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基于家庭和远程康复锻炼对阿尔茨海默病患者的精神和身体健康及疾病费用的影响:一项荟萃分析。

Effects of home-based and telerehabilitation exercise on mental and physical health, and disease cost in people with Alzheimer's disease: A meta-analysis.

机构信息

Fromerly, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.

出版信息

Ageing Res Rev. 2024 Jun;97:102284. doi: 10.1016/j.arr.2024.102284. Epub 2024 Apr 9.

DOI:10.1016/j.arr.2024.102284
PMID:38599523
Abstract

BACKGROUND

Alzheimer's disease (AD) is a very disabling long-term disease that requires continuous regular care. A cost-effective and sustainable means of such care may be physical activity or exercise delivered at home or through telerehabilitation. The aim of this study is to determine the effects of home-based or telerehabilitation exercise in people with AD.

METHOD

PubMED, Embase, Web of Science (WoS), PEDro, and CENTRAL were searched for randomized controlled trials until January 2024. The data extracted include the characteristics of the participants, the interventions used for both experimental and the control groups, the baseline, post-intervention and follow-up mean and standard deviation values on the outcomes assessed and the findings of the included studies. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risks of bias and methodological quality of the studies. The results were analyzed using narrative and quantitative syntheses.

RESULT

Eleven articles from nine studies (n=550) were included in the study. The results showed that, only global cognitive function (SMD = 0.72, 95% CI = 0.19-1.25, p=0.007), neuropsychiatric symptom (MD = -5.28, 95% CI =-6.22 to -4.34, p<0.0001) and ADL (SMD =3.12, 95% CI =0.11-6.13, p=0.04) improved significantly higher in the experimental group post-intervention. At follow-up, the significant difference was maintained only in neuropsychiatric symptoms (MD =-6.20, 95% CI =-7.17 to -5.23, p<0.0001).

CONCLUSION

There is a low evidence on the effects of home-based physical activity or exercise on global cognitive function, neuropsychiatric symptoms and ADL.

摘要

背景

阿尔茨海默病(AD)是一种非常致残的长期疾病,需要持续的定期护理。一种具有成本效益且可持续的护理方式可能是在家中或通过远程康复进行的身体活动或运动。本研究的目的是确定家庭或远程康复运动对 AD 患者的影响。

方法

在 2024 年 1 月之前,在 Pubmed、Embase、Web of Science(WoS)、PEDro 和 CENTRAL 上搜索随机对照试验。提取的数据包括参与者的特征、实验组和对照组使用的干预措施、基线、干预后和随访时评估结果的平均值和标准差值,以及纳入研究的结果。使用 Cochrane 偏倚风险评估工具和 PEDro 量表评估研究的偏倚风险和方法学质量。使用叙述性和定量综合分析来分析结果。

结果

纳入了 9 项研究的 11 篇文章(n=550)。结果表明,仅在干预后,总体认知功能(SMD=0.72,95%CI=0.19-1.25,p=0.007)、神经精神症状(MD=-5.28,95%CI=-6.22-4.34,p<0.0001)和 ADL(SMD=3.12,95%CI=0.11-6.13,p=0.04)在实验组中显著改善。在随访时,只有神经精神症状(MD=-6.20,95%CI=-7.17-5.23,p<0.0001)仍保持显著差异。

结论

家庭身体活动或运动对整体认知功能、神经精神症状和 ADL 的影响的证据级别较低。

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