多组分运动对痴呆或轻度认知障碍老年人认知、身体功能和日常生活活动的影响：系统评价和荟萃分析。
Effect of Multicomponent Exercise on Cognition, Physical Function and Activities of Daily Life in Older Adults With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-analysis.
机构信息
College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
出版信息
Arch Phys Med Rehabil. 2023 Dec;104(12):2092-2108. doi: 10.1016/j.apmr.2023.04.011. Epub 2023 May 2.
OBJECTIVE
To review the evidence for the effectiveness of multicomponent exercise (an exercise program combining aerobic, endurance, balance, and flexibility exercises) on cognition, physical function, and activities of daily living in people with dementia and mild cognitive impairment (MCI).
DATA SOURCES AND STUDY SELECTION
We conducted this study under the guidance of a designated protocol (PROSPERO CRD42022324641). Pertinent randomized controlled trials were selected from PubMed, Embase, Web of Science, and the Cochrane Library by 2 independent authors through May 2022.
DATA EXTRACTION
Two authors independently extracted the data and assessed the quality of the included studies following the Cochrane Risk of Bias tool. Outcome data were extracted in a random effects model and estimated as Hedges' g and 95% confidence interval (CI). To validate specific results, the Egger test combined the Duval and Tweedie "trim and fill" method and sensitivity analysis with study removed were performed.
DATA SYNTHESIS
A total of 21 publications were eligible for the quantitative analysis. In dementia, estimates of Hedges' g showed effects on global cognition (g=0.403; 95% CI, 0.168-0.638; P<.05), especially executive function (g=0.344; 95% CI, 0.111-0.577; P<.05), flexibility (g=0.671; 95% CI, 0.353-0.989; P<.001), agility and mobility (g=0.402; 95% CI, 0.089-0.714; P<.05), muscle strength (g=1.132; 95% CI, 0.420-1.845; P<.05), and activities of daily living (g=0.402; 95% CI, 0.188-0.615; P<.05). Also, a positive trend was observed in gait speed. Additionally, multicomponent exercise had positive effects on global cognition (g=0.978; 95% CI, 0.298-1.659; P<.05) and executive function (g=0.448; 95% CI, 0.171-0.726; P<.05) in patients with MCI.
CONCLUSIONS
Our findings confirm the viability of multicomponent exercise as a management strategy for patients with dementia and MCI.
目的
综述多组分运动（将有氧运动、耐力运动、平衡和灵活性运动相结合的运动方案）对痴呆和轻度认知障碍（MCI）患者认知、身体功能和日常生活活动的有效性的证据。
数据来源和研究选择
我们在指定方案（PROSPERO CRD42022324641）的指导下进行了这项研究。通过 2 位独立作者，从PubMed、Embase、Web of Science 和 Cochrane Library 中选择了相关的随机对照试验，截至 2022 年 5 月。
数据提取
2 位作者独立提取数据，并按照 Cochrane 偏倚风险工具评估纳入研究的质量。使用随机效应模型提取结局数据，并以 Hedges'g 和 95%置信区间（CI）进行估计。为了验证特定结果，采用 Egger 检验结合 Duval 和 Tweedie“修剪和填充”方法，并对删除研究进行敏感性分析。
数据综合
共有 21 篇出版物符合定量分析的条件。在痴呆症中，Hedges'g 的估计值显示对整体认知（g=0.403；95%CI，0.168-0.638；P<.05），特别是执行功能（g=0.344；95%CI，0.111-0.577；P<.05）、灵活性（g=0.671；95%CI，0.353-0.989；P<.001）、敏捷性和移动性（g=0.402；95%CI，0.089-0.714；P<.05）、肌肉力量（g=1.132；95%CI，0.420-1.845；P<.05）和日常生活活动（g=0.402；95%CI，0.188-0.615；P<.05）有积极的趋势。此外，还观察到了步态速度的积极趋势。此外，多组分运动对 MCI 患者的整体认知（g=0.978；95%CI，0.298-1.659；P<.05）和执行功能（g=0.448；95%CI，0.171-0.726；P<.05）也有积极影响。
结论
我们的研究结果证实了多组分运动作为痴呆和 MCI 患者管理策略的可行性。
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