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多发性硬化症患者的运动与生活质量：关注超越身体功能的心理健康及生活主动性
Exercise and Quality of Life Among People With Multiple Sclerosis: Looking Beyond Physical Functioning to Mental Health and Participation in Life
Turner AP, Kivlahan DR, Haselkorn JK  2009/7/24 12:13:21 
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Arch Phys Med Rehabil, 2009,
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C
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Objective:
To describe the prevalence of exercise in a national sample of veterans with multiple sclerosis (MS) and the association of exercise with quality of life, including physical health, mental health, and participation restriction.

Design:
Cross-sectional cohort study linking computerized medical records to mailed survey data from 1999.

Setting:
Veterans Health Administration.

Participants:
Veterans with MS (N=2995; 86.5% men) who received services in the Veterans Health Administration and returned survey questionnaires.

Interventions:
Not applicable.

Main Outcome Measures:
Demographic information, Veteran RAND 36-Item Health Survey (VR-36), self-reported exercise frequency.

Results:
Among all survey respondents with MS, only 28.6% (95% confidence interval, 26.9–30.2) endorsed any exercise. In adjusted logistic regression, exercise was associated with younger age, more education, living alone, lower levels of bodily pain, and higher body mass index. After adjusting for demographic variables and medical comorbidities, exercise was associated with better physical and mental health. People who exercised reported they had better social functioning and better role functioning (participation in life despite physical and emotional difficulties).

Conclusions:
Exercise in veterans with MS is uncommon. In the context of chronic illness care, the identification of exercise patterns and promotion of physical activity may represent an important opportunity to improve mental health and quality of life among people with MS. Intervention should address factors associated with lower rates of exercise including age, education, and pain.
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病例分析 <span class="ModTitle_Intro_Right" id="EPMI_Home_MedicalCases_Intro_div" onclick="javascript:window.location='http://portal.elseviermed.cn/tabid/127/Default.aspx'" onmouseover="javascript:document.getElementById('EPMI_Home_MedicalCases_Intro_div').style.cursor='pointer';document.getElementById('EPMI_Home_MedicalCases_Intro_div').style.textDecoration='underline';" onmouseout="javascript:document.getElementById('EPMI_Home_MedicalCases_Intro_div').style.textDecoration='none';">[栏目介绍]</span>  病例分析 [栏目介绍]
多饮、多尿、全身乏力、闭经1年，体重增加、肝区不适半年——长海医院病例

曹晶珠  邹大进

 

解放军第二军医大学附属长海医院内分泌科

 

患者为中年女性，35岁，因“多饮、多尿、全身乏力、闭经1年，体重增加、肝区不适半年”于2008年8月入院。患者2007年感冒后出现多饮、多尿，每日饮水约10,000 ml，未予重视及诊治。2007年出现闭经，在外院妇产科就诊，先后予2次黄体酮肌肉注射，仍未来月经。半年前体重增加25 kg，肝区不适，肝功能示转氨酶升高。患者无便秘腹胀、无皮肤感染、无双下肢水肿，活动后稍感胸闷、气喘，夜尿增多，平均每小时1次。最大体重88.7 kg。既往史无特殊。月经史：初潮14岁，4/28～30，2008年6月。

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