Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis
Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis
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DOI：
10.3109/03009742.2014.931456
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发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Kraus, W. E.
中科院分区：
文献类型：
--
作者：
Huffman, K. M.;Pieper, C. F.;Kraus, W. E.
目的：直到最近，类风湿性关节炎（RA）的身体活动报告仅限于自我报告方法和/或休闲时间的身体活动。我们的目的是评估、确定典型RA临床队列中运动和久坐时间的相关性，并与匹配良好的对照进行比较。方法：对无糖尿病或心血管疾病的确诊RA患者（血清阳性或x线片侵蚀；n = 41）进行传统和疾病特异性相关的体力活动评估，并进行7天的三轴加速度测量。对27名年龄、性别和体重指数（BMI）匹配的对照组进行了评估。结果：对于RA患者，客观测量的运动时间中位数（25 -75百分位数）为3（1-11）分钟/天；只有10% （n = 4）的参与者每天锻炼30分钟。静坐活动的时间占92%（89-95%）。运动时间与疼痛无关，但与疾病活动度呈负相关（r = -0.3, p < 0.05），与残疾呈负相关（r = -0.3, p < 0.05），与耐力活动自我效能感呈正相关（r = 0.4, p < 0.05）。久坐活动仅与耐力活动的自我效能感相关（r = -0.4, p < 0.05）。与匹配的对照组相比，RA患者在体力活动方面表现出较差的自我效能感，但运动量和久坐时间相似。结论：对于没有糖尿病或心血管疾病的类风湿性关节炎患者，运动时间远低于既定指南，活动模式主要是久坐不动。对于类风湿性关节炎的最佳护理，除了促进运动外，临床医生应考虑评估久坐行为和运动的自我效能。未来的干预可能会确定自我效能感的增加是否会增加RA患者的身体活动。
Objectives: Until recently, reports of physical activity in rheumatoid arthritis (RA) were limited to self-report methods and/or leisure-time physical activity. Our objectives were to assess, determine correlates of, and compare to well-matched controls both exercise and sedentary time in a typical clinical cohort of RA.Method: Persons with established RA (seropositive or radiographic erosions; n = 41) without diabetes or cardiovascular disease underwent assessments of traditional and disease-specific correlates of physical activity and 7 days of triaxial accelerometry. Twenty-seven age, gender, and body mass index (BMI)-matched controls were assessed.Results: For persons with RA, objectively measured median (25th-75th percentile) exercise time was 3 (1-11) min/day; only 10% (n = 4) of participants exercised for >= 30 min/day. Time spent in sedentary activities was 92% (89-95%). Exercise time was not related to pain but was inversely related to disease activity (r = -0.3, p < 0.05) and disability (r = -0.3, p < 0.05) and positively related to self-efficacy for endurance activity (r = 0.4, p < 0.05). Sedentary activity was related only to self-efficacy for endurance activity (r = -0.4, p < 0.05). When compared to matched controls, persons with RA exhibited poorer self-efficacy for physical activity but similar amounts of exercise and sedentary time.Conclusions: For persons with RA and without diabetes or cardiovascular disease, time spent in exercise was well below established guidelines and activity patterns were predominantly sedentary. For optimal care in RA, in addition to promoting exercise, clinicians should consider assessing sedentary behaviour and self-efficacy for exercise. Future interventions might determine whether increased self-efficacy can increase physical activity in RA.