讲真，体育锻炼可改善狼疮的乏力与疼痛

方法：

本研究为横断面研究，共纳入123例成人系统性红斑狼疮患者。乏力的主要评估终点为乏力严重程度评分。次要终点是七个健康领域PROMIS标准化T值评分。在7天的时间内进行进行加速锻炼，统计患者每日轻度锻炼以及中等/剧烈运动时间。应用Cronbachα值评估每项PROMIS评分的内部一致性。应用Spearman偏相关系数（r），校正的平均每日锻炼时间分析体育锻炼与乏力严重程度和PROMIS评分之间的关系。

结果：

乏力严重程度评分平均为4.3分，与临床乏力水平一致。每日中等/剧烈运动的时间与平均乏力严重程度评分减低相关。对PROMIS而言，中等/剧烈运动时间与乏力减轻相关，PROMIS内部一致性极好。对于乏力、疼痛、焦虑、睡眠障碍、睡眠相关损害以及躯体功能的PROMIS评分T值狼疮患者较普通美国人群为差。中等/剧烈运动时间较长与与疼痛减轻相关。轻度锻炼与中等/剧烈运动时间均与机体功能改善相关。

附原文：

OBJECTIVE:Fatigue is a common symptom in systemic lupus erythematosus (SLE), and engaging in physical activity may reduce fatigue. We aimed to characterize relationships between fatigue, other health status measures assessed with the Patient Reported Outcomes Measurement Information System (PROMIS) instruments, and accelerometer-based physical activity measurements in patients with SLE. The internal consistency of each PROMIS measure in our SLE sample was also evaluated.METHODS:This cross-sectional study analyzed 123 adults with SLE. The primary fatigue outcome was Fatigue Severity Scale score. Secondary outcomes were PROMIS standardized T-scores in seven health status domains. Accelerometers were worn for seven days, and mean daily minutes of light, moderate/vigorous, and bouted (10 minutes) moderate/vigorous physical activity were estimated. Cronbach's alpha was determined for each PROMIS measure to assess internal consistency. Relationships between Fatigue Severity Scale, PROMIS, and physical activity were summarized with Spearman partial correlation coefficients (r), adjusted for average daily accelerometer wear time.RESULTS:Mean Fatigue Severity Scale score (4.3, SD 1.6) was consistent with clinically relevant levels of fatigue. Greater daily and bouted moderate/vigorous physical activity minutes correlated with lower Mean Fatigue Severity Scale score (r = -0.20, p = 0.03 and r = -0.30, p = 0.0007, respectively). For PROMIS, bouted moderate/vigorous physical activity minutes correlated with less fatigue (r = -0.20, p = 0.03). PROMIS internal consistency was excellent, with Cronbach's alpha > 0.90 for each domain. Mean PROMIS T-scores for fatigue, pain interference, anxiety, sleep disturbance, sleep-related impairment, and physical function were worse than reported for the general US population. More moderate/vigorous physical activity minutes were associated with less pain interference (r = -0.22, p = 0.01). Both light physical activity and moderate/vigorous physical activity minutes correlated with better physical function (r = 0.19, p = 0.04 and r = 0.25, p = 0.006, respectively).CONCLUSION: More time spent in moderate/vigorous physical activity was associated with less fatigue (Fatigue Severity Scale and PROMIS), less pain interference, and better physical function (PROMIS). PROMIS had excellent internal consistency in our SLE sample, and six of seven PROMIS measures indicated poorer average health status in SLE patients compared with the general US population.

引自：

Mahieu MA,Ahn GE,Chmiel JS, et al.Fatigue, patient reported outcomes, and objective measurement of physical activity in systemic lupus erythematosus.Lupus.2016 Feb 10. pii: 0961203316631632.