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Background
Health-related and disease-specific quality of life (HRQoL) has been increasingly valued as relevant clinical parameter in cystic fibrosis (CF) clinical care and clinical trials. HRQoL measures should assess – among other domains – daily functioning from a patient’s perspective. However, validation studies for the most frequently used HRQoL questionnaire in CF, the Cystic Fibrosis Questionnaire (CFQ), have not included measures of physical activity or fitness. The objective of this study was, therefore, to determine the cross-sectional and longitudinal relationships between HRQoL, physical activity and fitness in patients with CF.
Methods
Baseline (n = 76) and 6-month follow-up data (n = 70) from patients with CF (age ≥12 years, FEV1 ≥35%) were analysed. Patients participated in two multi-centre exercise intervention studies with identical assessment methodology. Outcome variables included HRQoL (German revised multi-dimensional disease-specific CFQ (CFQ-R)), body composition, pulmonary function, physical activity, short-term muscle power, and aerobic fitness by peak oxygen uptake and aerobic power.
Results
Peak oxygen uptake was positively related to 7 of 13 HRQoL scales cross-sectionally (r = 0.30-0.46). Muscle power (r = 0.25-0.32) and peak aerobic power (r = 0.24-0.35) were positively related to 4 scales each, and reported physical activity to 1 scale (r = 0.29). Changes in HRQoL-scores were directly and significantly related to changes in reported activity (r = 0.35-0.39), peak aerobic power (r = 0.31-0.34), and peak oxygen uptake (r = 0.26-0.37) in 3 scales each. Established associates of HRQoL such as FEV1 or body mass index correlated positively with fewer scales (all 0.24 < r < 0.55).
Conclusions
HRQoL was associated with physical fitness, especially aerobic fitness, and to a lesser extent with reported physical activity. These findings underline the importance of physical fitness for HRQoL in CF and provide an additional rationale for exercise testing in this population.
Körperliche Aktivität ist ein wichtiges Element im Leben von Patienten mit Cystischer Fibrose. Die körperliche Fitness gilt zur Zeit als einer der besten Prädiktoren für die Langzeit-Mortalität bei Patienten mit CF. Bisherige Studien führten ausschließlich überwachtes Training durch. Ziel dieser Arbeit war es zu überprüfen, ob ein unüberwachtes regelmäßiges körperliches Heimtraining bei Mukoviszidosepatienten über 6 Monate durchführbar ist und eine Verbesserung der körperlichen Leistungsfähigkeit ermöglicht. Es wurden 48 Patienten in Trainingsgruppe (n=23) und Kontrollgruppe (n=25) randomisiert. Die Untersuchungen ergaben im Verlauf eine signifikante Verbesserung der maximalen Sauerstoffaufnahme (VO2 max;p=0.0017) und der maximalen Leistungsfähigkeit (W:p=0.0293) bei der Trainingsgruppe im Vergleich zur Kontrollgruppe. Es wurde nachgewiesen, dass unüberwachtes körperliches Training bei CF-Patienten einen Leistungszuwachs bringt und damit Konsequenzen für ihre Lebensqualität und Lebenserwartung hat.