临床与病理杂志2025，Vol.45Issue(9)：1169-1179,11.DOI:10.11817/j.issn.2095-6959.2025.250299
体力活动水平在老年慢性阻塞性肺疾病患者运动自我效能和平衡功能间的中介效应
Mediating effect of physical activity level on the relationship between exercise self-efficacy and balance function in older patients with chronic obstructive pulmonary disease
摘要
Abstract
Objective:Chronic obstructive pulmonary disease(COPD)is highly prevalent among older adults.In addition to respiratory symptoms,patients often experience severe complications,among which impaired balance function and the resulting increased risk of falls are key factors affecting quality of life and clinical prognosis.This study aims to examine the status of balance function,physical activity level,and exercise self-efficacy in older patients with COPD;analyze the relationships among these variables;and explore the mediating effect of physical activity level on the association between exercise self-efficacy and balance function. Methods:A cross-sectional study was conducted among 301 older patients with COPD who visited the First Affiliated Hospital of Chengdu Medical College from October 2023 to August 2024.The Brief-Balance Evaluation System Test(Brief-BESTest),the Physical Activity Scale for the Elderly(PASE),and the Exercise Self-Regulatory Efficacy Scale(EX-SRES)were used to assess balance function,physical activity level,and exercise self-regulatory efficacy,respectively.Differences in Brief-BESTest scores among patients with different demographic characteristics were compared.Pearson correlation analysis was employed to explore correlations among balance function,physical activity level,and exercise self-efficacy.The mediating effect of physical activity level on the relationship between exercise self-efficacy and balance function was analyzed using Model 4 of the PROCESS macro,with 5 000 bootstrap samples to test the significance of the mediating effect. Results:Significant differences in balance function scores were observed across groups stratified by gender,age,marital status,monthly household income,smoking history,dyspnea severity,pulmonary function grade,number of falls in the past year,frequency of COPD acute exacerbations in the past year,and receipt of long-term oxygen therapy(all P<0.05).The Brief-BESTest,PASE,and EX-SRES scores of COPD patients were 16.72±4.02,99.00±55.53,and 89.11±23.93,respectively.Pearson correlation analysis indicated that physical activity level was positively correlated with exercise self-efficacy(r=0.604,P<0.01)and balance function(r=0.512,P<0.01),and exercise self-efficacy was positively correlated with balance function(r=0.490,P<0.01).After adjusting for confounders,mediation analysis showed that physical activity level partially mediated the relationship between exercise self-efficacy and balance function(β=0.022,P<0.001),accounting for 30.6%of the total effect. Conclusion:Older patients with COPD generally exhibit reduced balance function,insufficient physical activity,and low exercise self-efficacy,and the 3 factors are closely interrelated.Physical activity level plays a partial mediating role in the relationship between exercise self-efficacy and balance function.Healthcare professionals should pay particular attention to older COPD patients with low exercise self-efficacy and inadequate physical activity levels.关键词
慢性阻塞性肺疾病/平衡功能/体力活动水平/运动自我效能/中介效应Key words
chronic obstructive pulmonary disease/balance function/physical activity level/exercise self-efficacy/mediating effect引用本文复制引用
YANG Naihui,YANG Li,WU Dingfen,QI Hong..体力活动水平在老年慢性阻塞性肺疾病患者运动自我效能和平衡功能间的中介效应[J].临床与病理杂志,2025,45(9):1169-1179,11.基金项目
四川养老与老年健康协同创新中心联合基金(YLKYYB2222).This work was supported by the Sichuan Collaborative Innovation Center for Aging Care and Geriatric Health Joint Fund,China(YLKYYB2222). （YLKYYB2222）
