解放军医学院学报2026，Vol.47Issue(3)：252-260,268,10.DOI:10.12435/j.issn.2095-5227.25100802
体力活动强度与中轴型脊柱关节炎患者病情、心理健康及生活质量的关联分析
Association of physical activity intensity with disease status,mental health and quality of life in patients with axial spondyloarthritis
杨世伟 1李坤鹏 2朱剑 2黄烽 2冀肖健 2胡立冬 2王一雯 2张奕楠 1曾露露 1胡嘉文 1张家鑫 1李涛3
作者信息
- 1. 解放军医学院,北京 100853||解放军总医院第一医学中心风湿免疫科,北京 100853
- 2. 解放军总医院第一医学中心风湿免疫科,北京 100853
- 3. 解放军总医院医学创新研究部,北京 100853
- 折叠
摘要
Abstract
Background Axial spondyloarthritis(axSpA)is characterized primarily by low back pain and restricted spinal mobility,affecting quality of life severely.Physical activity(PA)serves as one of the key interventions for improving disease outcomes.Objective To analyze the association between objectively quantified PA intensity and mental health,quality of life,and overall disease status,and clarify the clinical significance of moderate-to-vigorous physical activity(MVPA).Methods This cross-sectional study enrolled axSpA patients attending the outpatient and inpatient departments of Rheumatology and Immunology at the First Medical Center of PLA General Hospital from August 2024 to March 2025.PA was monitored for 7 days using the Huawei Band 7.Participants were stratified into"guideline-met"group(≥150 min/week of MVPA)and"guideline-unmet"group(＜150 min/week).Mental health was assessed using the self-rating depression scale(SDS),self-rating anxiety scale(SAS),multidimensional assessment of fatigue(MAF),and Pittsburgh sleep quality index(PSQI).Quality of life was evaluated using the Assessment of Spondyloarthropathy International Society Health Index(ASAS-HI).Disease status was assessed using the ankylosing spondylitis disease activity score(ASDAS),Bath ankylosing spondylitis disease activity index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),and Bath ankylosing spondylitis metrology index(BASMI).Logistic regression analysis was used to examine the associations between PA and ASDAS,and between PA and ASAS-HI,respectively.A structural equation model(SEM)was constructed with weekly MVPA volume as the independent variable,ASDAS and BASFI as mediators,and SDS and SAS as dependent variables,adjusting for age,sex,and body mass index(BMI),so as to explore the mediating effects of ASDAS and BASFI on the association between PA and mental health.Results A total of 166 axSpA patients were included,comprising 133 males(80.1%)with a median age of 35(IQR:29-40)years.The median daily MVPA was 19.4(IQR:11.6-30.2)min.Totally 75 patients(45.2%)met the PA guidelines,while 91(54.8%)did not.Meeting PA guidelines was significantly associated with lower scores on SAS(P＜0.001),SDS(P＜0.001),MAF(P＜0.001),PSQI(P=0.019),ASAS-HI(P＜0.001),ASDAS(P=0.02),BASDAI(P=0.002),BASFI(P＜0.001),and BASMI(P=0.015).Multivariable logistic regression analysis revealed that MVPA was independently associated with disease activity scores(OR=0.96,P=0.002)and quality of life(OR=0.97,P=0.021).The revised structural equation model showed a good fit.Mediation analysis showed that the total mediating effect of ASDAS accounted for 35.4%(SAS)and 35.8%(SDS)of the total effect between MVPA volume and mental states,while the total mediating effect of BASFI accounted for 33.2%(SAS)and 32.8%(SDS).Conclusion AxSpA patients achieve the recommended MVPA level(≥150 min/week)exhibit a healthier comprehensive mental status,higher quality of life,lower disease activity,and better functional status.Exercise prescriptions should be based on moderate-intensity physical activity(MPA)and supplemented by vigorous-intensity physical activity(VPA).关键词
中轴型脊柱关节炎/中高强度体力活动/心理健康/生活质量/疾病活动度/功能指数/结构方程模型/横断面研究Key words
axial spondyloarthritis/moderate-to-vigorous physical activity/mental health/quality of life/disease activity/functional index/equation structural model/cross-sectional study分类
医药卫生引用本文复制引用
杨世伟,李坤鹏,朱剑,黄烽,冀肖健,胡立冬,王一雯,张奕楠,曾露露,胡嘉文,张家鑫,李涛..体力活动强度与中轴型脊柱关节炎患者病情、心理健康及生活质量的关联分析[J].解放军医学院学报,2026,47(3):252-260,268,10.
