重度神经认知障碍患者多组分运动方案的应用研究

doi:10.3761/j.issn.0254-1769.2023.19.009

摘要/Abstract

摘要：

目的探究Vivifrail多组分运动干预方案在重度神经认知障碍患者中的应用及效果。方法采用类实验研究，选取2021年6月—2022年6月在浙江省衢州市精神专科医院住院的重度神经认知障碍患者52例作为研究对象，A病房为试验组（26例），B病房为对照组（26例），试验组在常规护理的基础上给予为期12周的Vivifrail多组分运动，对照组采用常规护理。在干预前后均采用简易体能状况量表（Short Physical Performance Battery，SPPB）、“起立-行走”计时测试（Timed "Up and Go" Test，TUGT）、6 min步行试验（6 Minutes Walking Test，6MWT）、椅子坐位体前屈（Chair Sit and Reach，CSR）测试评估两组的躯体功能。结果试验组26例、对照组24例完成干预。干预12周后，SPPB总分（t=-4.312，P<0.001）及其3个测试维度——平衡测试（t=-3.029，P=0.004）、4 m步速测试（t=-3.972，P<0.001）、椅子坐立测试（t=-2.912，P=0.005）以及CSR测试结果（t=-3.446，P=0.001）两组间差异有统计学意义。重复测量方差分析结果显示，两组患者所有指标均有交互效应（P<0.001），除SPPB的4 m步速测试外，其余指标的时间效应均有统计学意义（P<0.05），组间效应有统计学意义的变量有SPPB平衡测试、CSR测试（P<0.05）。结论 Vivifrail多组分运动可显著改善重度神经认知障碍患者的平衡功能、步行速度、肌肉力量、柔韧性等躯体功能，但对躯体灵活性及心肺功能的改善不明显。

关键词: Vivifrail多组分运动, 重度神经认知障碍, 躯体功能, 护理

Abstract:

Objective To explore the application and effect of Vivifrail multi-component exercise intervention program in patients with major neurocognitive disorders. Methods In this quasi-experimental study，52 patients with major neurocognitive disorders who were hospitalized in a municipal psychiatric hospital from June 2021 to June 2022 were selected as research subjects and divided into Ward A as the intervention group（26 cases） and Ward B as the control group（26 cases）. The control group was treated with routine nursing，and the intervention group was treated with 12-week Vivifrail multi-component exercise on the basis of routine nursing. Short Physical Performance Battery（SPPB），Timed "Up and Go" Test（TUGT），6 Minutes Walking Test（6MWT） and Chair Sit and Reach（CSR） were used to evaluate physical function in both groups before and after intervention. Results After 12 weeks of intervention，the total score of SPPB（t=-4.312，P<0.001） and its 3 test dimensions-balance test（t=-3.029，P=0.004），4 m walking speed test（t=-3.972，P<0.001），chair standing test（t=-2.912，P=0.005），and CSR test results （t=-3.446，P=0.001） were significantly different between the 2 groups. The results of repeated measures analysis of variance showed that all the indexes in the 2 groups had interaction effects（P<0.001）. Except for the 4 m walking test of SPPB，the time effects of other indexes were statistically significant（P<0.05），and the variables with statistical significance of intergroup effect included balance test of SPPB and CSR test（P<0.05）. Conclusion Vivifrail multicomponent exercise can significantly improve the balance function，walking speed，muscle strength and flexibility of patients with major neurocognitive disorders in medical institutions，but the improvement of body flexibility and heart and lung function was not obvious.

Key words: Vivifrail Multi-Component Exercise, Major Neurocognitive Disorders, Physical Functioning, Nursing Care

金群, 黄丽华, 胡悦, 姚春女, 胡梦倩. 重度神经认知障碍患者多组分运动方案的应用研究[J]. 中华护理杂志, 2023, 58(19): 2364-2372.

JIN Qun, HUANG Lihua, HU Yue, YAO Chunnü, HU Mengqian. Application of a multi-component exercise program in patients with major neurocognitive disorders[J]. Chinese Journal of Nursing, 2023, 58(19): 2364-2372.

图/表 3

表1 Vivifrail多组分运动方案

Table 1 Vivifrail Multi-component Exercise Program

表2 两组一般资料的比较

Table 2 >Comparison of general data between 2 groups

表3 两组在各时间点躯体功能测量指标比较结果（$ \overline{x}\pm s$）

Table 3 >Comparison of physical function measurements between the 2 groups at each time point （$ \overline{x}\pm s$）

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