John Hopkins Bayview Medical Center, Baltimore, MD, USA.
Int J Geriatr Psychiatry. 2009 Jul;24(7):680-5. doi: 10.1002/gps.2175.
To determine the feasibility and efficacy of a home-based exercise intervention program to improve the functional performance of patients with Alzheimer's Disease (AD).
Twenty-seven home-dwelling patients with AD were randomized to either an exercise intervention program delivered by their caregivers or a home safety assessment control. Measures of functional performance (primary), cognition, neuropsychiatric symptoms, quality of life and caregiver burden (secondary) were obtained at baseline and at 6 and 12 weeks following randomization. For each outcome measure, intent-to-treat analyses using linear random effects models were performed. Feasibility and adverse events were also assessed.
Adherence to the exercise program was good. On the primary outcomes (functional performance) patients in the exercise group demonstrated a trend for improved performance on measures of hand function and lower extremity strength. On secondary outcome measures, trends toward worse depression and lower quality of life ratings were noted.
The physical exercise intervention developed for the study, delivered by caregivers to home-dwelling patients with AD, was feasible and was associated with a trend for improved functional performance in this group of frail patients. Given the limited efficacy to date of pharmacotherapies for AD, further study of exercise intervention, in a variety of care setting, is warranted.
确定基于家庭的运动干预方案改善阿尔茨海默病（AD）患者功能表现的可行性和疗效。
将 27 名居家 AD 患者随机分为由照顾者实施的运动干预组或家庭安全评估对照组。在随机分组后 6 周和 12 周时测量功能表现（主要结局）、认知、神经精神症状、生活质量和照顾者负担（次要结局）。对于每个结局指标，均采用线性随机效应模型进行意向治疗分析。还评估了可行性和不良事件。
运动方案的依从性良好。在主要结局（功能表现）方面，运动组患者在手功能和下肢力量测量方面表现出改善的趋势。在次要结局指标方面，抑郁和生活质量评分变差的趋势明显。
为该研究开发的、由照顾者为居家 AD 患者实施的身体运动干预措施是可行的，并与该组脆弱患者的功能表现改善趋势相关。鉴于目前针对 AD 的药物治疗疗效有限，需要在各种护理环境中进一步研究运动干预措施。
