记忆障碍患者及其照护者的对偶小组练习：通过锻炼预防独立性丧失（PLIÉ）随机试验的混合方法研究结果。
Dyadic Group Exercises for Persons with Memory Deficits and Care Partners: Mixed-Method Findings from the Paired Preventing Loss of Independence through Exercise (PLIÉ) Randomized Trial.
机构信息
University of California San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA.
University of California San Francisco, Osher Center for Integrative Medicine, San Francisco, CA, USA.
出版信息
J Alzheimers Dis. 2020;78(4):1689-1706. doi: 10.3233/JAD-200713.
BACKGROUND
Non-pharmacological therapies for persons with dementia (PWD) are needed.
OBJECTIVE
To develop and test the Paired Preventing Loss of Independence through Exercise (PLIÉ) program, an integrative group movement program for PWD and care partners (CPs).
METHODS
Participants were randomized to immediate or delayed start to Paired PLIÉ in community-based classes (1 hour, 2 days/week, 12 weeks, 3 home visits). Co-primary outcomes included standard measures of cognition, physical function,and quality of life (PWD) and caregiver burden (CPs) assessed by blinded assessors, analyzed using linear mixed models to calculate effect sizes for outcome changes during Paired PLIÉ, controlling for randomization group. Anonymous satisfaction surveys included satisfaction ratings and thematic analysis of open-ended responses.
RESULTS
Thirty dyads enrolled, 24 (80%) completed. PWD (mean age 80; 55% female) experienced significant improvement in self-rated quality of life (Effect Size+0.23; p = 0.016) when participating in Paired PLIÉ, while CPs experienced a non-significant increase in burden (-0.23, p = 0.079). Changes in physical and cognitive function in PWD were not significant. All CPs returning the satisfaction survey (n = 20) reported being moderately-to-highly satisfied with the program. Thematic analyses identified physical (e.g., sit-to-stand, more energy), emotional (enjoyment), and social benefits (peer-to-peer interaction) for PWD and CPs; challenges were primarily related to getting to the in-person classes.
CONCLUSION
Paired PLIÉ is a promising integrative group movement program that warrants further study. It is feasible and may improve self-rated quality of life in PWD. Although CPs may experience increased burden due to logistical challenges, most reported high satisfaction and physical, emotional, and social benefits.
背景
需要为痴呆症患者（PWD）提供非药物治疗。
目的
开发和测试“通过运动成对预防独立性丧失（PLIÉ）”计划，这是一种针对 PWD 和护理伙伴（CPs）的综合团体运动计划。
方法
参与者随机分配到社区基础班中的立即开始或延迟开始的成对 PLIÉ（1 小时，每周 2 天，12 周，3 次家访）。主要结局指标包括由盲法评估者评估的认知、身体功能和生活质量（PWD）和照顾者负担（CPs）的标准测量，使用线性混合模型进行分析，以计算在 Paired PLIÉ 期间进行干预时的结果变化的效应大小，同时控制随机分组。匿名满意度调查包括满意度评分和对开放式回答的主题分析。
结果
30 对 dyad 入组，24 对（80%）完成。参与 Paired PLIÉ 的 PWD（平均年龄 80 岁；55%为女性）在自我报告的生活质量方面有显著改善（效应量+0.23；p=0.016），而 CPs 的负担则略有增加（-0.23，p=0.079）。PWD 的身体和认知功能变化不显著。所有返回满意度调查的 CPs（n=20）报告对该计划表示中度至高度满意。主题分析确定了 PWD 和 CPs 的身体（例如，从坐到站，更有活力）、情感（享受）和社会获益（同伴互动）；挑战主要与参加实地课程有关。
结论
Paired PLIÉ 是一种有前途的综合团体运动计划，值得进一步研究。它是可行的，可能会改善 PWD 的自我报告生活质量。尽管由于后勤挑战，CPs 的负担可能会增加，但大多数人报告了很高的满意度以及身体、情感和社会获益。
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