Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome
Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome
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DOI：
10.1002/art.20779
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发表时间：
2005-01-01
影响因子：
--
通讯作者：
Clauw, DJ
中科院分区：
文献类型：
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作者：
Kop, WJ;Lyden, A;Clauw, DJ
客观的。纤维肌痛（FM）和慢性疲劳综合症（CFS）与严重的身体残疾有关。人们对自我报告的身体残疾的决定因素知之甚少。这项调查使用客观的动态活动监测将 FM 和/或 CFS 患者与对照组进行比较，并检查日常生活活动期间动态活动水平与身体功能和症状的关联。方法。 FM 和/或 CFS 患者（n = 38，平均 SD 年龄 41.5 +/- 8.2 岁，74% 女性）完成了为期 5 天的体力活动和症状（疼痛、疲劳和痛苦）动态监测计划，并将结果与年龄匹配的对照组（n = 27，平均 SD 年龄 38.0 +/- 8.6 岁，44% 女性）进行比较。持续评估活动水平，使用每天 5 个时间点的电子时间戳记录确定动态症状，并在 5 天监测期结束时通过 36 项简短健康调查测量身体功能。结果。与对照组相比，患者的峰值活动水平显着较低（平均值 +/- SEM 8,654 +/- 527 对比 12,913 +/- 1,462 单位；P = 0.003），并且与对照组相比，患者花在高水平活动上的时间更少（P = 0.001）。相比之下，患者的平均活动水平与对照组相似（平均值 +/- SEM 1,525 +/- 63 对比 1,602 +/- 89；P = 0.47）。在患者中，低活动水平与前一个月自我报告的身体功能较差相关。活动水平与并发的行走疼痛（P = 0.031）和疲劳（P < 0.001）呈负相关。疼痛和疲劳与随后的步行活动水平降低相关，而活动水平并不能预测随后的症状。结论。与久坐的对照受试者相比，FM 和/或 CFS 患者的高强度体力活动较少。这种峰值活动的减少与身体机能较差的测量结果相关。观察到的关联可能与行为激活程序的设计相关，因为活动水平似乎取决于症状，而不是预测症状。
Objective. Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are associated with substantial physical disability. Determinants of self-reported physical disability are poorly understood. This investigation uses objective ambulatory activity monitoring to compare patients with FM and/or CFS with controls, and examines associations of ambulatory activity levels with both physical function and symptoms during activities of daily life.Methods. Patients with FM and/or CFS (n = 38, mean +/- SD age 41.5 +/- 8.2 years, 74% women) completed a 5-day program of ambulatory monitoring of physical activity and symptoms (pain, fatigue, and distress) and results were compared with those in age-matched controls (n = 27, mean SD age 38.0 +/- 8.6 years, 44% women). Activity levels were assessed continuously, ambulatory symptoms were determined using electronically time-stamped recordings at 5 time points during each day, and physical function was measured with the 36-item Short Form health survey at the end of the 5-day monitoring period.Results. Patients had significantly lower peak activity levels than controls (mean +/- SEM 8,654 +/- 527 versus 12,913 +/- 1,462 units; P = 0.003) and spent less time in high-level activities when compared with controls (P = 0.001). In contrast, patients had similar average activity levels as those of controls (mean +/- SEM 1,525 +/- 63 versus 1,602 +/- 89; P = 0.47). Among patients, low activity levels were associated with worse self-reported physical function over the preceding month. Activity levels were inversely related to concurrent ambulatory pain (P = 0.031) and fatigue (P < 0.001). Pain and fatigue were associated with reduced subsequent ambulatory activity levels, whereas activity levels were not predictive of subsequent symptoms.Conclusion. Patients with FM and/or CFS engaged in less high-intensity physical activities than that recorded for sedentary control subjects. This reduced peak activity was correlated with measures of poor physical function. The observed associations may be relevant to the design of behavioral activation programs, because activity levels appear to be contingent on, rather than predictive of, symptoms.