Parc Sanitari Pere Virgili, Carrer d'Esteve Terradas 30, 08023, Barcelona, Spain.
REFiT Barcelona Research Group, Vall d'Hebrón Institute of Research (VHIR), Barcelona, Spain.
Eur Geriatr Med. 2020 Feb;11(1):83-93. doi: 10.1007/s41999-020-00290-6. Epub 2020 Feb 17.
This article aims to analyze the intersections between delirium, physical exercise and rehabilitation, to better understand their interrelation and to visualize future lines of research.
In this narrative review, after an overview of brain neurophysiology and function, as common substrates to understand the relationship between delirium and physical function, we explore the scientific evidence in: (1) physical dysfunction as a risk factor for delirium; (2) physical dysfunction as a symptom of delirium and (3) functional consequences related to delirium. Later, we analyze the physical therapy as one of the main strategies in multicomponent interventions to prevent delirium, by examining intervention studies including rehabilitation, which have shown to be effective in managing delirium. Finally, we analyze how frailty, delirium and physical exercise interact with each other.
This review confirms the close relationship between delirium and physical dysfunction; therefore, it is not surprising that physical exercise is widely used in delirium preventive strategies. Although delirium is catalogued as a neurocognitive disorder, scientific evidence shows that it is also a motor disorder, which is to be expected, since a vast body of literature already supports an interaction between motor and cognitive function.
The motor component of delirium should be taken into account when designing interventions or strategies to address delirium. These interventions may have a special importance in frail older adults.
本文旨在分析谵妄、身体锻炼和康复之间的交叉点，以更好地理解它们之间的相互关系，并展望未来的研究方向。
在这篇叙述性综述中，在概述了大脑神经生理学和功能作为理解谵妄和身体功能之间关系的共同基础之后，我们探讨了以下方面的科学证据：（1）身体功能障碍是谵妄的危险因素；（2）身体功能障碍是谵妄的症状之一；（3）与谵妄相关的功能后果。随后，我们分析了物理疗法作为多成分干预措施预防谵妄的主要策略之一，通过检查包括康复在内的干预研究，这些研究表明物理疗法在管理谵妄方面是有效的。最后，我们分析了衰弱、谵妄和身体锻炼之间的相互作用。
本综述证实了谵妄与身体功能障碍之间的密切关系；因此，身体锻炼被广泛用于预防谵妄的策略中也就不足为奇了。尽管谵妄被归类为神经认知障碍，但科学证据表明它也是一种运动障碍，这是可以预料的，因为大量文献已经支持运动和认知功能之间的相互作用。
在设计干预措施或策略来解决谵妄时，应考虑到谵妄的运动成分。这些干预措施在体弱的老年人中可能具有特殊的重要性。
