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医学结局研究中慢性病患者身体活动和锻炼相关的长期功能及健康状况结果

Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study.

作者信息

Stewart A L, Hays R D, Wells K B, Rogers W H, Spritzer K L, Greenfield S

机构信息

University of California San Francisco, Institute for Health & Aging 94143, USA.

出版信息

J Clin Epidemiol. 1994 Jul;47(7):719-30. doi: 10.1016/0895-4356(94)90169-4.

DOI:10.1016/0895-4356(94)90169-4
PMID:7722585
Abstract

This study was carried out to determine whether levels of physical activity of patients with various chronic diseases are associated with subsequent functioning and well-being. It was an observational 2-year longitudinal design. The setting was offices of medical and mental health practices within health maintenance organizations, large multispecialty groups, and solo practices or small single-specialty group practices in three U.S. cities. Included in the study were 1758 adult patients with one or more of the following: diabetes, hypertension, congestive heart failure, recent myocardial infarction, depressive symptoms, or current depressive disorder. Outcome measures included physical, role, and functioning; energy/fatigue; pain intensity; sleep problems; depressed affect, anxiety, positive affect, and overall psychological distress/well-being; health distress; and current health perceptions. Cross-sectional (base-line), 2-year endpoint, and change score relationships were evaluated between baseline levels of physical activity and each outcome, controlling for chronic conditions, comorbidity, smoking, alcohol use, overweight, self-reported adherence, and other patient and study characteristics. Higher baseline levels of exercise were uniquely associated with better functioning and well-being at baseline and 2 years later for some measures. The magnitude of the differences varied by disease group, but tended to be between 0.17 and 0.39 of the baseline SD. Greater levels of exercise are associated with feeling and functioning better for patients with chronic conditions over a 2-year period, suggesting that this is a fruitful area for further study using controlled interventions.

摘要

本研究旨在确定患有各种慢性病的患者的身体活动水平是否与随后的功能状态和幸福感相关。这是一项为期两年的观察性纵向研究设计。研究地点为美国三个城市的健康维护组织、大型多专科医疗集团以及个体诊所或小型单专科医疗集团内的医疗和心理健康科室。纳入研究的1758名成年患者患有以下一种或多种疾病:糖尿病、高血压、充血性心力衰竭、近期心肌梗死、抑郁症状或当前的抑郁症。结果指标包括身体功能、角色功能和整体功能;精力/疲劳;疼痛强度;睡眠问题;抑郁情绪、焦虑、积极情绪以及总体心理困扰/幸福感;健康困扰;以及当前的健康认知。在控制慢性病、合并症、吸烟、饮酒、超重、自我报告的依从性以及其他患者和研究特征的情况下,评估了身体活动的基线水平与每个结果之间的横断面(基线)、两年终点和变化分数关系。较高的基线运动水平在基线时以及两年后,对于某些指标而言,与更好的功能状态和幸福感存在独特关联。差异的幅度因疾病组而异,但往往在基线标准差的0.17至0.39之间。在两年期间,更多的运动水平与慢性病患者感觉更好和功能更佳相关,这表明这是一个使用对照干预措施进行进一步研究的富有成果的领域。

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