背景:生活方式体力活动(PA)定义为作为日常生活一部分进行的任何类型的PA。它可以包括参与日常生活活动(即,家务,园艺,步行上班),附带PA,步行和/或减少久坐或坐着行为(SB)。常规PA建议用于类风湿关节炎(RA)患者,以减少疾病活动和全身性炎症,以及改善患者和临床医生重要的健康结果。然而,在该人群中,没有针对生活方式PA和SB的干预措施的有效性的总结证据.这项系统评价与荟萃分析的目的是评估针对1)疾病活动的生活方式PA和/或SB的干预措施;2)PA,SB和3)RA患者的患者和临床医生重要结果。
方法:八个数据库[Medline,Cochrane图书馆中心,WebofScience,心理信息,护理和相关健康文献的累积指数,Scopus,从2022年8月开始搜索ExcerptaMedica数据库和物理治疗证据数据库]。纳入标准要求干预措施以生活方式PA和/或SB为目标,在患有RA的成年人中进行,评估患者和/或临床医生重要的结果。
结果:在880篇相关文章中,16项干预措施符合纳入标准。Meta分析显示,干预措施对疾病活动的影响具有统计学意义(标准化平均差=-0.12(95%置信区间=-0.23至-0.01,I2=6%,z=2.19,p=.03),中度至剧烈的PA,光/休闲PA,steps,功能能力,和疲劳。然而,总PA没有观察到干预效果,疼痛,焦虑或生活质量。
结论:生活方式PA干预导致PA增加,RA患者的SB降低和疾病活动以及其他患者和/或临床医生重要的健康结局的改善。未来的干预措施应该在内容上不那么多样化,结构,用于帮助理解改善健康的最有效干预成分的重点和结果指标。需要更多的SB干预措施来确定其在产生临床益处方面的有效性。
BACKGROUND: Lifestyle physical activity (PA) is defined as any type of PA undertaken as part of daily life. It can include engagement in activities of daily living (i.e., household chores, gardening, walking to work), incidental PA, walking and/or reducing sedentary or sitting behaviours (SB). Regular PA is recommended for people with Rheumatoid Arthritis (RA) to reduce disease activity and systemic inflammation, as well as to improve patient- and clinician-important health outcomes. However, there is no summarised evidence of the effectiveness of interventions specifically targeting lifestyle PA and SB in this population. The aims of this systematic review with meta-analysis were to evaluate interventions targeting lifestyle PA and/or SB on 1) disease activity; 2) PA, SB and 3) patient- and clinician-important outcomes in people with RA.
METHODS: Eight databases [Medline, Cochrane Library CENTRAL, Web of Science, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Scopus, Excerpta Medica database and Physiotherapy Evidence Database] were searched from inception-August 2022. Inclusion criteria required interventions to target lifestyle PA and/or SB, conducted in adults with RA, assessing patient- and/or clinician-important outcomes.
RESULTS: Of 880 relevant articles, 16 interventions met the inclusion criteria. Meta-analyses showed statistically significant effects of interventions on disease activity (standardised mean difference = -0.12 (95% confidence interval = -0.23 to -0.01, I2 = 6%, z = 2.19, p = .03), moderate-to-vigorous PA, light/leisure PA, steps, functional ability, and fatigue. Whereas, no intervention effects were visualised for total PA, pain, anxiety or quality of life.
CONCLUSIONS: Lifestyle PA interventions led to increased PA, reductions in SB and improvements in disease activity and other patient- and/or clinician-important health outcomes in people with RA. Future interventions should be less heterogenous in content, structure, focus and outcome measures used to aid understanding of the most effective intervention components for improving health. More SB interventions are needed to determine their effectiveness at producing clinical benefits.