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一项关于运动对多发性硬化症患者认知和移动能力影响的对照临床试验。

A Controlled Clinical Trial on the Effects of Exercise on Cognition and Mobility in Adults With Multiple Sclerosis.

机构信息

From the Faculty of Medicine, Universidade Federal University de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil (LAF, GC); Multiple Sclerosis Outpatient Clinic, Hospital Complex, Campo Grande, Brazil (PRS); Institute of Health, Universidade Federal University de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil (DSS, GC); and Department of Physiotherapy at the Universidade Estadual de Londrina, Londrina, Brazil (SMS).

出版信息

Am J Phys Med Rehabil. 2019 Feb;98(2):97-102. doi: 10.1097/PHM.0000000000000987.

Abstract

OBJECTIVE

The aim of the study was to investigate the effects of a 6-mo exercise program on cognition and mobility in participants with multiple sclerosis.

DESIGN

This is a prospective, single-blind, controlled clinical trial.

SETTING

A community rehabilitation program within a large metropolitan health service.

PARTICIPANTS

Twenty-eight patients with multiple sclerosis were referred for outpatient rehabilitation.

INTERVENTIONS

Participants were allocated to one of two groups and undertook a cognitive-motor exercise program or monitoring (control group).

MAIN OUTCOME MEASURES

Cognition and mobility were the main outcome measures. Cognition was evaluated using the Mini-Mental State Examination and the Frontal Assessment Battery. Mobility was assessed with the Timed Get Up and Go test, applied with and without dual task distractors.

RESULTS

The findings showed benefits provided by exercise on cognition and mobility. Differently, participants of the control group did not have significant changes in cognition scores after 6 mos of follow-up and had a worse performance in mobility tests.

CONCLUSION

Six months of exercise provided benefits to cognition and mobility in adults with multiple sclerosis. This trial was registered prospectively with the Brazilian Clinical Trials Register, ID: RBR-9gh4km (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-9gh4km).

TO CLAIM CME CREDITS

Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Recognize the physical and cognitive decline in multiple sclerosis; (2) Identify the importance of exercise on cognition and mobility in patients with multiple sclerosis; and (3) Appreciate the potential benefit of dual tasking in the rehabilitation of individuals with multiple sclerosis.Level: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

摘要

目的

本研究旨在探讨 6 个月运动方案对多发性硬化症患者认知和移动能力的影响。

设计

这是一项前瞻性、单盲、对照临床试验。

地点

大型都市卫生服务中的社区康复计划。

参与者

28 名多发性硬化症患者被转介接受门诊康复治疗。

干预措施

参与者被分配到两组之一,并进行认知-运动锻炼计划或监测(对照组)。

主要观察指标

认知和移动能力是主要观察指标。认知采用简易精神状态检查和额叶评估电池进行评估。移动能力通过计时起立和行走测试进行评估,应用和不应用双重任务干扰。

结果

研究结果表明,运动对认知和移动能力有获益。相比之下,对照组参与者在 6 个月随访后认知评分没有显著变化,并且在移动测试中表现更差。

结论

6 个月的运动为多发性硬化症成人的认知和移动能力提供了益处。本试验在巴西临床试验注册中心进行了前瞻性注册,注册号:RBR-9gh4km(http://www.ensaiosclinicos.gov.br/rg/?q=RBR-9gh4km)。

索取 CME 学分:在线完成自我评估活动和评估,网址为 http://www.physiatry.org/JournalCME

CME 目标:完成本文后,读者应能够:(1)认识到多发性硬化症的身体和认知下降;(2)认识到运动对多发性硬化症患者认知和移动能力的重要性;(3)欣赏双重任务在多发性硬化症患者康复中的潜在益处。

级别

高级

认可

学术物理治疗医师协会经继续医学教育认可委员会认可,可为医生提供继续医学教育。学术物理治疗医师协会将这项基于期刊的 CME 活动指定为最多 1.0 个 AMA PRA 类别 1 学分(TM)。医生只能要求与其参与活动的程度相称的学分。

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