運動介入對精神分裂症患者認知功能之影響

前言：運動可以改善腦部血液循環，是促進大腦功能的重要生理機轉之一，且對於增進認知功能有其益處。認知功能缺損是精神分裂症的核心症狀之一，臨床上以藥物治療、系統化的認知復健方式來提升病患認知功能表現，但改善結果並未獲得一致性的結果。因此，本研究將探討運動介入前後精神分裂症患者認知功能的變化，以做為臨床規劃復健活動之參考。研究方法：本研究為前、後測控制組實驗設計，以南部某醫學中心精神科日間病診斷為精神分裂症，發病超過兩年以上且症狀穩定者為樣本。共收案41 名，實驗組17名，控制組18名，個案流失6名。實驗組除常規性治療活動外再接受每週三次，每次六十分鐘的運動介入，為期三個月；控制組則參加常規性治療活動。於介入前後兩組分別進行認知功能評估，並進一步分析介入前後兩組認知功能之變化。研究結果：本研究結果發現實驗組在接受運動介入後，在注意力、立即性記憶力、延遲記憶力、語意流暢度等認知功能變項出現顯著差異。結論：本研究結果支持運動介入對於精神分裂症患者之認知功能改善有正向效益。研究建議臨床復健治療專業人員在規劃慢性精神分裂症患者復健治療活動時，提供規律次數及足夠運動強度的運動團體，將能強化個案之基本認知功能，進而提升個案之復健治療品質。

關鍵字

運動；認知功能；精神分裂症

並列摘要

Introduction：Exercise program is known to improve cerebral circulation, which is expected to enhance both cerebral function and cognitive functions as well. Cognitive impairment is one of the core symptoms of schizophrenia. Clinically, psychopharmacology and systemic cognitive rehabilitation were used to enhance patients’ cognitive performance, but no consistent result was shown. Therefore, the aim of this study was to investigate the cognitive function improvements after an intervention of exercise program for persons with chronic schizophrenia. Methods：This study adopted a pretest-posttest control group research design. Participants, with schizophrenia for more than 2 years, were recruited from the day hospital of a medical center. Forty-one participants were enrolled；17 participants in the experimental group, 18 participants in control group and 6 dropped during the study. In addition to routine therapeutic programs, the experimental group took an additional exercises program, with intensity as 60 minutes a session, 3 sessions a week. The program duration was executed for 3 months. In comparison, the control group received only the routine therapeutic programs. Cognitive function evaluations were performed before and after the interventions for both groups. Results：Significant improvements were noted in the areas of attention, immediate memory, delayed recall memory, and verbal fluency after an intervention of exercise program for the experimental group. Conclusions：This study supports exercises program with sufficient intensity has the positive effect on cognitive functions for patients with schizophrenia. Findings in this study would provide rehabilitation practitioners with useful reference in designing rehabilitation program for chronic schizophrenia.