抗阻运动降低阿尔茨海默病患者跌倒的风险：一项随机临床试验。

IF 3.1 3区医学 Q1 REHABILITATION

Physiotherapy Pub Date : 2024-10-28 DOI:10.1016/j.physio.2024.101440

Rubén Cámara-Calmaestra , Antonio Martínez-Amat , Agustín Aibar-Almazán , Fidel Hita-Contreras , Nerea de Miguel-Hernando , Daniel Rodríguez-Almagro , José Daniel Jiménez-García , Alexander Achalandabaso-Ochoa

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引用次数: 0

摘要

目的：评估抗阻运动对阿尔茨海默病（AD）患者跌倒风险、跌倒恐惧、肌肉力量、神经精神症状和日常生活活动能力的影响。设计：单盲随机对照试验。环境：位于西班牙Andalucía的五家老年护理中心专门治疗AD。参与者：60名被诊断为AD的人被随机分配到干预组（n = 30）或对照组（n = 30）。干预：干预组除了进行认知训练外，每周进行三次阻力训练，持续12周，直到研究结束。对照组单独进行认知训练。主要结果测量：主要结果测量：跌倒的风险（短物理性能电池）。次要结局：肌肉力量（手部动力测量）、神经精神症状（神经精神问卷）、害怕跌倒（特定活动平衡信心量表）和进行日常生活活动的能力（劳顿日常生活工具活动量表）。结果：分析显示干预组在短期和中期跌倒风险方面的差异[治疗后：平均差异（MD） 1.5，差异的95% CI为0.9至2.0；3个月随访：MD 1.1, 95% CI（差异0.6 ~ 1.6）；害怕跌倒(治疗后：MD 1.5，差异的95% CI为4.0 ~ 7.7；3个月随访：MD为6.3,95% CI（差异为4.3至8.2）；日常生活活动(治疗后：MD为0.2,95% CI差异为-0.01 ~ 0.4；3个月随访：MD 0.3, 95% CI（差异0.01 ~ 0.5）；神经精神症状(治疗后：MD -2.2，差异的95% CI -3.3至-1.0；3个月随访：MD -2.4, 95% CI（差异-3.7至-1.2）；和动力学(治疗后：MD 3.1，差异的95% CI为2.5至3.7；3个月随访：MD为2.6,95% CI（差异1.9 ~ 3.3）。结论：阻力运动可有效降低AD患者跌倒风险、跌倒恐惧和神经精神症状，并可在中短期内改善AD患者的肌肉力量。论文贡献。

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Resistance exercise to reduce risk of falls in people with Alzheimer’s disease: a randomised clinical trial

Objectives

To evaluate the impact of resistance exercise on the risk of falls, fear of falling, muscle strength, neuropsychiatric symptoms and ability to perform activities of daily living in people with Alzheimer’s disease (AD).

Design

Single-blinded randomised controlled trial.

Setting

Five aged care centres specialising in AD, located in Andalucía, Spain.

Participants

Sixty people diagnosed with AD were assigned at random to either the intervention group (n = 30) or the control group (n = 30).

Interventions

The intervention group completed three weekly resistance exercise sessions for 12 weeks, in addition to cognitive training, until completion of the study. The control group undertook cognitive training alone.

Main outcome measure

Main outcome measure: risk of falls (Short Physical Performance Battery). Secondary outcomes: muscle strength (hand dynamometry), neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire), fear of falling (Activities-Specific Balance Confidence Scale) and ability to perform activities of daily living (Lawton Instrumental Activities of Daily Living Scale).

Results

The analysis demonstrated differences in favour of the intervention group, in both the short and medium term, for risk of falls [post-treatment: mean difference (MD) 1.5, 95% CI of the difference 0.9 to 2.0; 3-month follow up: MD 1.1, 95% CI of the difference 0.6 to 1.6]; fear of falling (post-treatment: MD 1.5, 95% CI of the difference 4.0 to 7.7; 3-month follow up: MD 6.3, 95% CI of the difference 4.3 to 8.2); activities of daily living (post-treatment: MD 0.2, 95% CI of the difference −0.01 to 0.4; 3-month follow up: MD 0.3, 95% CI of the difference 0.01 to 0.5); neuropsychiatric symptoms (post-treatment: MD −2.2, 95% CI of the difference −3.3 to −1.0; 3-month follow up: MD −2.4, 95% CI of the difference −3.7 to −1.2); and dynamometry (post-treatment: MD 3.1, 95% CI of the difference 2.5 to 3.7; 3-month follow up: MD 2.6, 95% CI of the difference 1.9 to 3.3).

Conclusion

Resistance exercise effectively reduces the risk of falls, fear of falling and neuropsychiatric symptoms, and improves muscle strength in people with AD in both the short and medium term.

Contribution of the Paper

−
Resistance training reduces the risk of falls, fear of falling and neuropsychiatric symptoms in people with AD.
−
Resistance training improves muscle strength in people with AD.
−
The short-term effects of resistance training are maintained in the medium term in people with AD.

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来源期刊

Physiotherapy 医学-康复医学

CiteScore

6.40

自引率

3.00%

发文量

377

审稿时长

82 days

期刊介绍： Physiotherapy aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions worldwide. Dedicated to the advancement of physiotherapy through publication of research and scholarly work concerned with, but not limited to, its scientific basis and clinical application, education of practitioners, management of services and policy. We are pleased to receive articles reporting original scientific research, systematic reviews or meta-analyses, theoretical or debate articles, brief reports and technical reports. All papers should demonstrate methodological rigour.