Physical Activity and Fatigue in Patients with Sarcoidosis
Physical Activity and Fatigue in Patients with Sarcoidosis
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DOI：
10.1159/000481827
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发表时间：
2018-01-01
期刊：
影响因子：
3.7
通讯作者：
Kirsten, Anne-Marie
中科院分区：
文献类型：
--
作者：
Bahmer, Thomas;Watz, Henrik;Kirsten, Anne-Marie
背景：对结节病患者日常生活中的体力活动了解甚少。疲劳是一种常见的致残症状，可能会对身体活动水平产生负面影响。方法：在结节病患者中，我们通过加速度计（SenseWear臂带）测量了1周的身体活动（每天步数）。我们评估了肺功能（DLCO， FVC）、运动能力（6分钟步行距离[6MWD]）、健康相关生活质量（圣乔治呼吸问卷[SGRQ]）、一般生活质量（12项简短健康调查[SF-12]）和疲劳（多维疲劳量表[MFI-20]）。结果：我们调查了57例结节病患者（平均年龄50岁，男性56%，平均DLCO预测73%，平均FVC预测91%，平均6MWD 525 m，平均每日步数7490），其中n = 14例（25%）有严重疲劳。在双变量水平上，MFI-20子量表“活动减少”和“身体疲劳”与每日步数呈弱相关（Spearman rho = -0.274和rho = -0.277, p < 0.05），而其他子量表和总分则无显著相关性。在双变量分析中，mwd、SGRQ评分和SF-12（身体健康）评分与每天的步数有较强的相关性（Pearson r = 0.499, r = -0.386和r = 0.467, p < 0.01），在校正混杂因素的多变量线性回归分析中，它们是每天步数的独立预测因子（p < 0.05）。在ROC曲线分析中，6MWD、SGRQ评分和SF-12（身体健康）评分能正确识别久坐患者（每天步数< 5000，AUROC分别为0.90、0.81和0.80,p < 0.01）。疲劳的预测性较低（MFI-20子量表“一般疲劳”，AUROC为0.70;p = 0.03）。结论：虽然运动能力和生活质量测量是结节病患者体力活动的可靠预测指标，但客观测量的体力活动与疲劳的相关性却令人惊讶地弱。在结节病中，尽管这种症状主观上被认为是高度致残的，但疲劳可能不妨碍受影响的患者进行体力活动。(C) 2017作者：s . Karger AG，巴塞尔出版
Background: Little is known about physical activity in daily life among patients with sarcoidosis. Fatigue is a frequent and disabling symptom that might negatively affect physical activity levels. Methods: In patients with sarcoidosis, we measured physical activity (steps per day) by accelerometry (SenseWear Armband) for 1 week. We assessed lung function (DLCO, FVC), exercise capacity (6-min walking distance [6MWD]), health-related quality of life (St George's Respiratory Questionnaire [SGRQ]), generic quality of life (12-Item Short-Form Health Survey [SF-12]), and fatigue (Multidimensional Fatigue Inventory [MFI-20]). Results: We investigated 57 patients with sarcoidosis (mean age 50 years, 56% male, mean DLCO 73% predicted, mean FVC 91% predicted, mean 6MWD 525 m, mean steps per day 7,490), of whom n = 14 (25%) had severe fatigue. The MFI-20 subscales "reduced activity" and "physical fatigue" were weakly associated with steps per day on a bivariate level (Spearman rho = -0.274 and rho = -0.277, respectively; p < 0.05), while the other subscales and the total score were not. 6MWD, SGRQ score, and SF-12 (physical health) score showed stronger associations with steps per day in bivariate analyses (Pearson r = 0.499, r = -0.386, and r = 0.467, respectively; p < 0.01), and were independent predictors of steps per day in multivariate linear regression analyses adjusting for confounders (p < 0.05). In ROC curve analyses, 6MWD, SGRQ score, and SF-12 (physical health) score properly identified sedentary patients (steps per day < 5,000; AUROC 0.90, 0.81, and 0.80, respectively; p < 0.01). Fatigue was less predictive (MFI-20 subscale "general fatigue," AUROC 0.70; p = 0.03). Conclusion: While exercise capacity and quality of life measurements were robust predictors of physical activity in patients with sarcoidosis, associations of objectively measured physical activity with fatigue were surprisingly weak. In sarcoidosis, fatigue might not preclude affected patients from being physically active, although this symptom is subjectively perceived as highly disabling. (C) 2017 The Author(s) Published by S. Karger AG, Basel