中华护理杂志 ›› 2026, Vol. 61 ›› Issue (17): 2309-2317.DOI: 10.3761/j.issn.0254-1769.2026.17.001
• 老年人健康管理与促进专题 • 下一篇
李斐斐1(
), 楼巍敏2, 吴美倩3, 胡昕铖4, 胡镕镕5, 江碧艳2, 郑瑶6, 郑玲燕1, 刘彩霞2,*()
收稿日期:2026-04-17
出版日期:2026-09-10
发布日期:2026-09-03
*通讯作者:
刘彩霞，E-mail：zjyylcx@126.com作者简介:李斐斐：女，硕士，护师，E-mail：2443483675@qq.com李斐斐：研究设计、方案构建、研究实施、统计学分析、论文撰写与修改；楼巍敏：研究指导、论文审阅与修改、基金支持；吴美倩、胡昕铖：资料收集与整理；胡镕镕：方案构建、统计学分析；江碧艳、郑玲燕、刘彩霞：研究指导、论文审阅与修改；郑瑶：研究实施
基金资助:
LI Feifei1(), LOU Weimin2, WU Meiqian3, HU Xincheng4, HU Rongrong5, JIANG Biyan2, ZHENG Yao6, ZHENG Lingyan1, LIU Caixia2,*()
Received:2026-04-17
Online:2026-09-10
Published:2026-09-03
* Corresponding author:
LIU Caixia，E-mail：zjyylcx@126.comFunding program:摘要：
目的 探讨方块踏步运动方案对养老机构轻度认知障碍老年人的干预效果，为临床实践提供参考。 方法 通过文献分析、专家论证及预试验构建方块踏步运动方案。采用随机对照试验设计，便利选取2025年7—10月杭州市某所养老机构的70例轻度认知障碍老年人作为研究对象，随机分为试验组与对照组（各35例）。试验组在养老机构常规照护的基础上接受为期12周的方块踏步运动方案，对照组接受养老机构常规照护。比较两组干预前后的认知功能、平衡功能、移动能力及生活质量。 结果 最终试验组33例、对照组34例完成研究。干预后，试验组蒙特利尔认知评估量表总分、视空间与执行功能得分、注意力得分、延迟回忆得分、Berg平衡量表得分、计时起立行走测试时间及简明健康状况调查量表中生理与心理健康得分均优于对照组，差异有统计学意义（P<0.05）。试验组未发生运动相关不良事件。 结论 在养老机构轻度认知障碍老年人中实施方块踏步运动方案安全、可行，能有效延缓其短期认知下降，提高平衡功能及移动能力，改善其生活质量。
李斐斐, 楼巍敏, 吴美倩, 胡昕铖, 胡镕镕, 江碧艳, 郑瑶, 郑玲燕, 刘彩霞. 方块踏步运动方案在养老机构轻度认知障碍老年人中的应用研究[J]. 中华护理杂志, 2026, 61(17): 2309-2317.
LI Feifei, LOU Weimin, WU Meiqian, HU Xincheng, HU Rongrong, JIANG Biyan, ZHENG Yao, ZHENG Lingyan, LIU Caixia. Application of a square stepping exercise program on the elderly with mild cognitive impairment in a nursing home[J]. Chinese Journal of Nursing, 2026, 61(17): 2309-2317.
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表1 方块踏步运动方案
Table 1 Square stepping exercise program
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表2 两组一般资料的比较[例（百分比，%）]
Table 2 Comparison of general data between the 2 groups [case（percentage，%）]
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表3 干预前后两组认知功能的比较[分，M（P25，P75）]
Table 3 Comparison of cognitive functions between the 2 groups before and after the intervention[scores，M（P25，P75）]
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表4 干预前后两组平衡功能、移动能力的比较（$\overline{x}\pm s$）
Table 4 Comparison of balance function and mobility ability between the 2 groups before and after the intervention（$\overline{x}\pm s$）
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表5 干预前后两组生活质量的比较（分，$\overline{x}\pm s$）
Table 5 Comparison of quality of life between the 2 groups before and after the intervention（scores，$\overline{x}\pm s$）
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| [1] | 中华医学会神经病学分会痴呆与认知障碍学组. 阿尔茨海默病源性轻度认知障碍诊疗中国专家共识2024[J]. 中华神经科杂志, 2024, 57(7):715-737. |
| Chinese Society of Dementia and Cognitive Impairment,Chi-nese Medical Association. Chinese expert consensus on the diagnosis and treatment of mild cognitive impairment due to Alzheimer’s disease 2024[J]. Chin J Neurol, 2024, 57(7):715-737. | |
| [2] |
Jia LF, Du YF, Chu L, et al. Prevalence,risk factors,and management of dementia and mild cognitive impairment in adults aged 60 years or older in China:a cross-sectional study[J]. Lancet Public Health, 2020, 5(12):e661-e671.
DOI URL |
| [3] |
Yang L, Jin XQ, Yan J, et al. Comparison of prevalence and associated risk factors of cognitive function status among elderly between nursing homes and common communities of China:a STROBE-compliant observational study[J]. Medicine, 2019, 98(49):e18248.
DOI URL |
| [4] |
Ghanem A, Berry DS, Burkes A, et al. Prevalence of and annual conversion rates to mild cognitive impairment and dementia:prospective,longitudinal study of an essential tremor cohort[J]. Ann Neurol, 2024, 95(6):1193-1204.
DOI PMID |
| [5] |
Hao YQ, Zhao YJ, Luo HH, et al. Comparative effectiveness of different dual task mode interventions on cognitive function in older adults with mild cognitive impairment or dementia:a systematic review and network meta-analysis[J]. Aging Clin Exp Res, 2025, 37(1):139.
DOI |
| [6] | Siqueira VAAA, Shigematsu R, Sebastião E. Stepping towards health:a scoping review of square-stepping exercise protocols and outcomes in older adults[J]. BMC Geriatr, 2024,24(1):590. |
| [7] |
Fränzel K, Koschate J, Freiberger E, et al.Square-stepping exercise in older inpatients in early geriatric rehabilitation. A randomized controlled pilot study[J]. BMC Geriatr,2024, 24(1):326.
DOI |
| [8] |
Franco-García JM, Carlos-Vivas J, Castillo-Paredes A, et al. Impacts of square stepping exercise on physical-cognitive function,biomarkers,body composition and mental health in healthy senior aged 60 and above:a systematic review[J]. Healthcare, 2024, 12(23):2325.
DOI URL |
| [9] |
中国老年护理联盟, 中南大学湘雅护理学院, 中南大学湘雅医院, 等. 认知衰退老年人非药物干预临床实践指南:身体活动[J]. 中国全科医学, 2023, 26(16):1927-1937,1971.
DOI |
| China Elderly Nursing Alliance, et al. Xiangya School of Nursing of Central South University,Xiangya Hospital of Central South University, Clinical practice guidelines for non-pharmacological interventions in older adults with cognitive decline:physical activity[J]. Chin Gen Pract, 2023, 26(16):1927-1937, 1971. | |
| [10] | 中国医师协会神经内科医师分会, 认知训练中国指南写作组. 认知训练中国指南(2022年版)[J]. 中华医学杂志, 2022, 102(37):2918-2925. |
| Chinese Medical Doctor Association, Neurologist Branch of Cognitive Training Chinese Guideline Writing Group. Chinese guideline on cognitive training(2022 edition)[J]. Natl Med J China, 2022, 102(37):2918-2925. | |
| [11] | 中国痴呆与认知障碍诊治指南写作组, 中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J]. 中华医学杂志, 2018, 98(17):1294-1301 |
| The Team of Guidelines for the Diagnosis and Treatment of Dementia and Cognitive Impairment in China,Cognitive Disorders Committee of Neurology Branch of Chinese Medical Doctor Association. Guidelines for the diagnosis and treatment of dementia and cognitive impairment in China in 2018(V):diagnosis and treatment of mild cognitive impairment[J]. Natl Med J China, 2018, 98(17):1294-1301 | |
| [12] | 张立秀, 刘雪琴. 蒙特利尔认知评估量表中文版的信效度研究[J]. 护理研究, 2007, 21(31):2906-2907. |
| Zhang LX, Liu XQ. A study on reliability and validity of MOCA scale of Chinese version[J]. Chin Nurs Res, 2007, 21(31):2906-2907. | |
| [13] | 李双力, 李为华, 赵燕琼, 等. 基于严肃游戏的双重任务训练对养老机构轻度认知障碍老年人的干预效果[J]. 护理学杂志, 2023, 38(24):88-91. |
| Li SL, Li WH, Zhao YQ, et al. Effects of dual-task training based on serious games[J]. J Nurs Sci, 2023, 38(24):88-91. | |
| [14] | 金冬梅, 燕铁斌, 曾海辉. Berg平衡量表的效度和信度研究[J]. 中国康复医学杂志, 2003, 18(1):25-27. |
| Jin DM, Yan TB, Zeng HH. Validity and reliability of Berg Balance Scale on assessing balance function[J]. Chin J Reha-bil Med, 2003, 18(1):25-27. | |
| [15] |
Podsiadlo D, Richardson S. The timed “up & go”:a test of basic functional mobility for frail elderly persons[J]. J Am Geriatr Soc, 1991, 39(2):142-148.
DOI PMID |
| [16] | 鲍春蓉, 吴绪波, 卞邹吉, 等. 计时起立-行走测试应用于社区老年人的信效度[J]. 中国老年学杂志, 2021, 41(23):5407-5410. |
| Bao CR, Wu XB, Bian ZJ, et al. Reliability and validity of timed stand-up-walking test for the elderly in community[J]. Chin J Gerontol, 2021, 41(23):5407-5410. | |
| [17] |
Ware JE,Jr, Kosinski M, et al. A 12-item Short-Form Health Survey:construction of scales and preliminary tests of reliability and validity[J]. Med Care, 1996, 34(3):220-233.
DOI PMID |
| [18] |
Shou J, Ren LM, Wang HT, et al. Reliability and validity of 12-item Short-Form Health Survey(SF-12) for the health status of Chinese community elderly population in Xujiahui district of Shanghai[J]. Aging Clin Exp Res, 2016, 28(2):339-346.
DOI URL |
| [19] | 钟名阳. 养老机构轻度认知障碍老年人运动认知协同干预方案的构建及应用研究[D]. 南宁: 广西中医药大学, 2025. |
| Zhong MY. A study on the construction and application of a collaborative motor-cognitive intervention program for older adults with mild cognitive impairment in a nursing facility[D]. Nanning: Guangxi University of Chinese Medicine, 2025. | |
| [20] |
Cha HJ, Kim KB, Baek SY. Square-stepping exercise program effects on fall-related fitness and BDNF levels in older adults in Korea:a randomized controlled trial[J]. Int J Environ Res Public Health, 2022, 19(12):7033.
DOI URL |
| [21] |
郝雨晴, 胡慧秀, 赵雅洁, 等. 老年人社交活动与认知功能关系的研究进展及护理启示[J]. 中华护理杂志, 2025, 60(2):251-256.
DOI |
|
Hao YQ, Hu HX, Zhao YJ, et al. Research progress and nursing inspiration on the relationship between social activities and cognitive function in older adults[J]. Chin J Nurs, 2025, 60(2):251-256.
DOI |
|
| [22] |
Wang YH, Liu YH, Yang YR, et al. Effects of square-stepping exercise on motor and cognitive function in older adults:a systematic review and meta-analysis[J]. Geriatr Nurs, 2021, 42(6):1583-1593.
DOI URL |
| [23] |
Gao Y, Liu NQ. Effectiveness of cognitive-motor dual task training in preventing falls in community older adults:a meta-analysis and systematic review[J]. Geriatr Nurs, 2025, 64:103366.
DOI URL |
| [24] | 陈晓莹, 王向荣, 肖强兵, 等. 社区老年骨质疏松症患者认知-运动双重任务训练方案的构建及应用[J]. 护理学杂志, 2025, 40(10):10-13,33. |
| Chen XY, Wang XR, Xiao QB, et al. Construction and application of a cognitive-motor dual-task training programme for community-dwelling elderly patients with osteoporosis[J]. J Nurs Sci, 2025, 40(10):10-13,33. | |
| [25] |
Özel A, Tütün Yümin E, Konuk S. Comparative effects of square-stepping and strengthening exercises on cognitive and balance functions in chronic obstructive pulmonary disease:a randomized clinical trial[J]. PeerJ, 2025, 13:e19792.
DOI URL |
| [26] | Yang HZ, Li JH, Shan W, et al. The effect of different exer-cise modalities on older adults’ quality of life:an assessor-blinded randomized controlled trial[J]. Sci Rep, 2025,15:26177. |
| [27] |
Song D, Yu DSF. Effects of a moderate-intensity aerobic exercise programme on the cognitive function and quality of life of community-dwelling elderly people with mild cognitive impairment:a randomised controlled trial[J]. Int J Nurs Stud,2019, 93:97-105.
DOI URL |
| [28] |
Hussenoeder FS, Conrad I, Roehr S, et al. Mild cognitive impairment and quality of life in the oldest old:a closer look[J]. Qual Life Res, 2020, 29(6):1675-1683.
DOI PMID |
| [29] |
郭晓贝, 王颖, 郭月, 等. 方步运动在老年人运动认知风险综合征预防中的应用进展[J]. 中华护理杂志, 2026, 61(6):852-858.
DOI |
|
Guo XB, Wang Y, Guo Y, et al. Research progress of square step exercise in the prevention of motor cognitive risk syndrome in the elderly[J]. Chin J Nurs, 2026, 61(6):852-858.
DOI |
|
| [30] |
熊丽莎, 袁越, 王思雪, 等. 实施性研究视角下认知障碍患者干预方案保真度的研究进展[J]. 中华护理杂志, 2026, 61(8):1141-1147.
DOI |
|
Xiong LS, Yuan Y, Wang SX, et al. Research progress on fidelity of intervention programs for cognitive impairment patients from the perspective of implementation science[J]. Chin J Nurs, 2026, 61(8):1141-1147.
DOI |
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