Therapy, Saxion, University of Applied Sciences, Enschede, The Netherlands.
出版信息
PLoS One. 2024 May 17;19(5):e0301965. doi: 10.1371/journal.pone.0301965. eCollection 2024.
OBJECTIVE
To evaluate daily physical activity (PA) in relation to psychosocial factors, such as anxiety, depression and different types of coping strategies, as well as patient- and disease-related factors in patients with axial spondyloarthritis (axSpA).
METHODS
Consecutive outpatients from the Groningen Leeuwarden AxSpA (GLAS) cohort completed the modified Short Questionnaire to assess health-enhancing PA (mSQUASH), Hospital Anxiety and Depression Scale (HADS) and Coping with Rheumatic Stressors (CORS) questionnaires, as well as standardized patient- and disease-related assessments. Univariable and multivariable linear regression analyses and comparison of lowest and highest PA tertiles were performed to explore associations between the HADS, CORS, patient- and disease-related factors and PA.
RESULTS
In total, 84 axSpA patients were included; 60% male, mean age 49 (SD ±14) years, median symptom duration 20 (25th-75th percentiles: 12-31) years, mean ASDAS 2.1 (±1.0). Higher PA levels were significantly associated with better scores on patient-reported disease activity (BASDAI), physical function (BASFI) and quality of life (ASQoL). Furthermore, higher levels of PA were associated with less impact of axSpA on wellbeing and lower HADS depression scores. In the multivariable linear regression model, less use of the coping strategy 'decreasing activities' (β: -376.4; p 0.003) and lower BMI (β:-235.5; p: 0.030) were independently associated with higher level of PA. Comparison of patients from the lowest and highest PA tertiles showed results similar to those found in the regression analyses.
CONCLUSION
In this cohort of axSpA patients, higher levels of daily PA were associated with better patient-reported outcomes and lower depression scores. Additionally, the passive coping strategy "decreasing activities" and lifestyle factor BMI were independently associated with PA. Besides anti-inflammatory treatment, coping strategies and lifestyle should be taken into account in the management of individual axSpA patients. Incorporating these aspects into patient education could increase patient awareness and self-efficacy. In the future, longitudinal studies are needed to better understand the complex relationship between patient-, disease- and psychosocial factors associated with daily PA.
目的
评估与心理社会因素（如焦虑、抑郁和不同类型的应对策略）以及与患者和疾病相关的因素相关的日常体力活动（PA），在患有中轴型脊柱关节炎（axSpA）的患者中。
方法
连续来自格罗宁根-吕伐登 axSpA（GLAS）队列的门诊患者完成了改良的短问卷评估健康促进体力活动（mSQUASH）、医院焦虑和抑郁量表（HADS）和应对风湿性应激源（CORS）问卷，以及标准化的患者和疾病相关评估。进行单变量和多变量线性回归分析，并比较最低和最高 PA 三分位数，以探讨 HADS、CORS、患者和疾病相关因素与 PA 之间的关系。
结果
共纳入 84 例 axSpA 患者；60%为男性，平均年龄 49（SD ±14）岁，中位症状持续时间 20（25 至 75 百分位：12 至 31）年，平均 ASDAS 2.1（±1.0）。较高的 PA 水平与更好的患者报告的疾病活动（BASDAI）、身体功能（BASFI）和生活质量（ASQoL）评分显著相关。此外，较高的 PA 水平与 axSpA 对幸福感的影响较小和 HADS 抑郁评分较低有关。在多变量线性回归模型中，较少使用应对策略“减少活动”（β：-376.4；p<0.003）和较低的 BMI（β：-235.5；p：0.030）与较高的 PA 水平独立相关。比较最低和最高 PA 三分位的患者显示出与回归分析中相似的结果。
结论
在这个 axSpA 患者队列中，较高的日常 PA 水平与更好的患者报告的结果和较低的抑郁评分相关。此外，被动应对策略“减少活动”和生活方式因素 BMI 与 PA 独立相关。除了抗炎治疗外，还应考虑应对策略和生活方式在个体 axSpA 患者的管理中。将这些方面纳入患者教育可以提高患者的意识和自我效能。未来需要进行纵向研究，以更好地了解与日常 PA 相关的患者、疾病和心理社会因素之间的复杂关系。
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