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运动对血液透析患者认知障碍的影响:一项随机对照试验的系统评价和荟萃分析。

Effect of exercise on cognitive impairment in patients undergoing haemodialyses: A systematic review and meta-analysis of randomised controlled trials.

机构信息

Medical School, Nantong University, Nantong, China.

出版信息

J Ren Care. 2022 Dec;48(4):243-252. doi: 10.1111/jorc.12420. Epub 2022 Mar 26.

Abstract

BACKGROUND

The influence of exercise on cognition in patients undergoing haemodialysis has been examined. However, evidence elucidating the effects in this patient group is scarce.

OBJECTIVE

To examine the effect of exercise on cognitive impairment in patients undergoing haemodialysis and provide insight into the effects of various characteristics of exercise on cognitive impairment in this population.

DESIGN

A systematic review and meta-analysis, following the guidance of PRISMA was undertaken.

PARTICIPANTS

Adult patients undergoing haemodialysis.

RESULTS

This review found that exercise significantly improved cognitive impairment in patients undergoing haemodialysis (SMD = 0.37, 95% CI: 0.13, 0.60, p = 0.002). Subgroup analyses demonstrated that both intradialytic exercise (SMD = 0.82, 95% CI: 0.37, 1.26, p < 0.001) and interdialytic exercise (SMD = 0.24, 95% CI: 0.01, 0.47, p = 0.038), exercise for 16 weeks or over (SMD = 0.33, 95% CI: 0.07, 0.58, p = 0.012), and lasting for more than 30 minutes (SMD = 0.52, 95% CI: 0.17, 0.86, p = 0.004) significantly alleviated cognitive impairment. The effect of exercise on cognitive impairment in patients less than 65 years of age (SMD = 0.39, 95% CI: 0.10, 0.68, p = 0.009) was significantly better than those over 65.

CONCLUSION

Exercise significantly improves cognitive impairment in patients undergoing haemodialysis. Both Intradialytic and interdialytic exercise of at least 30 minutes duration, 3 times weekly, and at least for 16 weeks may play a significant role in alleviating cognitive impairment in patients under 65 years of age.

摘要

背景

已经研究了运动对血液透析患者认知功能的影响。然而,针对该患者群体的证据很少。

目的

检查运动对血液透析患者认知障碍的影响,并深入了解该人群中各种运动特征对认知障碍的影响。

设计

根据 PRISMA 指南进行了系统评价和荟萃分析。

参与者

正在接受血液透析的成年患者。

结果

本综述发现,运动可显著改善血液透析患者的认知障碍(SMD=0.37,95%CI:0.13,0.60,p=0.002)。亚组分析表明,血液透析内运动(SMD=0.82,95%CI:0.37,1.26,p<0.001)和血液透析间运动(SMD=0.24,95%CI:0.01,0.47,p=0.038)、运动时间为 16 周或更长时间(SMD=0.33,95%CI:0.07,0.58,p=0.012)以及持续时间超过 30 分钟(SMD=0.52,95%CI:0.17,0.86,p=0.004)均可显著缓解认知障碍。年龄小于 65 岁的患者运动对认知障碍的影响(SMD=0.39,95%CI:0.10,0.68,p=0.009)明显优于年龄大于 65 岁的患者。

结论

运动可显著改善血液透析患者的认知障碍。对于年龄小于 65 岁的患者,至少 30 分钟、每周 3 次、至少 16 周的血液透析内和血液透析间运动可能对缓解认知障碍发挥重要作用。

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