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针对处于缓解期且肢端肥大症得到控制的库欣病患者的为期12周的个性化体育活动计划的益处。

Benefits of a 12 weeks-individually tailored physical activity program in patients with Cushing's disease in remission and controlled acromegaly.

作者信息

Martel-Duguech Luciana, Bascuñana Helena, Corredor Víctor Priego, González-Viñuela Oriol, Ribé Judith Vinyals, Pons Toni Caparrós, Webb Susan M, Valassi Elena

机构信息

Department of Endocrinology, Hospital S Pau, Research Center for Pituitary Diseases, Institut de Recerca Sant Pau (IIB-Sant Pau), Barcelona, Spain.

Rehabilitation unit, Hospital Sant Pau, Barcelona, Spain.

出版信息

Endocrine. 2025 Jul 10. doi: 10.1007/s12020-025-04331-7.

Abstract

BACKGROUND

Patients with controlled Cushing's disease (CD) and acromegaly (ACRO) often experience persistent musculoskeletal dysfunction and impaired quality of life (QoL) despite biochemical normalization. Although undergoing supervised physical activity is a clear unmet need of pituitary patients, evidence on the effectiveness of individually tailored exercise programs in these populations is scanty.

OBJECTIVE

The aim of this pilot study was to evaluate the effectiveness of a 12-week individually tailored and supervised exercise program on muscle function and patient-reported outcomes (PROMs) in patients with biochemically controlled CD and ACRO.

METHODS

Twenty patients (10 women with CD in remission, 10 men with controlled ACRO) participated in a structured program combining aerobic and resistance exercises, supervised by professional trainers, three times a week over 12 weeks. Outcomes assessed at baseline and post-intervention included, grip strength and physical performance on gait speed, timed up-and-go, chair stand test, muscle structure and quality on ultrasound examination and QoL, as evaluated using disease-specific (CushingQoL, AcroQoL) and generic (SF-12, PANAS, PHQ-9, and GAD-7) questionnaires.

RESULTS

After the 12-week intervention, significant improvements were observed in physical performance tests (p < 0.05 for all parameters vs. baseline) in both CD and ACRO patients. Ultrasound-measured muscle thickness increased CD patients after completion of the program (p < 0.05), while a decreased echogenicity was found in ACRO patients (p < 0.05) CD patients demonstrated significant improvements in waist circumference, diastolic blood pressure (p < 0.05). No significant changes were observed in PROMs in either group after the intervention.

CONCLUSION

An individually tailored, supervised, 12-week exercise intervention significantly enhanced muscle structure and physical performance in patients with controlled CD and ACRO. Further randomized controlled studies are required to confirm the clinical effectiveness of incorporating supervised exercise programs into multidisciplinary management for pituitary disease patients.

摘要

背景

库欣病(CD)和肢端肥大症(ACRO)病情得到控制的患者,尽管生化指标已恢复正常,但常伴有持续的肌肉骨骼功能障碍和生活质量(QoL)受损。尽管接受有监督的体育活动显然是垂体疾病患者尚未满足的需求,但关于针对这些人群的个性化运动计划有效性的证据却很少。

目的

本试点研究的目的是评估一项为期12周的个性化且有监督的运动计划对生化指标得到控制的CD和ACRO患者肌肉功能和患者报告结局(PROMs)的有效性。

方法

20名患者(10名处于缓解期的CD女性患者,10名ACRO病情得到控制的男性患者)参加了一项结构化计划,该计划结合了有氧运动和抗阻运动,由专业教练监督,每周进行3次,共持续12周。在基线和干预后评估的结局包括握力、步态速度、计时起立行走测试、椅子站立测试中的身体表现、超声检查中的肌肉结构和质量以及使用疾病特异性问卷(CushingQoL、AcroQoL)和通用问卷(SF-12、PANAS、PHQ-9和GAD-7)评估的生活质量。

结果

经过12周的干预,CD和ACRO患者在身体表现测试中均观察到显著改善(所有参数与基线相比,p < 0.05)。项目完成后,超声测量的CD患者肌肉厚度增加(p < 0.05),而ACRO患者的回声性降低(p < 0.05)。CD患者的腰围、舒张压有显著改善(p < 0.05)。干预后两组的PROMs均未观察到显著变化。

结论

一项为期12周的个性化、有监督的运动干预显著改善了生化指标得到控制的CD和ACRO患者的肌肉结构和身体表现。需要进一步的随机对照研究来证实将有监督的运动计划纳入垂体疾病患者多学科管理的临床有效性。

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