Nakamura-Taira Nanako, Horikawa Naoshi, Oka Fumie, Igarashi Yuri, Kobayashi Sayaka, Kato Shingo, Enomoto Takashi, Kimura Hitomi, Watanabe Yukari, Kumada Toru, Matsuyama Kimihiko, Matsuoka Naoki, Yoshimasu Haruo
Department of Psychology, Faculty of Letters, Chuo University, Tokyo, Japan.
Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Health Psychol Behav Med. 2021 Aug 30;9(1):741-760. doi: 10.1080/21642850.2021.1966302. eCollection 2021.
This study aimed to examine the effects of a six-month group-based low-intensity resistance exercise program on depression and the cognitive function of hemodialysis patients.
We conducted a quasi-cluster randomized, open-label controlled study from October 2017 to December 2018. Forty-two patients undergoing hemodialysis completed the trial over six months; half participated in the resistance exercise group ( = 21, mean = 74.90 years of age, = 2.23, 66.67% female) and the other half were in a stretching control group ( = 21, mean = 72.57 years of age, SD = 2.26, 28.57% female). Depressive symptoms and cognitive function were the primary outcome measures. Behavioral and psychological problems associated with cognitive decline (NPI-Q), subjective insomnia, and exercise self-efficacy were secondary outcomes. Outcomes were measured at baseline, three-month (mid-intervention), six-month (end of intervention), and 12-month (six months after intervention) follow-ups. Linear mixed model analyses were used to determine short-term (immediately after intervention) and long-term (six months after intervention) effects.
In depression, cognitive function, and the NPI-Q, there were no significant effects. In subjective insomnia, a short-term group-by-time interaction in the intervention group compared to the control group was found (ES = .43). However, the effect had disappeared by the 12-month follow-up. In exercise self-efficacy, short- and long-term group-by-time interactions were found. A significant short-term increase in the resistance exercise and a significant decrease in the stretching control was observed (ES = -.83). However, the effect was weakened in the long term (ES = -.38).
The results showed that low-intensity group resistance exercise would reduce subjective insomnia and improve exercise self-efficacy, but the effect was not maintained by six months after the program. This study was registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029372). UMIN Japan identifier: UMIN000029372.
本研究旨在探讨为期六个月的基于小组的低强度抗阻运动计划对血液透析患者抑郁及认知功能的影响。
我们于2017年10月至2018年12月进行了一项半集群随机、开放标签对照研究。42例接受血液透析的患者在六个月内完成了试验；其中一半参与抗阻运动组（n = 21，平均年龄 = 74.90岁，标准差 = 2.23，66.67%为女性），另一半为伸展对照组（n = 21，平均年龄 = 72.57岁，标准差 = 2.26，28.57%为女性）。抑郁症状和认知功能是主要结局指标。与认知功能下降相关的行为和心理问题（神经精神症状问卷简表，NPI-Q）、主观失眠和运动自我效能感是次要结局指标。在基线、三个月（干预中期）、六个月（干预结束时）和12个月（干预后六个月）随访时测量结局指标。采用线性混合模型分析来确定短期（干预后立即）和长期（干预后六个月）效应。
在抑郁、认知功能和NPI-Q方面，未发现显著影响。在主观失眠方面，与对照组相比，干预组发现了短期的组×时间交互作用（效应量 = 0.43）。然而，到12个月随访时该效应已消失。在运动自我效能感方面，发现了短期和长期的组×时间交互作用。观察到抗阻运动组有显著的短期增加，伸展对照组有显著下降（效应量 = -0.83）。然而，长期来看该效应减弱（效应量 = -0.38）。
结果表明，低强度小组抗阻运动可减轻主观失眠并提高运动自我效能感，但该效应在计划结束六个月后未持续存在。本研究已在大学医院医学信息网络临床试验注册中心注册（UMIN000029372）。日本UMIN标识符：UMIN000029372。
