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作者：Laurie Barclay, MD  
出處：WebMD醫學新聞

　　March 31, 2010 — 根據線上發表於3月29日關節炎研究治療(Arthritis Research & Therapy)期刊的一篇隨機試驗結果，某種生活型態體能(LPA)介入方式中的短時間爆發性運動，可以減少纖維肌痛(FM)症狀且改善身體功能。
　　
　　第一作者、馬里蘭州巴爾的摩約翰霍普金斯大學醫學院Kevin R. Fontaine博士在新聞稿中表示，估計美國人口約有2%患有纖維肌痛，對女性的影響是男性的八倍之多，雖然運動顯示有幫助，但通常會因為症狀而對充足運動以獲得幫助產生阻礙。
　　
　　研究目標為評估84名活動力低的FM成年病患，在自我選擇的生活型態體能介入方式中，累積至少30分鐘的運動對於察覺生理功能、疼痛、疲勞、身體質量指數、憂鬱、壓痛、以及6分鐘走路測試等等的影響。研究對象被指派到生活型態體能介入組(LPA組)，或者到纖維肌痛教育對照組(FME組)接受資訊與支持照護。
　　
　　在LPA組中，教導研究對象進行足以引起沉重有力呼吸強度的LPA，但未預先交談，適合的中等強度體能活動包括登階、園藝與散步，目標是每週有5-7天各累積自我選擇的中等強度LPA至少30分鐘。
　　
　　84名研究對象中，共有73人(87%)完成12週的試驗，LPA組的平均每日步數增加約54%，LPA組的察覺功能不佳與疼痛顯著比FME組少(P值分別是P = .032 和P = .006)。這幾組在6分鐘走路測試表現(P = .067)、疲勞、憂鬱、身體質量指數、壓痛等方面並無差異。
　　
　　Fontaine博士表示，纖維肌痛症狀的本質、身體疼痛和疲勞，造成病患難以參與傳統運動，我們的結果顯示，LPA可以幫助他們至少比較有活動一點，而這似乎有助於他們改善症狀。
　　
　　研究限制包括，無法確認LPA組和傳統無治療控制組之間的比較；採用自我報告的結果；使用計步器來評估LPA，無法量化騎腳踏車或水中運動，此外，試驗中並未測量肌肉強度，排除了有其他共病症的患者。
　　
　　研究作者結論表示，原本因為FM而活動力有限的病患，整天累積30分鐘的LPA對於察覺生理功能和疼痛方面可以有臨床相關的改變，不過，LPA介入只能讓研究對象從久坐不動變成低度活動，重點在鼓勵FM病患在不影響忍受力下增加體能活動的期間， 增加適度且長期的活動。
　　
　　國家健康研究中心/國家關節炎與肌肉骨骼與皮膚疾病研究中心支持本研究，研究作者之一(Daniel J. Clauw醫師)擔任Pfizer、Lilly、Forest Laboratories、Cypress Biosciences、Pierre Fabre、UCB和Wyeth等的顧問，且接受Pfizer、Cypress Bioscience與Forest等提供的資金。
　　
　　Arthr Res Therapy. 線上發表於2010年3月29日。


Short Bursts of Physical Activity May Reduce Fibromyalgia Symptoms

By Laurie Barclay, MD
Medscape Medical News

March 31, 2010 — Short bursts of physical activity in a lifestyle physical activity (LPA) intervention may reduce fibromyalgia (FM) symptoms and improve physical function, according to the results of a randomized trial reported online in the March 29 issue of Arthritis Research Therapy.

"Fibromyalgia is estimated to occur in 2% of the U.S. general population, affecting about eight times more women than men," said lead author Kevin R. Fontaine, PhD, from Johns Hopkins University School of Medicine, in Baltimore, Maryland, in a news release. "Although exercise has been shown to be beneficial, the symptoms often create obstacles that deter many from exercising consistently enough to derive benefits."

The goal of this study was to assess the effects in 84 minimally active adults with FM of accumulating at least 30 minutes of self-selected LPA on perceived physical function, pain, fatigue, body mass index, depression, tenderness, and the 6-minute walk test. Participants were assigned to either LPA or a FM education control (FME) group receiving information and support.

In the LPA intervention, participants were taught to perform LPA intense enough to cause heavy breathing without preventing conversation. Suitable moderate-intensity physical activities included climbing stairs, gardening, and walking. The goal was to accumulate 30 minutes of self-selected moderate-intensity LPA at 5 to 7 days per week.

A total of 73 (87%) of the 84 participants completed the 12-week trial. Average daily steps in the LPA group increased by 54%. Perceived functional deficits and pain were significantly less in the LPA group vs the FME group (P = .032 and P = .006, respectively). The groups did not differ on 6-minute walk test performance (P = .067), fatigue, depression, body mass index, or tenderness.

"The nature of fibromyalgia's symptoms, the body pain and fatigue, make it hard for people with this malady to participate in traditional exercise," Dr. Fontaine said. "We've shown that LPA can help them to get at least a little more physically active, and that this seems to help improve their symptoms."

Limitations of this study include inability to determine how LPA compares with a traditional no-treatment control group; use of self-reported outcomes; and use of pedometers to assess LPA, which failed to quantify cycling or water exercise. In addition, muscle strength was not measured during the trial, and persons with other comorbid conditions were excluded.

"Accumulating 30 minutes of LPA throughout the day produces clinically relevant changes in perceived physical function and pain in previously minimally active adults with FM," the study authors conclude. "However, the LPA intervention only moved the participants from the sedentary to low physical activity category. This suggests that it is essential to encourage FM patients to increase the duration of their physical activity in ways that do not compromise their ability to sustain the increased level of activity over the intermediate- and long-term."

The National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases supported this study. One of the study authors (Daniel J. Clauw, MD) has acted as a consultant for Pfizer, Lilly, Forest Laboratories, Cypress Biosciences, Pierre Fabre, UCB, and Wyeth, and has received grant support from Pfizer, Cypress Bioscience, and Forest.

Arthr Res Therapy. Published online March 29, 2010.