2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases
2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases
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DOI：
10.1136/annrheumdis-2021-222020
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发表时间：
2022-03-07
影响因子：
27.4
通讯作者：
Verstappen, Suzanne M. M.
中科院分区：
文献类型：
--
作者：
Gwinnutt, James M.;Wieczorek, Maud;Verstappen, Suzanne M. M.
目的召集欧洲抗风湿病联盟特别工作组，对有关风湿和肌肉骨骼疾病(RMD)的生活方式行为的文献进行综述，并提出建议。方法6种生活方式暴露(运动、饮食、体重、酒精、吸烟、参与工作)和7种RMD(骨关节炎、类风湿性关节炎、轴性脊柱性关节炎、银屑病关节炎、系统性红斑狼疮、系统性硬化症、痛风)。该工作组包括风湿学的健康专业人员、老年病学家、流行病学家、公共卫生专家、RMD患者和暴露领域的专家。进行了系统的审查，以收集现有证据，并根据这些证据提出建议。结果根据现有证据，确定了5项总体原则和18项具体建议。最重要的原则定义了健康生活方式的重要性，如何实施生活方式改变，以及它们在医疗方面的作用。运动建议强调了运动对疼痛和残疾的安全性和益处，特别是在患有骨性关节炎和轴性脊柱性关节炎的人中。饮食建议强调了健康、均衡的饮食对患有RMD的人的重要性。患有RMD的人和健康专业人员应该共同努力，以达到并保持健康的体重。少量酒精不太可能对RMD患者的结局产生负面影响，尽管类风湿性关节炎和痛风患者在适度饮酒后可能会有红肿的风险。应该支持吸烟者戒烟。工作参与可能对RMD结果有好处，应在协商中讨论。结论这些建议涵盖了一系列生活方式行为，并可在制定和监测治疗计划时指导RMD患者和卫生专业人员之间的共同决策。
Objectives A European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs). Methods Six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed. Results Five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations. Conclusions These recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.