5类14种运动疗法对轻度认知障碍病人总体认知功能影响的网状Meta分析

Efficacy of 5 categories and 14 types of exercise therapy on global cognition in patients with mild cognitive impairment:a network Meta⁃analysis

目的:运用网状Meta分析方法评价5类14种运动疗法治疗轻度认知障碍(MCI)病人总体认知功能的效果,为探讨精准化运动方案提供参考依据。方法:计算机检索PubMed、EMbase、The Cochrane Library、中国知网和万方数据库有关运动疗法治疗MCI病人的随机对照试验(RCTs),检索时限均从建库至2022年2月15日。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 15.1进行网状Meta分析。结果:共纳入29项RCTs,包括2024例MCI病人。网状Meta分析结果显示,5类运动疗法中,多模式运动[SMD=1.54,95%CI(0.87,2.21)]治疗MCI病人总体认知功能最有效,其次是有氧运动[SMD=0.89,95%CI(0.37,1.40)]、抗阻运动[SMD=0.80,95%CI(0.13,1.48)]和身心运动[SMD=0.67,95%CI(0.15,1.18)];14种运动疗法中,有氧体操[SMD=2.78,95%CI(1.17,4.39)]治疗MCI病人总体认知功能最有效,其次是多模式运动[SMD=1.83,95%CI(1.15,2.51)]、有氧舞蹈[SMD=1.02,95%CI(0.17,1.87)]和八段锦[SMD=0.69,95%CI(0.07,1.30)]。结论:现有证据表明,多模式运动可能是改善MCI病人总体认知功能最有效的方式,有氧体操、有氧舞蹈和八段锦也具有较大潜力。未来可基于运动伴随音乐治疗MCI病人开展更多的RCTs。

Objectives:To systematically review the efficacy of exercise therapy on global cognition in patients with mild cognitive impairment(MCI)by network meta⁃analysis(NMA)and provide reference for the precision exercise scheme.Methods:The PubMed,EMbase,The Cochrane Library,CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials(RCTs)on exercise for patients with MCI from inception to February 15,2022.Two reviewers independently screened literatures,extracted data and assessed the risk of bias of included studies,then,NMA was performed by using the Stata 15.1 software.Results:A total of 29 RCTs involving 2024 MCI patients were included.The effect of 5 categories of exercise therapy in patients with MCI were in the following rankings:multicomponent exercise(SMD=1.54,95%CI:0.87⁃2.21),aerobic exercise(SMD=0.89,95%CI:0.37⁃1.40),resistance exercise(SMD=0.80,95%CI:0.13⁃1.48)and mind⁃body exercise(SMD=0.67,95%CI:0.15⁃1.18).The effect of 14 types of exercise therapy in patients with MCI were in the following rankings:aerobic gymnastics(SMD=2.78,95%CI 1.17 to 4.39),multicomponent exercise(SMD=1.83,95%CI:1.15⁃2.51),aerobic dance(SMD=1.02,95%CI:0.17⁃1.87)and Baduanjin(SMD=0.69,95%CI:0.07⁃1.30).Conclusions:The current evidence showed that multicomponent exercise may be the most effective exercise type to improve global cognition of MCI patients,aerobic gymnastics,aerobic dance and Baduanjin may also be three effective exercise types with the most potential.More randomized controlled trials examining the efficacy of exercise therapy combined with music are needed.