运动训练干预卧床不起痴呆患者的临床研究

A clinical study of exercise training intervention to bedridden patients with dementia

目的:探讨运动训练干预对痴呆晚期卧床不起患者肢体运动功能、日常生活活动(ADL)能力及卧床并发症的临床效果。方法:符合痴呆晚期且卧床不起诊断标准的老年患者76例,随机分为观察组(常规药物治疗、基本护理、运动训练)和对照组(常规药物治疗、基本护理)两组。干预前和干预8周后对患者进行老年人身体移动量表(EMS)、改良Barth-el指数(MBI)评分,以及肺部感染、泌尿系感染等常见卧床并发症等方面进行评定。结果:观察组在EMS、MBI评分方面改善效果优于对照组(P<0.01),在肺部感染、泌尿系感染、消化系统症状、营养不良及贫血等并发症的发生率均明显低于对照组(P<0.05),而电解质紊乱及压疮的发生率在两组间差异无显著性意义(P>0.05)。结论:运动训练干预能提高痴呆卧床不起患者肢体功能,改善其ADL能力,减少长期卧床并发症的发生。

Objective：To investigate the clinical effects of exercise training intervention on motor function of extremities,ability of activities of daily living（ADL） and bed rest complications in bedridden patients with advanced dementia. Method： Seventy-six elderly patients with advanced dementia and bedridden were randomly allocated into exercise training intervention group（n=40） and control group（n=36）. Control group received conventional drug treatment and basic care, exercise training intervention group received exercise training in addition to the same intervention for control group. The elderly mobility scale（EMS）, modified Barthel index（MBI） score, pulmonary infection,urinary tract infection and other common complications of bedridden patients were assessed before and after 8-week intervention in both groups. Result：In exercise training intervention group EMS,MBI scores improved（P〈0.01）, and the incidences of pulmonary infection, urinary tract infection, digestive symptoms, malnutrition and anemia were less than those in control group significantly（P〈0.05）,while there was no statistical difference in incidences of electrolyte disorders and pressure sores between the two groups（P〈0.05）. Conclusion：The exercise training intervention can improve motor function of extremities and ability of ADL, and reduce the occurrence of complications of long-term bed rest in bedridden patients with dementia.