目的探讨中高强度有氧运动疗法对阿尔茨海默病(AD)患者的干预作用。方法将52例AD患者分为中等强度有氧运动(中等强度)组(13例)、高强度有氧运动(高强度)组(13例)和对照组(26例)。所有入组患者均按AD常规治疗,中等强度组和高强度组分别接受强度为50%和70%最大运动能力的有氧运动训练12周,每周3次。于治疗前、治疗后8和12周对3组患者进行AD相关量表(MMSE、ADCS-ADL、NPI、NPI-D和ADAS-cog)评价,同时进行体格检查、血常规、血生化常规等检查。结果中等强度组、高强度组有氧运动能明显改善患者的认知能力和精神神经症状,与对照组比较差异有统计学意义(P〈0.05);中等强度组和高强度组有氧运动对患者日常生活活动能力无有益影响。第8周,高强度组MMSE和NPI评分较中等强度组改善更多(P〈0.05);而12周时,两组差异无统计学意义。结论有氧运动疗法可显著改善AD患者认知功能和精神神经症状,但对日常生活活动能力无影响;短期内高强度有氧运动较中等强度可能获益更多,长期则中等强度有氧运动与高强度的获益相似。
Aim To evaluate the clinical efficacy of aerobic exercises training of different intensities in patients with Alzheimer's disease.Methods 52 patients with mild to moderate Alzheimer's disease were randomly allocated into 3 groups. Two exercise groups were treated with aerobic exercises training at 50% or 70% of maximal intensity for 12 weeks, respectively.The efficacy of aerobic exercises was evaluated by MMSE, ADCS-ADL, NPI, NPI-D, and ADAS-cog at baseline, the end of 8 weeks and the end of 12 weeks.Results Patients of the exercise groups got statistically significant improvement in MMSE, NPI, NPI-D and ADAS-cog Tests(P〈0.05). However, aerobic exercises did not improve the ADCS-ADL(P〈0.05). Patients with 70% of maximal intensity exercise got a better improvement of MMSE and NPI than the patients with 50% of maximal intensity exercise(P〈0.05) at the end of 8 weeks. However, 50% and 70% of maximalintensity provide similar effects at the end of 12 weeks.Conclusion Aerobic exercises can improve the cognitive and functional symptoms of AD patients, with acceptable safety and tolerance. Long term aerobic exercises with different intensity may provide similar benefit.