Cox Narelle S, Alison Jennifer A, Button Brenda M, Wilson John W, Morton Judith M, Holland Anne E
School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia.
Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Respirology. 2016 Apr;21(3):511-8. doi: 10.1111/resp.12719. Epub 2015 Dec 30.
Studies in children with cystic fibrosis (CF) suggest greater physical activity (PA) is associated with a slower rate of decline in respiratory function. In adults with CF, objectively measured PA time and its relationship to long-term clinical outcomes of respiratory function and need for hospitalization are unknown.
PA measured objectively (SenseWear armband), pulmonary function, exercise capacity (Modified Shuttle Test-25) and CF-related quality of life (CFQ-R) were assessed in 65 adults (34 male; mean age 28 years) with CF during a stable phase. A sub-group of these participants undertook additional measurement of PA at hospital discharge for a respiratory exacerbation.
Median daily habitual moderate-vigorous PA (MVPA) time was 31-min (IQR:15-53). Participants who accumulated ≥30-min MPVA daily experienced fewer hospital days (P = 0.04), better exercise capacity and higher FEV1 at 12 months (P ≤ 0.001). Daily, fewer females than males accrued ≥30-min MVPA (P = 0.02). Compared with those who did not, participants who accumulated 30-min MVPA in bouts ≥10-min (n = 21) recorded better FEV1 (P = 0.02) and exercise capacity (P = 0.006), and reduced hospital admissions (P = 0.04) and hospital days (P = 0.04) at 12 months. MVPA participation declined significantly 1 month post-hospital discharge (median 12 min (4-34); P = 0.04).
Adults with CF are able to achieve recommended MVPA targets of 30mins/day; however, a significant gender difference in activity time is apparent. Greater time in MVPA is related to more positive clinical outcomes over 12 months. Whether increasing PA levels can improve clinical outcomes in adults with CF warrants further investigation. See Editorial, page 404.
对囊性纤维化(CF)患儿的研究表明,更多的体力活动(PA)与呼吸功能下降速度减缓有关。在成年CF患者中,客观测量的PA时间及其与呼吸功能长期临床结局和住院需求的关系尚不清楚。
在65名处于稳定期的成年CF患者(34名男性;平均年龄28岁)中,评估了客观测量的PA(SenseWear臂带)、肺功能、运动能力(改良往返跑测试-25)和CF相关生活质量(CFQ-R)。这些参与者中的一个亚组在因呼吸道加重而出院时进行了额外的PA测量。
日常习惯性中度至剧烈PA(MVPA)时间中位数为31分钟(四分位间距:15-53)。每天累积≥30分钟MVPA的参与者住院天数较少(P = 0.04),运动能力较好,12个月时FEV1较高(P≤0.001)。每天累积≥30分钟MVPA的女性比男性少(P = 0.02)。与未累积的参与者相比,以≥10分钟的时长累积30分钟MVPA的参与者(n = 21)在12个月时FEV1更好(P = 0.02)、运动能力更好(P = 0.006),住院次数减少(P = 0.04),住院天数减少(P = 0.04)。出院后1个月MVPA参与度显著下降(中位数12分钟(4-34);P = 0.04)。
成年CF患者能够达到每天30分钟的推荐MVPA目标;然而,活动时间上存在明显的性别差异。更多的MVPA时间与12个月内更积极的临床结局相关。增加PA水平是否能改善成年CF患者的临床结局值得进一步研究。见社论,第404页。