- 學位論文
運動介入措施對失智症患者之影響:系統性回顧
The effectiveness of exercise interventions in patients with dementia: a systematic review
摘要
目的 依照內政部2017年人口統計資料估算，台灣65歲以上長者患有輕度認知障礙及失智症者約有83.9萬人。失智症之治療除了以藥物介入控制其疾病進展外，亦有以非藥物介入方式進行疾病管理，但至今較缺乏運動介入成效之整合文獻，本研究之目的即以系統性文獻回顧的方式，彙整與探討失智症運動介入措施之發展，與運動介入措施對失智症患者之影響。 方法 本研究方法為系統性文獻回顧，運用形成問題、文獻搜尋、篩選標準、文獻品質評析及資料萃取整合。搜尋Cochrane Library、ProQuest、PubMed、華藝線上圖書館、台灣碩博士論文系統的中英文文獻，鍵入Alzheimer’s disease、dementia、mild cognitive impairment、exercise、fitness、intervention、physical activity、functional performance及阿茲海默症、失智症、輕度認知障礙、運動介入、體適能、身體功能等關鍵字，總共搜尋到353篇文章，經過逐一檢視文獻，運用納入標準及排除條件，最後共有15篇文獻符合條件，續以Modified Jadad Scale（MJS）的標準來評定本研究所篩選的文章，再進行文獻資料分析及彙整。 結果 本研究之重要結果為：一、運動介入因具有成本低和可近性高的特質，為非常具潛力的措施之一，是目前各國積極嘗試用來管理失智症症狀的非藥物治療方法。二、運動介入在身體功能的上下肢肌力、下肢柔軟度部分，可達成正向影響。三、運動介入對身體質量（BMI）並無顯著影響。四、運動介入結合認知活動課程，對認知功能可產生有效影響。五、運動介入對生活品質無顯著影響。六、運動介入對提供照護人員的生活品質有正向影響。 結論 運動介入對於失智症患者在身體功能、認知功能及照護人員有正向影響，可作為在未來對失智症患者提供運動介入及相關整合性服務的重要參考。
並列摘要
Purpose According to the 2017 demographic data of the Ministry of the Interior, there are approximately 839,000 elderly people aged 65 years or older with mild cognitive impairment and dementia in Taiwan. In addition to pharmacological interventions to control the disease progression, non-pharmacological interventions are also used to manage dementia, but there is a lack of literature on the effectiveness of exercise interventions. The purpose of this study is to compile and investigate the development of exercise interventions for dementia and the effectiveness of exercise interventions in patients with dementia through a systematic literature review. Method The methodology of this study is a systematic literature review, using formative questions, literature search, selection criteria, literature quality assessment and data extraction and integration. Search the Cochrane Library, ProQuest, PubMed, Airiti Library, and National Digital Library of Theses and Dissertation System for English and Chinese literature. Key words for Alzheimer's disease, dementia, mild cognitive impairment, exercise, fitness, intervention, physical activity, functional performance, etc. Total 353 articles were found. After reviewing the literatures, applying the inclusion criteria and exclusion criteria, a total of 15 papers met the criteria. The articles selected for this study were evaluated using the Modified Jadad Scale (MJS), and then the literature was analyzed and compiled. Result 1.Exercise interventions are one of the most promising interventions due to their low cost and high accessibility, and are currently being actively tried as a non-pharmacological treatment for managing dementia symptoms in various countries. 2. Exercise intervention can achieve positive effects on upper and lower extremity strength and lower extremity flexibility of body functions. 3. No significant effect of exercise intervention on BMI. 4. Exercise interventions combined with cognitive activity sessions have the effectiveness on cognitive function. 5. No benefits were observed of exercise on QoL. 6. The exercise intervention was contributing to a lower load of distress for the caregivers. Conclusion Exercise interventions have positive effects on physical function, cognitive function and caregivers for people with dementia. It can be used as an important reference for future exercise interventions and related integrated services for patients with dementia.