Fatigue and Lifestyle Physical Activity in SLE

SLE 患者的疲劳和生活方式体力活动

基本信息

批准号：
8318574
负责人：
Rosalind Ramsey-Goldman
金额：
$ 17.17万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-01 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8318574
关键词：
Address Affect Anxiety Autoimmune Diseases Behavior Child Chronic Chronic Disease Chronically Ill Clinical Cognitive Communities Cross-Sectional Studies Data Development Disease Excess Mortality Exercise Fatigue Frequencies Funding Future Goals Guidelines Health Health Care Costs Health Surveys Household Individual Inflammatory Information Systems Intervention Life Style Light Lupus Malignant Neoplasms Measurement Measures Mental Depression Monograph Morbidity - disease rate Movement Multiple Sclerosis Muscle National Institute of Arthritis and Musculoskeletal and Skin Diseases Nature Pain interference Patient Outcomes Assessments Patient Self-Report Patients Persons Physical activity Physicians Play Population Quality of life Research Research Design Research Priority Rheumatoid Arthritis Risk Severities Sleep Survey Methodology Symptoms Systemic Lupus Erythematosus Testing Transportation United States National Institutes of Health Walking Work combat fatigue computerized disability economic implication effective intervention improved new technology novel primary outcome programs social standardize measure tool

项目摘要

DESCRIPTION (provided by applicant): Systemic lupus erythematosus (SLE) affects up to 1.5 million persons in the US. Although excess mortality has decreased in SLE patients since the 1970's, substantial morbidity persists. Fatigue is the most disabling and enduring complaint in patients affected with this chronic incurable inflammatory autoimmune disease. The ramifications of fatigue are significant and include decreased quality of life, an increased risk of work disability, and an associated increase in health care costs. The overarching goal of this R21 application is to explore ways to improve the measurement of two constructs, physical activity and fatigue, as a necessary first step in a broader effort to use a behavior management intervention to lower fatigue scores by increasing lifestyle physical activity in persons with SLE. We propose a novel application of a relatively new technology to objectively measure physical activity (triaxial accelerometry, which provides a validated measurement of daily physical activity in the community dwelling setting). In addition, we propose to measure covariates of fatigue using computerized adaptive tests (CATs) patient-reported outcomes (PROs) that have been developed using state-of-the-art cognitive, qualitative, quantitative and health survey methodologies as part of the NIH-funded Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS tools were developed to standardize measurement of self-reported health domains affected by many chronic illnesses and these tools offer the advantages of minimizing patient burden and maximizing precision. Using a cross-sectional study design, the following specific aims will be tested in this R21 application: Aim 1. Evaluate the frequency, intensity, and duration of physical activity as measured by accelerometry to obtain patient-specific average daily activity counts, average daily moderate-to- vigorous minutes of activity (MVPA) (defined as e 2020 activity counts/min), average daily minutes of light physical activity (< 2020 activity counts/min), and average daily minutes of any activity (i.e., minutes of non-zero activity counts) in patients with SLE. Aim 2. Characterize the cross-sectional relationships between objectively measured physical activity and fatigue (primary outcome, Fatigue Severity Score, (FSS) in patients with SLE. We will do this with and without adjustment for the major factors that influence fatigue including sleep and wake disturbance, depression, anxiety, and pain interference using PROMIS tools, and SLE disease activity and severity. The adverse clinical, social, and economic implications of fatigue support the critical need for an improved understanding of factors contributing to fatigue in SLE, a research priority identified in the NIH/NIAMS monograph entitled, "The Future Directions of Lupus Research".

描述（由申请人提供）：系统性红斑狼疮 (SLE) 在美国影响多达 150 万人。尽管自 20 世纪 70 年代以来 SLE 患者的超额死亡率有所下降，但发病率仍然很高。对于患有这种慢性不可治愈的炎症性自身免疫性疾病的患者来说，疲劳是最严重和最持久的症状。疲劳的后果是显着的，包括生活质量下降、工作残疾风险增加以及相关的医疗费用增加。该 R21 应用程序的总体目标是探索改进对身体活动和疲劳这两个概念的测量的方法，这是使用行为管理干预措施通过增加人们的生活方式身体活动来降低疲劳分数的更广泛努力的必要的第一步患有系统性红斑狼疮。我们提出了一种相对较新的技术的新颖应用来客观地测量身体活动（三轴加速度测量法，它提供了社区住宅环境中日常身体活动的有效测量）。此外，我们建议使用计算机自适应测试 (CAT) 患者报告结果 (PRO) 来测量疲劳协变量，这些测试是使用最先进的认知、定性、定量和健康调查方法开发的，作为 NIH 的一部分-资助患者报告结果测量信息系统（PROMIS）。 PROMIS 工具的开发是为了标准化受许多慢性疾病影响的自我报告健康领域的测量，这些工具具有最小化患者负担和最大化精度的优点。使用横断面研究设计，在此 R21 应用程序中将测试以下具体目标：目标 1. 评估通过加速度计测量的身体活动的频率、强度和持续时间，以获得患者特定的平均每日活动计数、平均每日活动次数中度至剧烈活动分钟数 (MVPA)（定义为 2020 年活动次数/分钟）、轻度体力活动的平均每日分钟数（< 2020 年活动次数/分钟）以及任何活动的每日平均分钟数（即非零活动计数的分钟数）SLE 患者。目标 2. 描述 SLE 患者客观测量的身体活动与疲劳之间的横截面关系（主要结果，疲劳严重程度评分 (FSS)）。我们将在调整或不调整影响疲劳的主要因素（包括睡眠和疲劳）的情况下进行此研究。疲劳的不利临床、社会和经济影响表明迫切需要更好地了解导致 SLE 疲劳的因素（一项研究）。确定优先事项NIH/NIAMS 题为“狼疮研究的未来方向”的专着中。