有氧运动为主综合训练方式对轻度认知障碍的干预作用研究

发布时间：2017-12-27 18:38

本文关键词：有氧运动为主综合训练方式对轻度认知障碍的干预作用研究　出处：《南京医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：背景：轻度认知障碍(Mild cognitive impairment,MCI)是正常老年人和老年痴呆的中间过渡阶段,其发病率和患病率在逐年增加,并且MCI与老年痴呆(Alzheimer's Disease, AD)的高发病率密切相关。目前已有研究指出中等强度的有氧运动可能减缓MCI的发生。目的：本研究旨在观察有氧运动为主的综合训练方式对轻度认知障碍患者认知功能和生活质量的作用,为有氧运动在MCI老年人群推广提供依据。方法：将60名MCI患者按照随机数字表法随机分为运动组和对照组,其中运动组29名,对照组31名。运动组接受中等强度运动强度(心电运动试验中最大心率的60-80%),35分钟/次,3次/周,完成持续3个月的节奏感强的音乐引导下的有氧操；对照组仅接受健康宣教,未进行任何干预。在3个月的干预结束后,所有受试者接受为期3个月的随访观察。所有受试者在干预前、3月干预结束时、6月随访时均接受认知功能、生活质量以及运动功能等的评估。认知功能评估采用简明精神状态评分(Minimum Mental State Examination,MMSE)、北京版蒙特利尔认知评估(Montreal Cognitive Assessment(MoCA)Beijing version)、韦氏逻辑记忆测试、韦氏数字广度测试、连线测试-A、连线测试-B、符号数字模式测试以及事件相关电位P300检查；活动能力采用社会功能活动问卷(Functional Activities Questionnaire, FAQ)评估日常生活独立能力,中文版简明健康状况调查表(SF-36)评估生活质量,老年抑郁量表评估心理状态,运动能力方面采用用Berg平衡功能量表、心电运动试验的两项乘积(rate pressure product, RPP).最大代谢当量(metablic equivalent, METs)及运动中最大心率(max heart rate, HRmax)指标进行评估。结果：3个月的干预完成时共58名受试者完成所有功能评估(运动组27名,对照组31名),6月随访时54名受试者完成功能评估(运动组27名、对照组27名)。治疗前两组受试者在年龄、性别、受教育程度以及MMSE评分等方面,差异无统计学意义(P0.05),具有可比性。1、认知功能的变化比较：3个月的运动干预后,运动组MMSE评分为(28.0±1.3)分、MoCA评分为(24.7±-2.2)分、韦氏逻辑记忆测试评分为(17.5±3.8)分、连线测试-A为(66.2±24.5)秒、连线测试-B为(158.3+48.7)秒、符号数字模式测试评分为(35.6±8.8)分、事件相关电位P300潜伏期为(423.6±±40.2)ms,与干预前相比均有统计学意义(p0.05),其中韦氏逻辑记忆测试、连线测试-B与对照组相比差异有统计学意义(p0.05)。6月随访时运动组韦氏逻辑记忆评分为(16.7±±6.3)分、连线测试-A为(59.6±±19.5)秒、符号数字模式测试评分为(37.1±±8.7)分与干预前相比,差异有统计学意义(p0.05),且对照组韦氏数字广度测试评分(15.9±3.0)分、符号数字模式测(35.2±12.6)分、P300潜伏期为(444.9±-23.4)ms较干预前相比差异有统计学意义(p0.05),并且对照组P300潜伏期与运动组相比差异有统计学意义(p0.05)。2、活动能力、生活质量以及心理状态的变化比较：FAQ评分在3月、6月时进行组内和组间比较差异均无统计学意义。6月随访时运动组SF-36评分为(114.6+17.8)分,与干预前(107.8±16.7)分相比差异有统计学意义(P(0.05)。对照组3月老年抑郁评分为(11.2±±6.0)分、6月评分为(11.2±±6.7)分与干预前(14.5±±6.9)分相比差异有统计学意义(P0.05)。3、运动功能的变化比较：3月干预后,运动组Berg平衡功能量表评分为(55.5±±0.8)分与干预前和对照组比较差异有统计学意义。6月随访时运动组SF-36评分为(114.6±±17.8)分与干预前相比差异有统计学意义,运动组Berg平衡功能量表评分为(55.5±±1.0)分与对照组相比差异有统计学意义。3个月的干预后,运动组和对照组心电运动试验相关指标的变化均无统计学意义,6个月随访时运动组METs为(9.2±±2.2)和对照组METs为(9.9±±1.9)与干预前相比差异有统计学意义,6月随访时对照组最大心率为(148.8±19.4)次/人与干预前相比差异有统计学意义。4、多元线性回归分析：3月干预后,MCI患者韦氏逻辑记忆测试、连线测试-B、Berg平衡功能的改善与运动干预有显著相关性(p0.05)。MMSE评分和MCI患者的年龄、性别等密切相关,年龄越大,治疗后增加的分值越小；同时,女性患者治疗后增加的分值较男性小。FAQ的分值和年龄呈正相关,年龄越大,FAQ增大的分值越大。SF-36的分值和年龄呈现负相关,年龄越大,训练后SF-36的分值增加越小。6月随访时运动组MCI患者韦氏逻辑记忆、P300潜伏期、Berg平衡功能改善与运动干预有显著相关性(p0.05),并且结果提示年龄越小MCI患者韦氏逻辑记忆改善越明显。结论：研究结果显示通过对MCI患者进行中等强度(60-80%的最大心率),3次/周,35分钟/次,持续3个月的有氧运动操干预及持续3个月的随访观察,证实有氧运动操可以提高MCI患者认知功能,改善其生活质量。
[Abstract]:Background: Mild cognitive impairment (MCI) is the intermediate transition stage between the normal elderly and the senile dementia. Its incidence and prevalence are increasing year by year, and MCI is closely related to the high incidence of Alzheimer's Disease (AD). At present, studies have shown that moderate aerobic exercise may slow the occurrence of MCI. Objective: the purpose of this study is to observe the effect of aerobic exercise based comprehensive training on cognitive function and quality of life in patients with mild cognitive impairment, so as to provide evidence for the promotion of aerobic exercise in the elderly in MCI. Methods: 60 MCI patients were randomly divided into the exercise group and the control group according to the random number table method, of which 29 were in the exercise group and 31 in the control group. The exercise group received moderate intensity exercise intensity (60-80% of maximal heart rate in ECG exercise test), 35 minutes / time, 3 times / week, completed 3 months' aerobic exercise guided by rhythmic music, while the control group only received health education without any intervention. After 3 months of intervention, all the subjects were followed up for a period of 3 months. All subjects received assessment of cognitive function, quality of life, and motor function during the intervention, the end of intervention in March, and the follow-up of June. The cognitive function was assessed by mini mental state score (Minimum Mental, State Examination, MMSE), the Beijing version of the Montreal cognitive assessment (Montreal Cognitive Assessment Beijing (MoCA) version), logical memory test and Wechsler digit span test, Lian Xiance test, -A -B connection test and digital symbol mode test and event related potential P300 activity; the functional activities questionnaire (Functional Activities Questionnaire, FAQ) evaluation of independent ability of daily living, health status questionnaire version of Chinese (SF-36) quality of life assessment, geriatric depression scale to assess the psychological status, exercise capacity by two, the product table ECG exercise test with Berg balance amount (rate pressure product, RPP) the maximum metabolic equivalent (metablic equivalent METs) maximum heart rate and movement (max heart rate, HRmax) The index is evaluated. Results: a total of 58 subjects completed all the functional evaluations (27 in the exercise group and 31 in the control group) at the completion of the 3 month intervention. In June, 54 subjects completed the functional assessment (27 in the exercise group and 27 in the control group). There was no significant difference in age, sex, education and MMSE scores between the two groups before treatment (P0.05), which was comparable. Comparison of changes in cognitive function: 1, 3 months of exercise intervention, exercise group MMSE score was (28 + 1.3) and MoCA was (24.7 + -2.2), logical memory test scores for Webster (17.5 + 3.8) points, -A connection test (66.2 + 24.5) seconds, connection test -B (158.3+48.7) and digital symbol test mode second score (35.6 + 8.8) and event related potential P300 latency (423.6 + 40.2) ms, there were statistically significant differences before and after the intervention (P0.05), which compared the logical memory test and Wechsler connection test -B and the control group was statistically significant (P0.05). June follow-up exercise group Wechsler logical memory score (16.7 + 6.3) points, -A connection test (59.6 + + 19.5 seconds) and digital symbol mode test score (37.1 + 8.7) compared with before intervention, the difference was statistically significant (P0.05), the control group and the digit span test score (15.9 + 3), symbol digit (35.2 + 12.6) model test, the latency of P300 was (444.9 + -23.4) ms was statistically significant difference compared with before intervention (P0.05) and the control group, the latency of P300 and exercise group had significant difference (P0.05). 2, comparison of activity ability, quality of life and mental state: there was no significant difference in FAQ score between group and group in March and June. In June, the SF-36 score of the exercise group was (114.6+17.8) score, and the difference was statistically significant (P (0.05) before the intervention (107.8 + 16.7). In the control group, the geriatric depression score in March was (11.2 + 6), and the score in June was (11.2 + 6.7), which was significantly different from that before intervention (14.5 + + 6.9). The difference was statistically significant (P0.05). 3, the comparison of motor function changes: in March, the score of Berg balance function scale of exercise group was (55.5 + 0.8) after intervention, and the difference was statistically significant compared with that before intervention. In June follow-up, the SF-36 score of exercise group was (114.6 + 17.8), and the difference was statistically significant compared with that before intervention. The score of Berg balance function scale in exercise group was (55.5 + 1), which was significantly different from that in control group. 3 months after the intervention, changes in exercise group and control group electrocardiogram exercise test indexes were not statistically significant, 6 months follow-up exercise group (9.2 + METs + 2.2) and control group (9.9 + METs + 1.9) was statistically significant difference between before and after intervention, the control group were followed up in June the maximum heart rate (148.8 + 19.4) times per person compared with before intervention the difference was statistically significant. 4, multiple linear regression analysis: in March, after the intervention, there was a significant correlation between the improvement of Wechsler logical memory test, the connection test -B and Berg balance function in MCI patients and the exercise intervention (P0.05). The MMSE score is closely related to the age and gender of MCI patients. The larger the age, the smaller the increase score after treatment. At the same time, the increase score of female patients is smaller than that of males. The score of FAQ is positively correlated with age, and the larger the age is, the greater the score of FAQ increases. The score of SF-36 has a negative correlation with age, and the older the age is, the increase in the score of SF-36 is smaller after training. During June follow-up, there was a significant correlation between the improvement of Wechsler logical memory, P300 latency and Berg balance function in exercise group MCI and exercise intervention (P0.05), and the results showed that the smaller the age was, the more obvious the improvement of Wechsler logical memory in MCI patients. Conclusion: the results showed moderate intensity (maximum heart rate of 60-80%) in MCI patients.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.1

【相似文献】