物质滥用导致精神行为障碍有氧运动康复的健康和功能效益的系统综述

Health and functioning benefits of aerobic exercise rehabilitation for substance abuse-induced mental and behavioral disorders:a systematic review

目的基于《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF)系统综述有氧运动对于物质滥用者的干预方案及健康效益。方法构建PICO架构,检索建库至2023年4月PubMed、Web of Science、Embase和中国知网有氧运动对于物质滥用者干预的随机对照研究,对其健康和功能效益进行系统综述。结果纳入7篇随机对照研究,来自3个国家,涉及498例被试;主要来源于《国际心理健康与成瘾杂志》《精神病学前沿》《心理健康和身体活动》《BMC运动科学》《医学和康复》等期刊,发表日期主要集中在2010年至2022年。纳入研究中物质滥用人群的精神行为障碍主要分为7类:甲基苯丙胺依赖、可卡因依赖、大麻依赖、阿片类药物依赖、镇静剂依赖、海洛因依赖和氯胺酮依赖。有氧运动的活动方式涉及跑步、自行车、太极、气功、瑜伽、跳绳、攀岩等,频率为每次20~60 min,每周1~10次;强度主要集中于中等至高等;持续时间为12~48周。健康结局体现在6个方面:身体运动功能、认知功能、情绪情感功能、药物渴望、身体素质,以及整体功能和生活质量。结论基于ICD-11和ICF构建了物质滥用人群参与有氧运动的健康效果的理论架构。在身体运动功能方面,有氧运动可显著改善物质滥用者的柔韧性和平衡功能、握力指数、垂直跳跃高度和坐伸距离,提高体能、力量、灵活性、速度和敏捷性。在认知功能方面,有氧运动可帮助物质滥用者提高工作记忆、注意力和执行功能等,改善物质滥用者的认知和神经功能。在情绪情感功能方面,有氧运动康复能够改善物质滥用者的心理健康,如焦虑、抑郁、疲劳等,提高心理健康状况。在药物渴望方面,有氧运动康复能够减少物质滥用者的药物渴望,增强对抗物质依赖的能力。此外,有氧运动康复能够改善物质滥用者的身体素质,如体质量、血压、血脂等,降低患心血管疾病、糖尿病等疾病的风险。改善物质滥用者的整体社会功能,提高其社会适应性和生活质量,减少再次滥用物质的风险。

Objective To examine the interventions and health benefits of aerobic exercise for substance abusers using International Classification of Diseases,Eleventh Revision(ICD-11)and International Classification of Functioning,Disability and Health(ICF)framework.Methods The PICO framework was developed and randomized controlled trials were searched in PubMed,Web of Science,Embase,and CNKI dated from the inception of the databases to April,2023.Then a systematic review was conducted.Results Seven randomized controlled trials involving 498 participants from three countries were included.The studies were mainly published in international journals such as International Journal of Mental Health and Addiction,Psychiatry Research,Mental Health and Physical Activity,BMC Sports Science,and Medicine and Rehabilitation,and covered the period from 2010 to 2022.The substance abusers in the included studies were classified into seven categories of mental and behavioral disorders,including methamphetamine dependence,cocaine dependence,cannabis dependence,opioid dependence,sedative dependence,heroin dependence,and ketamine dependence.Aerobic exercise activities included running,cycling,Tai Chi,Qigong,yoga,jumping rope,climbing,etc.,with a frequency of 20 to 60 minutes per session,one to ten times per week.The activity intensity was mainly concentrated in moderate to high intensity,and the duration ranged from 12 to 48 weeks.The health outcomes were evaluated in six aspects:physical motor function,cognitive function,emotional functioning,medication cravings,physical fitness,and overall function and quality of life.Conclusion Based on ICD-11 and ICF,a theoretical framework was constructed to evaluate the health effects of aerobic exercise for substance abusers.Aerobic exercise could improve flexibility and balance,grip strength,vertical jump height,and sit and reach distance,as well as enhance physical fitness,strength,flexibility,speed and agility in substance abusers'physical function.In terms of cognitive function,aerobic exercise could help to improve working memory,attention and executive function,as well as cognitive and neurological functions.Aerobic exercise rehabilitation could also improve psychological health,such as anxiety,depression and fatigue,and increase the ability to resist substance dependence in substance abusers.In addition,aerobic exercise rehabilitation could improve physical fitness,such as body mass,blood pressure and blood lipid levels,and reduce the risk of cardiovascular disease,diabetes and other diseases.It could also improve overall social function,increase social adaptability and quality of life,and reduce the risk of substance abuse relapse in substance abusers.