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

다국어 초록 (Multilingual 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.

국문 초록 (Abstract)

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.

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