Coaching patients with early rheumatoid arthritis to healthy physical activity: A multicenter, randomized, controlled study
Coaching patients with early rheumatoid arthritis to healthy physical activity: A multicenter, randomized, controlled study
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DOI：
10.1002/art.23327
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发表时间：
2008-03-15
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影响因子：
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通讯作者：
Opava, Christina H.
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文献类型：
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作者：
Brodin, Nina;Eurenius, Eva;Opava, Christina H.
Objective.研究早期类风湿关节炎患者进行为期1年的健康体力活动指导计划对自觉健康状况、身体功能和活动限制的影响。共228名患者在用EuroQol视觉模拟量表（VAS）、Grippit、定时站立试验、Escola保利斯塔de Medicina运动范围量表、8字形行走、疼痛视觉模拟量表、健康评估问卷残疾指数、自我报告的体力活动问卷，以及28个关节的疾病活动评分。所有患者定期接受风湿病学家的检查，并按规定进行康复治疗。干预组的参与者由物理治疗师进一步单独指导，以达到或保持健康的身体活动（>= 30分钟，中等强度的活动，一周中的大部分时间）。1年后的保留率在干预组为82%，在对照组为85%。干预组和对照组中满足健康体力活动要求的个体百分比在干预前（47%对51%; P > 0.05）和干预后（54%对44%; P > 0.05）相似。结果变量的分析表明，干预组在EuroQol VAS（P = 0.025）和肌力（定时站立试验; P = 0.000）（Grippit; P = 0.003）方面优于对照组，但在评估的任何其他变量方面均无改善。一项为期1年的健康体力活动指导计划导致了感知健康状况和肌肉力量的改善，但机制仍不清楚，因为健康水平的自我报告体力活动没有改变。
Objective. To investigate the effect of a 1-year coaching program for healthy physical activity on perceived health status, body function, and activity limitation in patients with early rheumatoid arthritis.Methods. A total of 228 patients (169 women, 59 men, mean age 55 years, mean time since diagnosis 21 months) were randomized to 2 groups after assessments with the EuroQol visual analog scale (VAS), Grippit, Timed-Stands Test, Escola Paulista de Medicina Range of Motion scale, walking in a figure-of-8, a visual analog scale for pain, the Health Assessment Questionnaire disability index, a self-reported physical activity questionnaire, and the Disease Activity Score in 28 joints. All patients were regularly seen by rheumatologists and underwent rehabilitation as prescribed. Those in the intervention group were further individually coached by a physical therapist to reach or maintain healthy physical activity (>= 30 minutes, moderately intensive activity, most days of the week).Results. The retention rates after 1 year were 82% in the intervention group and 85% in the control group. The percentages of individuals in the intervention and control groups fulfilling the requirements for healthy physical activity were similar before (47% versus 51%; P > 0.05) and after (54% versus 44%; P > 0.05) the intervention. Analyses of outcome variables indicated improvements in the intervention group over the control group in the EuroQol VAS (P = 0.025) and muscle strength (Timed-Stands Test; P = 0.000) (Grippit; P = 0.003), but not in any other variables assessed.Conclusion. A 1-year coaching program for, healthy physical activity resulted in improved perceived health status and muscle strength, but the mechanisms remain unclear, as self-reported physical activity at healthy level did not change.