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一项关于抗阻训练和有氧运动与平衡和强度训练对轻度认知障碍老年人的经济学评价。

An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment.

机构信息

Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, Canada.

出版信息

PLoS One. 2013 May 14;8(5):e63031. doi: 10.1371/journal.pone.0063031. Print 2013.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) represents a critical window to intervene against dementia. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown. Thus, we estimated the incremental cost-effectiveness of resistance training or aerobic training compared with balance and tone exercises in terms of changes in executive cognitive function among senior women with probable MCI.

METHODS

Economic evaluation conducted concurrently with a six-month three arm randomized controlled trial including eighty-six community dwelling women aged 70 to 80 years living in Vancouver, Canada. Participants received twice-weekly resistance training (n = 28), twice weekly aerobic training (n = 30) or twice-weekly balance and tone (control group) classes (n = 28) for 6 months. The primary outcome measure of the Exercise for Cognition and Everyday Living (EXCEL) study assessed executive cognitive function, a test of selective attention and conflict resolution (i.e., Stroop Test). We collected healthcare resource utilization costs over six months.

RESULTS

Based on the bootstrapped estimates from our base case analysis, we found that both the aerobic training and resistance training interventions were less costly than twice weekly balance and tone classes. Compared with the balance and tone group, the resistance-training group had significantly improved performance on the Stroop Test (p = 0.04).

CONCLUSIONS

Resistance training and aerobic training result in health care cost saving and are more effective than balance and tone classes after only 6 months of intervention. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00958867.

摘要

背景

轻度认知障碍 (MCI) 代表了一个对抗痴呆症的关键窗口期。运动训练是一种很有前途的干预策略,但这种类型的训练的效率(即成本与效益的关系)尚不清楚。因此,我们评估了与平衡和力量训练相比,阻力训练或有氧运动训练对可能患有 MCI 的老年女性执行认知功能变化的增量成本效益。

方法

经济评估与一项为期 6 个月的三臂随机对照试验同时进行,该试验纳入了 86 名居住在加拿大温哥华的 70 至 80 岁的社区女性。参与者每周接受两次阻力训练(n = 28)、两次每周有氧运动训练(n = 30)或每周两次平衡和力量训练(对照组,n = 28),共 6 个月。EXCEL 研究的主要结局指标评估了执行认知功能,即选择性注意力和冲突解决测试(即斯特鲁普测试)。我们收集了 6 个月内的医疗资源利用成本。

结果

基于我们基本案例分析的引导估计,我们发现有氧运动训练和阻力训练干预均比每周两次的平衡和力量训练课程成本更低。与平衡和力量训练组相比,阻力训练组在斯特鲁普测试中的表现有显著改善(p = 0.04)。

结论

阻力训练和有氧运动训练可节省医疗保健费用,并且在干预仅 6 个月后比平衡和力量训练课程更有效。阻力训练是改变 MCI 老年人认知能力下降轨迹的一种很有前途的策略。

试验注册

ClinicalTrials.gov NCT00958867。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b245/3653911/a527120bae44/pone.0063031.g001.jpg

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