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体育锻炼对精神分裂症患者认知功能的影响:一项基于控制临床试验的 GRADE 评估系统评价和荟萃分析。

The effect of physical exercise on cognitive function in schizophrenia patients: A GRADE assessed systematic review and meta-analysis of controlled clinical trials.

机构信息

Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Psychosis Research Center, University of Social welfare and Rehabilitation Sciences, Tehran, Iran.

Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Schizophr Res. 2024 Sep;271:81-90. doi: 10.1016/j.schres.2024.07.020. Epub 2024 Jul 16.

Abstract

BACKGROUND

Physical exercise has demonstrated the potential to improve cognitive impairment in schizophrenia, although the results are limited. The objective of this meta-analysis is to synthesize the existing evidence on the impact of physical exercise on cognitive functions in schizophrenia.

METHODS

A systematic search of PubMed, Scopus, Web of Science, and Embase was conducted. The study included controlled clinical trials on patients with schizophrenia that received physical exercise as the intervention for improving cognition. A meta-analysis was conducted using a random-effects model, and the outcomes were reported using the standardized mean difference (SMD) and a 95 % confidence interval (95 % CI).

RESULTS

A total of 22 articles, including 1066 patients (565 in the intervention group and 501 in the control group), were included in the final analysis. Physical exercises significantly improved global cognition (SMD: 0.73, 95 % CI (0.46-1.00), P < 0.001), and aerobic exercise was found to have a more significant effect than resistance and mindfulness exercise (SMD: 0.76, 95 % CI (0.45-1.07), P < 0.001). The speed of processing [SMD: 0.88, 95 % CI (0.37-1.38), P = 0.001], attention [SMD: 0.61, 95 % CI (0.20-1.02), P = 0.004], and visual learning memory [SMD: 1.42, 95 % CI (0.14-2.71), P = 0.03] demonstrated significant improvement after physical exercise, while no significant effects were observed on working memory, verbal learning memory, reasoning and problem-solving, and social cognition.

CONCLUSIONS

Exercise can improve overall cognitive function in people with Schizophrenia. However, it is unclear whether this improvement is significant in specific cognitive domains.

摘要

背景

体育锻炼已被证明有改善精神分裂症认知障碍的潜力,尽管结果有限。本荟萃分析的目的是综合现有关于体育锻炼对精神分裂症认知功能影响的证据。

方法

对 PubMed、Scopus、Web of Science 和 Embase 进行了系统检索。研究纳入了接受体育锻炼作为改善认知干预措施的精神分裂症患者的对照临床试验。使用随机效应模型进行荟萃分析,使用标准化均数差(SMD)和 95%置信区间(95%CI)报告结果。

结果

共有 22 篇文章,包括 1066 名患者(干预组 565 名,对照组 501 名)纳入最终分析。体育锻炼显著改善了总体认知(SMD:0.73,95%CI(0.46-1.00),P<0.001),且有氧运动比抗阻运动和正念运动的效果更为显著(SMD:0.76,95%CI(0.45-1.07),P<0.001)。加工速度[SMD:0.88,95%CI(0.37-1.38),P=0.001]、注意力[SMD:0.61,95%CI(0.20-1.02),P=0.004]和视觉学习记忆[SMD:1.42,95%CI(0.14-2.71),P=0.03]在进行体育锻炼后均有显著改善,而工作记忆、言语学习记忆、推理和解决问题能力以及社会认知方面则没有显著改善。

结论

运动可以改善精神分裂症患者的整体认知功能,但在特定认知领域的改善是否具有显著意义尚不清楚。

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