运动结合认知训练在轻度认知障碍和阿尔茨海默病患者中应用的整合性综述

doi:10.3761/j.issn.1672-9234.2021.12.007

摘要/Abstract

摘要：

目的了解国内外运动结合认知训练在轻度认知障碍和阿尔茨海默病患者中应用的研究现状。方法根据Whittemore和Knafl提出的整合性综述框架对相关文献进行整合。结果最终纳入33篇文献,对应28项研究。轻度认知障碍和阿尔茨海默病患者的运动与认知训练的结合模式分为三类:双任务式、交互式和序贯式。双任务式的干预周期最长,干预形式较为简单;交互式与双任务式较为相似,干预形式多为有氧运动结合电脑游戏;序贯式周干预持续时间最长,干预频次最多,运动和认知训练形式比较复杂。此外,在设置对照组的25项研究中,18项研究（72.0%）是双臂研究;13项研究（46.4%）报道了依从率。效果评价指标包括认知功能、精神行为症状、日常生活活动能力、生活质量、步态等。结论轻度认知障碍和阿尔茨海默病患者的运动结合认知训练方案有待进一步规范化,建议未来研究设置合理的对照组,关注依从性,并结合客观指标探究其作用效果及路径。

关键词: 运动, 认知疗法, 阿尔茨海默病, 轻度认知障碍, 整合性综述

Abstract:

Objective To understand the current research status of exercise combined with cognitive training（ECT）in patients with mild cognitive impairment or Alzheimer’s disease. Methods We synthesized the studies according to the integrated review framework proposed by Whittemore and Knafl. Results A total of 33 articles from 28 studies were included. This review divided the combination modes of ECT into three types:dual-task,interactive and sequential types. Different modalities had various research schemes:the dual-task mode had the longest duration and the forms of interventions were relatively simple;the interactive mode was similar with dual-task mode in frequency and the duration of each session. Most studies of interactive mode adopted aerobic exercise combined with computer games. The sequential mode had the longest weekly time and the most frequency,and the forms of exercise and cognitive training were relatively complex. In addition,the review found that 18 articles（72.0%） from 25 studies with control group were dual-arm,and 13 articles（46.4%） reported adherence rates. Effectiveness evaluation indicators included cognitive function,psycho-behavioral symptoms,activities of daily living,quality of life,gait,etc. Conclusion The intervention schemes need to be further standardized. Future studies should pay more attention to reasonable control group,adherence,and objective indicators.

Key words: Exercise, Cognitive Therapy, Alzheimer Disease, Mild Cognitive Impairment, Integrated review

赵小燕,黄秀秀,万巧琴. 运动结合认知训练在轻度认知障碍和阿尔茨海默病患者中应用的整合性综述[J]. 中华护理教育, 2021, 18(12): 1098-1105.

ZHAO Xiao-yan,HUANG Xiu-xiu,WAN Qiao-qin. The effects of exercise combined with cognitive training in people with mild cognitive impairment and Alzheimer’s disease:an integrated review[J]. Chinese Journal of Nursing Education, 2021, 18(12): 1098-1105.

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