阿尔茨海默病的功能依赖性和照料者负担：一项关于运动干预益处的对照试验。

Functional dependence and caregiver burden in Alzheimer's disease: a controlled trial on the benefits of motor intervention.

机构信息

Department of Physiotherapy, University of Araras-SP, Araras, Brazil.

出版信息

Psychogeriatrics. 2012 Sep;12(3):186-92. doi: 10.1111/j.1479-8301.2012.00407.x.

DOI:10.1111/j.1479-8301.2012.00407.x

PMID:22994617

Abstract

BACKGROUND

Cognitive decline has a negative impact on functional activities in Alzheimer's disease. Investigating the effects of motor intervention with the intent to reduce the decline in functionality is an expected target for patients and caregivers. The aim of this study was to verify if a 6-month motor intervention programme promoted functionality in Alzheimer's patients and attenuated caregivers' burden.

METHODS

The sample comprised 32 community patients with Alzheimer's disease and their 32 respective caregivers. Patients were divided into two groups: 16 participated in the motor intervention programme and 16 controls. Subjects performed 60 minutes of exercises, three times per week during the 6-month period, to improve flexibility, strength, agility and balance. Caregivers followed the procedures with their patients during this period. Functionality was evaluated by the Berg Functional Balance Scale and the Functional Independence Measure. Caregivers completed the Neuropsychiatric Inventory Caregiver Distress Scale and the Zarit Carer Burden Scale. Two-way ANOVA was used to verify the interaction between time (pre- and post-intervention) and the motor intervention program.

RESULTS

While patients in the motor programme preserved their functionality, as assessed by the Functional Independence Measure, the controls suffered a relative decline (motor intervention group: from 109.6 to 108.4 vs controls: from 99.5 to 71.6; P= 0.01). Patients from motor intervention also had better scores than the controls on functional balance assessed by Berg scale (F: 22.2; P= 0.001). As assessed by the Neuropsychiatric Inventory and Zarit scale, burden was reduced among caregivers whose patients participated in the motor intervention programme compared with caregivers whose patients did not participate in this programme (Neuropsychiatric Inventory, caregiver's part: F: 9.37; P= 0.01; Zarit: F: 11.28; P= 0.01).

CONCLUSION

Patients from the motor intervention group showed reduced functional decline compared to the controls, and there was an associated decrease in caregivers' burden.

摘要

背景

认知能力下降对阿尔茨海默病患者的功能活动有负面影响。研究旨在通过运动干预来减少功能下降的效果，这是患者和照护者的预期目标。本研究旨在验证 6 个月的运动干预方案是否能提高阿尔茨海默病患者的功能，并减轻照护者的负担。

方法

该样本包括 32 名社区阿尔茨海默病患者及其 32 名相应的照护者。患者分为两组：16 名参加运动干预方案，16 名对照组。在 6 个月期间，患者每周进行 3 次，每次 60 分钟的运动，以提高灵活性、力量、敏捷性和平衡能力。在此期间，照护者与患者一起进行这些程序。通过 Berg 功能平衡量表和功能独立性测量来评估功能。照护者完成神经精神疾病护理者负担量表和 Zarit 照护者负担量表。使用双向方差分析来验证时间（干预前后）和运动干预方案之间的相互作用。

结果

虽然运动方案组患者的功能独立性测量结果保持不变，但对照组患者的功能相对下降（运动方案组：从 109.6 降至 108.4，对照组：从 99.5 降至 71.6；P=0.01）。运动方案组患者在 Berg 量表评估的功能平衡方面的得分也优于对照组（F：22.2；P=0.001）。根据神经精神疾病护理者负担量表和 Zarit 量表评估，与未参加运动干预方案的患者的照护者相比，参加运动干预方案的患者的照护者的负担有所减轻（神经精神疾病护理者负担量表，护理者部分：F：9.37；P=0.01；Zarit：F：11.28；P=0.01）。