Farran Carol J, Etkin Caryn D, Eisenstein Amy, Paun Olimpia, Rajan Kumar B, Sweet Cynthia M Castro, McCann Judith J, Barnes Lisa L, Shah Raj C, Evans Denis A
Adult Health and Gerontological Nursing, Rush University Medical Center, 600 South Paulina, AAC Suite 1080, Chicago, IL, 60612, USA.
American Joint Replacement Registry, 9400 West Higgins Road, Rosemont, IL, 60018, USA.
J Alzheimers Dis Parkinsonism. 2016 Aug;6(4). doi: 10.4172/2161-0460.1000253. Epub 2016 Aug 9.
Alzheimer's disease and related dementias (ADRD) affect more than five million Americans and their family caregivers. Caregiving creates challenges, may contribute to decreased caregiver health and is associated with $9.7 billion of caregiver health care costs. The purpose of this 12 month randomized clinical trial (RCT) was to examine if the Enhancing Physical Activity Intervention (EPAI), a moderate to vigorous physical activity (MVPA) treatment group, versus the Caregiver Skill Building Intervention (CSBI) control, would have greater: (1) MVPA adherence; and (2) physical function.
Caregivers were randomly assigned to EPAI or CSBI (N=211). MVPA was assessed using a self-report measure; and physical function was objectively assessed using two measures. Intention-to-treat analyses used descriptive, categorical and generalized estimating equations (GEE), with an exchangeable working correlation matrix and a log link, to examine main effects and interactions in change of MVPA and physical function over time.
At 12 months, EPAI significantly increased MVPA (=<0.001) and number of steps (=< .01); maintained stable caregiving hours and use of formal services; while CSBI increased hours of caregiving (=<0.001) and used more formal services (=<0.02). Qualitative physical function data indicated that approximately 50% of caregivers had difficulties completing physical function tests.
The EPAI had a stronger 12 month effect on caregiver MVPA and physical function, as well as maintaining stability of caregiving hours and formal service use; while CSBI increased caregiving hours and use of formal services. A study limitation included greater EPAI versus CSBI attrition. Future directions are proposed for dementia family caregiver physical activity research.
阿尔茨海默病及相关痴呆症（ADRD）影响着超过500万美国人及其家庭护理人员。护理工作带来了诸多挑战，可能导致护理人员健康状况下降，且与97亿美元的护理人员医疗保健成本相关。这项为期12个月的随机临床试验（RCT）的目的是检验强化身体活动干预（EPAI，即中度至剧烈身体活动（MVPA）治疗组）与护理人员技能培养干预（CSBI，对照组）相比，是否在以下方面有更大改善：（1）MVPA依从性；（2）身体功能。
将护理人员随机分配至EPAI组或CSBI组（N = 211）。使用自我报告测量法评估MVPA；使用两种测量方法客观评估身体功能。意向性分析采用描述性、分类和广义估计方程（GEE），以及可交换工作相关矩阵和对数链接，以检验MVPA和身体功能随时间变化的主要效应和相互作用。
在12个月时，EPAI显著增加了MVPA（P <= 0.001）和步数（P <= 0.01）；维持了稳定的护理时长和正式服务使用情况；而CSBI增加了护理时长（P <= 0.001）并使用了更多正式服务（P <= 0.02）。定性身体功能数据表明，约50%的护理人员在完成身体功能测试时存在困难。
EPAI在12个月时对护理人员MVPA和身体功能的影响更强，同时维持了护理时长和正式服务使用的稳定性；而CSBI增加了护理时长和正式服务的使用。研究的一个局限性是EPAI组的损耗率高于CSBI组。为痴呆症家庭护理人员身体活动研究提出了未来方向。
