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运动训练对老年痴呆症患者的治疗效果:一项随机对照试验。

Therapeutic Effects of Exercise Training on Elderly Patients With Dementia: A Randomized Controlled Trial.

机构信息

Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan.

Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

Arch Phys Med Rehabil. 2020 May;101(5):762-769. doi: 10.1016/j.apmr.2020.01.012. Epub 2020 Feb 19.

Abstract

OBJECTIVE

To investigate whether strength or aerobic training can offer significantly more benefits with regarding the activities of daily living of elderly patients with dementia as well as to determine the effects of exercise on cognition, depression, and biochemical markers.

DESIGN

Single-blind randomized controlled trial.

SETTING

A nursing home for veterans.

PARTICIPANTS

A volunteer sample of participants (N=80) whose scores on the Mini-Mental State Examination were between 15 and 26 were included. Because of cardiopulmonary or orthopedic conditions that prohibit exercise training, along with any cognitive problems that may impede answering the contents of our questionnaires, 11 participants were excluded. During the exercise training period, 8 participants voluntarily dropped out of the study.

INTERVENTIONS

The participants were randomly assigned to perform either strength or aerobic training for a total of 4 weeks.

MAIN OUTCOME MEASURES

The main outcome measure was the Barthel Index. Other outcome measures included the Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale, plasma monocyte chemotactic protein-1 levels, insulin-like growth factor-1 levels, and serum brain-derived neurotrophic factor levels.

RESULTS

After completion of the program, we discovered a significant improvement in the patients' Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in the strength-training group. For the patients who had received aerobic training, their serum brain-derived neurotrophic factor also improved significantly. However, the degree of improvement regarding these outcome measures did not achieve significant statistical difference between the 2 groups.

CONCLUSIONS

Through our study, an intensive 4-week exercise program, whether it be strength or aerobic training, is evidenced to bring significant benefits to elderly patients with dementia, while the serum brain-derived neurotrophic factor was additionally improved through aerobic training.

摘要

目的

探讨力量训练或有氧训练对老年痴呆症患者日常生活活动能力的益处是否更大,并确定运动对认知、抑郁和生化标志物的影响。

设计

单盲随机对照试验。

地点

退伍军人疗养院。

参与者

纳入了一项志愿者样本参与者(N=80),他们的简易精神状态检查分数在 15 到 26 之间。由于心肺或骨科状况禁止进行运动训练,以及任何可能妨碍回答我们问卷内容的认知问题,有 11 名参与者被排除在外。在运动训练期间,有 8 名参与者自愿退出了研究。

干预

参与者被随机分配进行力量或有氧训练,总共进行 4 周。

主要观察指标

主要观察指标是巴氏指数。其他观察指标包括简易精神状态检查、蒙特利尔认知评估、老年抑郁量表、血浆单核细胞趋化蛋白-1 水平、胰岛素样生长因子-1 水平和血清脑源性神经营养因子水平。

结果

在完成方案后,我们发现力量训练组患者的巴氏指数、简易精神状态检查、蒙特利尔认知评估和血浆单核细胞趋化蛋白-1 水平显著改善。接受有氧训练的患者的血清脑源性神经营养因子也显著改善。然而,两组之间这些观察指标的改善程度并未达到显著统计学差异。

结论

通过我们的研究,一项为期 4 周的强化运动计划,无论是力量训练还是有氧训练,都被证明对老年痴呆症患者有显著益处,而有氧训练还可额外改善血清脑源性神经营养因子。

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