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针对耐药性癫痫患者进行适度心血管运动的随机对照试验。

Randomized controlled trial of moderate cardiovascular exercise for patients with drug-resistant epilepsy.

作者信息

Åkerlund Sara, Varkey Emma, Klecki Judith, Zelano Johan, Ben-Menachem Elinor

机构信息

Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Occupational and Physiotherapy, Gothenburg, Sweden; Department of Health and Rehabilitation/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg University, Sweden.

出版信息

Epilepsy Behav. 2021 Sep 30;124:108335. doi: 10.1016/j.yebeh.2021.108335.

Abstract

OBJECTIVE

The primary research question of this study was whether a moderate cardiovascular exercise program can reduce seizure frequency in patients with focal drug-resistant epilepsy (DRE). The hypothesis is that cardiovascular fitness will reduce seizure frequency in persons with epilepsy (PWE).

METHODS

Twenty-eight patients were randomized into two groups; exercise or relaxation. The exercise group were given an ergometric bicycle sent to their home to be used for 150 min/week, 30 min/day for 5 days a week for the study period of 6 months. Participants in the relaxation group were given audio muscular relaxation exercises to be performed for 20 min at least five times per week for the study period of 6 months. Seizure counts and exercise/relaxation sessions were registered daily in a written diary. Both groups received monthly motivational telephone calls. Seizures, anxiety, and depression symptom ratings (Hospital Anxiety and Depression Scale (HADS)), health status ratings (RAND-36), aerobic capacity (estimated VOmax), self-efficacy for exercise (SEE), level of physical activity, and adverse events were measured at the baseline and after the 6 months of intervention. CONSORT guidelines were followed.

RESULTS

Twenty-two patients completed the intervention. There were no significant changes in seizure frequency in either of the groups. Six months of moderate exercise did increase the level of physical activity and maximal oxygen uptake.

SIGNIFICANCE

Moderate exercise did not affect seizure frequency in this study. The patients in the exercise group did increase their estimated VO, which is an important indicator for health, without deterioration of seizure frequency. This was accomplished with only minimal support from a physiotherapist every month. To exercise at home at a moderate intensity level with regular support may therefore be an option for patients with epilepsy. The patients in the exercise group increased their level of physical activity significantly, which indicates that they were compliant to the treatment.

摘要

目的

本研究的主要研究问题是适度的心血管运动计划是否能降低局灶性耐药性癫痫(DRE)患者的癫痫发作频率。假设是心血管健康状况将降低癫痫患者(PWE)的癫痫发作频率。

方法

28名患者被随机分为两组;运动组或放松组。运动组患者收到一台测力计自行车,可在家中使用,每周使用150分钟,每天30分钟,每周5天,为期6个月。放松组的参与者接受音频肌肉放松练习,每周至少进行5次,每次20分钟,为期6个月。癫痫发作次数和运动/放松课程每天记录在书面日记中。两组患者每月都会接到一次激励电话。在基线时以及干预6个月后,测量癫痫发作、焦虑和抑郁症状评分(医院焦虑和抑郁量表(HADS))、健康状况评分(RAND-36)、有氧能力(估计最大摄氧量)、运动自我效能感(SEE)、身体活动水平和不良事件。遵循CONSORT指南。

结果

22名患者完成了干预。两组的癫痫发作频率均无显著变化。六个月的适度运动确实提高了身体活动水平和最大摄氧量。

意义

在本研究中,适度运动并未影响癫痫发作频率。运动组患者的估计最大摄氧量有所增加,这是一个重要的健康指标,而癫痫发作频率并未恶化。这仅在每月理疗师的极少支持下就得以实现。因此,对于癫痫患者来说,在家中在定期支持下进行适度强度的运动可能是一种选择。运动组患者的身体活动水平显著提高,这表明他们遵守了治疗方案。

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