抗阻训练重塑血管性认知障碍进程：一项随机对照试验研究方案。

Reshaping the path of vascular cognitive impairment with resistance training: a study protocol for a randomized controlled trial.

机构信息

Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada.

Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada.

出版信息

Trials. 2021 Mar 18;22(1):217. doi: 10.1186/s13063-021-05156-1.

DOI:10.1186/s13063-021-05156-1

PMID:33736706

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7971404/

Abstract

BACKGROUND

Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention.

METHODS

Eighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression.

DISCUSSION

The burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02669394 . Registered on February 1, 2016.

摘要

背景

皮质下缺血性血管性认知障碍（SIVCI）是最常见的血管性认知障碍形式。重要的是，由于其可改变的危险因素，如高血压、糖尿病和高胆固醇血症，SIVCI 被认为是老年人最可治疗的认知障碍形式。运动训练是一种很有前途的干预措施，可以延缓 SIVCI 的进展，因为它积极针对这些心血管代谢危险因素。尽管抗阻力训练对认知功能有明显的益处，并且有新的证据表明抗阻力训练可能会减缓白质高信号（WMHs）的进展，但针对 SIVCI 的研究主要集中在有氧运动的使用上。因此，本概念验证随机对照试验的主要目的是研究为期 12 个月、每周两次的渐进式抗阻力训练方案对 SIVCI 成人认知功能和 WMH 进展的疗效。我们还将评估干预的效率。

方法

将从大温哥华地区招募 88 名年龄在 55 岁以上、患有 SIVCI 的社区居民参加这项研究。SIVCI 将通过认知障碍（蒙特利尔认知评估<26）和使用计算机断层扫描或磁共振成像的脑小血管疾病来确定。参与者将被随机分配到每周两次的运动计划中，包括（1）渐进式抗阻力训练或（2）平衡和张力训练（即主动对照）。主要结果是使用阿尔茨海默病评估量表认知加项（ADAS-Cog-13 加额外的认知测试）测量的认知功能和 WMH 进展。