경도치매 노인의 복합운동 실시와 중지 후 재실시가 기능체력 및 인지기능에 미치는 영향
Effects of Multi-Component Exercise and Retraining after Detraining on Functional Fitness and Cognitive Function in Elder People with Mild Dementia
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배경: 급속한 고령화와 함께 치매 유병률이 증가하면서운동이 치매의 1, 2, 3차 예방에 미치는 영향에 관한 관심이 증가하고 있다. 이 같은 관심에도 불구하고 치매고령자대상의 24주 이상의 운동중재연구 및 치매 환자의 특성상빈번히 나타나는 운동중지 이후 재운동의 효과에 대한 연구는 극히 제한적이다. 이에 본 연구는 24주의 복합운동실시 후 운동중지와 운동 재실시가 치매노인의 신체, 인지기능 및 수행능력에 미치는 영향을 연구하고자 한다. 방법: 치매진단 후 입원한 35명의 치매노인은 실험군과대조군으로 나누었으며 실험군은 24주의 복합운동을 실시후 12주 운동중지, 12주의 운동 재실시기간에 주 2회 이상, 회당 35-70분간 운동을 실시하였으며 대조군은 운동하지 않고 일상생활을 유지하였다. 생리학적 변인, 신체기능, 인지기능이 측정되었으며, 최종 48주까지 남은 운동군(n=10)과 대조군(n=6)의 자료가 분석되었다. 시점별 평균차이는 비모수 Friedman과 Wilcox signed rank 검정을 유의수준 5%에서 실시하였다. 결과: 분석 결과 24주 운동, 12주 운동중지, 12주 재운동은 실험군과 대조군의 생리학적 변인에 영향이 없었다. 24주 운동은 운동군의 하지근력, 상완근력, 하지 유연성, 평형성, 동적평형성, 신체수행을 향상시켰으나, 12주 운동중지 후 유의하게 감소하였고, 12주의 재운동 후 하지근력,상완근력, 신체수행이 유의하게 향상됨으로써 대조군과유의한 차이를 보였다. 인지기능은 24주 운동 후 유의한향상을 보였으나 운동중지 기간 후 유의한 변화가 없었으며 대조군과도 유의한 차이가 없었다. 결론: 치매노인에게 운동은 신체기능에 긍정적인 효과가 있으며, 이런 효과는 운동중지와 함께 사라지는 경향을보이나 운동 재실시를 통하여 향상되므로 치매 환자의 지속적인 운동참여를 독려하는 전략이 필요하다. 또한 운동을 하는 것이 하지 않는 것보다 신체기능 유지측면에서바람직하므로 현장에서는 치매노인에 대한 적극적인 운동권장이 필요하다.
Abstract
Background: With rapid growth in the number of older Koreans and prevalence of dementia, exercise has beenemphasized as first, second and third prevention of dementia. A few study, however, investigate effects of detrainingand retraining in demented elders. Therefore, the purpose of this study was to investigate the effects of24 week exercise followed by 12 week detraining and retraining on physical and cognitive function in dementedseniors. Methods: Thirty-five demented older adults were assigned into exercise and control group. Exercise group performedmulti-component exercise, 2 times a week for 24 weeks. After 12 week detraining, subjects were retrainingfor 12 weeks. Subjects were tested four times on physiological variables, physical function and cognitivefunction. Ten subjects in exercise group and 6 subjects in control group were remained at final 48 week, anddata from them were analyzed. Results: There were no significant effects on physiological variable in both groups. However, 24 week exerciseimproved upper and lower body strength, flexibility, dynamic mobility and physical function. These effects, however,were significantly decreased in 12 week detraining period and increased again after 12 week retraining. There were significance group differences. Cognitive function was improved after 24 week exercise but decreasedin detraining and retraining period and no significant difference between groups was shown. Conclusions: The present study suggests that positive effects after exercise tend to be reduced once one stopsexercise, and be improved again after retraining. Therefore, strategies to encourage demented elders to exerciseare needed.
참고문헌 (28)
- National Health Insurance Services, "Fight with dementia", ~ (2013)
- Recognition and initial assessment of Alzheimer's diease and related dementias, "Costa PT", US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, ~, pp.Clinical practice guidelines no 19 (1996)
- Colcombe S, "Fitness effects on the cognitive function of older adults", Psychological Science, 14(2), pp.125~130 (2003)
- Munoz VM, "Gait and balance impairments in Alzheimer disease patients", Alzheimer Dis Assoc Disord, 24(1), pp.79~84 (2010)
- Rolland Y, "Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial", J Am Geriatr Soc, 55(2), pp.158~165 (2007)
- Kwak YS, "Effect of regular exercise on senile dementia patients", Int J Sports Med, 29(6), pp.471~474 (2008)
- Williams CL, "Exercise training for depressed older adults with Alzheimer's disease", Aging and Mental Health, 12(1), pp.72~80 (2008)
- Dishman RK, "Exercise adherence: its impact on public health" (1988), Human Kinetics
- Cohen J, "Statistical power analysis for the behavioral sciences" (1988), Psychology Press
- Heyn P, "The effects of exercise training on elderly persons with cognitive impairment and dementia:a meta-analysis", Arch Phys Med Rehabil, 85(10), pp.1694~1704 (2004)
- Rikli RE, "Senior fitness test manual", pp.161~ (2001), Human Kinetics
- 조비룡, "노인의 신체 기능 평가", Korean Journal of Family Medicine, 24(8), pp.2~695 (2003), 대한가정의학회
- 홍승연, "An Investigation of the Validity of Thirty-second Chair Stand Test as a Measure of Lower Body Strength in Korean Older Adults", INTERNATIONAL JOURNAL OF HUMAN MOVEMENT SCIENCE, 6(1), pp.17~28 (2012), 한국체육학회[DOI]
- Van Pelt RE, "Contribution of total and regional fat mass to risk for cardiovascular disease in older women. American Journal of Physiology", Endocrinology and Metabolism, 282, pp.E1023~E1028 (2002)
- Whitmer RA, "Central obesity and increased risk of dementia more than three decades later", Neurology, 71(14), pp.1057~1064 (2008)
- Fratiglioni L, "Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group", Neurology, 54(11 Suppl 5), pp.S10~S15 (2000)
- Andersen CK, "Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia", Health and Quality of Life Outcomes, 2(1), pp.52~58 (2004)
- Bullock R, "Realistic expectations: the management of severe Alzheimer disease", Alzheimer Dis Assoc Disord, 17, pp.S80~S85 (2003)
- Kovach CR, "Planning activities for patients with dementia: a descriptive study of therapeutic activities on special care units", J Gerontol Nurs, 22(9), pp.33~38 (1996)
- 이소은, "치매 및 경도인지장애 노인의 건강관련체력과 골밀도에 관한 연구", 한국체육과학회지, 20(4), pp.789~798 (2011), 한국체육과학회
- Dvorak RV, "Appendicular skeletal muscle mass, physical activity, and cognitive status in patients with Alzheimer's disease", Neurology, 51(5), pp.1386~1390 (1998)
- 엄상용, "규칙적인 운동이 여성 치매환자의 인지기능과 혈중지질 성분에 미치는 영향", 체육과학연구, 15(1), pp.57~65 (2004), 국민체육진흥공단 부설 한국스포츠개발원
- Brill PA, "The feasibility of conducting strength and flexibility programs for elderly nursing home residents with dementia", Gerontologist, 35(2), pp.263~266 (1995)
- Winters KM, "Detraining reverses positive effects of exercise on the musculoskeletal system in premenopausal women", J Bone Miner Res, 15(12), pp.2495~2503 (2000)
- Son H, "The Effects of exercise program on activities of daily living and balance in elderly with dementia", pp.2007
- 박현숙, "치매노인의 인지기능 및 전도관련체력에 대한 시설 운동프로그램의 효과", 한국생활환경학회지, 17(1), pp.77~85 (2010), 한국생활환경학회
- van Gelder BM, "Physical activity in relation to cognitive decline in elderly men", Neurology, 63(12), pp.2316~2321 (2004)
- Lautenschlager NT, "Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease", JAMA, 300(9), pp.1027~1037 (2008)