Bastos P A D, Barbosa R
CEDOC, Chronic Diseases Research Center, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Portugal; NOVA Medical School, Faculdade de Ciências Médicas Universidade Nova de Lisboa, Lisbon, Portugal.
Department of Neurology, Hospital de Egas Moniz Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas Universidade Nova de Lisboa, Lisbon, Portugal.
Rev Neurol (Paris). 2022 Oct;178(8):845-854. doi: 10.1016/j.neurol.2021.12.012. Epub 2022 Feb 17.
With the percentage of the population above age 65 expected to double by 2030, the healthcare costs across neurodegenerative diseases will in all likelihood significantly increase. As such, disease-modifying, preventive strategies are urgently needed. However, despite major technological advances and massive concerted efforts, we still fall short of disease prevention, delayed progression or reversal when it comes to neurodegenerative diseases. An increasing wealth of information has come to formally demonstrate that exercise serves as one of the best strategies for coping with neurodegeneration. Herein, we review the available evidence on how and to which extent physical activity can expand one's motor reserve in the settings of neuropathology and ageing. Individuals who attain higher levels of functionality via lifelong experience develop a higher motor reserve throughout life and clinically relevant symptoms only later in life. The higher the motor reserve, the higher the degree of resilience and the better individuals can cope with a given level of neuropathology. Physical exercise is an efficacious and efficient way of strengthening one's motor reserve, allowing for an increased ability to cope with neuropathology throughout life and resulting in delayed disease onset and progression. Motor learning, and not necessarily motor performance, seems to be the key when aiming at maximizing the benefits of physical exercise in the context of motor reserve. As a result, a variety of challenging activities are to be recommended and maintained throughout life.
预计到2030年，65岁以上人口的比例将翻倍，神经退行性疾病的医疗成本很可能会大幅增加。因此，迫切需要能够改变疾病进程的预防策略。然而，尽管取得了重大技术进步并付出了巨大的协同努力，但在神经退行性疾病的预防、延缓疾病进展或逆转方面，我们仍然做得不够。越来越多的信息正式表明，运动是应对神经退行性变的最佳策略之一。在此，我们回顾现有证据，探讨身体活动在神经病理学和衰老背景下如何以及在多大程度上能够扩展一个人的运动储备。通过终身经历获得更高功能水平的个体在一生中会发展出更高的运动储备，并且直到晚年才会出现临床相关症状。运动储备越高，恢复力程度越高，个体应对给定水平神经病理学的能力就越好。体育锻炼是增强运动储备的有效方式，能够提高个体在一生中应对神经病理学的能力，从而延缓疾病的发作和进展。在运动储备的背景下，旨在最大限度地发挥体育锻炼的益处时，运动学习而非运动表现似乎是关键。因此，建议在一生中进行并维持各种具有挑战性的活动。
