2013年5月14日火曜日

拒食症の運動療法:系統的レビュー

神経性食思不振症に対する運動の系統的レビューを紹介します。

Fiona J. Moola, et al. Exercise in the Care of Patients with Anorexia Nervosa: A Systematic Review of the Literature. Mental Health and Physical Activity, http://dx.doi.org/10.1016/j.mhpa.2013.04.002

神経性食思不振症に対する運動療法のエビデンスは基本的に少ないです。しかし、栄養レポートをしながら実施する運動介入は、医学的に安定した神経性食思不振症のアウトカムを改善しますし、おそらく実施可能で安全です。そのため、運動を神経性食思不振症のケアに含めてよいというレビューです。

Nutritionally supported exercise interventionsというのはまさにリハ栄養です。体重を減少させるために過活動になりやすい部分の活動量コントロールも含めて、神経性食思不振症のリハ栄養はもっと実践されるべきだと考えます。

Highlights

•Anorexia Nervosa (AN) is associated with morbidity and poor psychological health.
•Historically, a negative view toward exercise in AN has been adopted.
Nutritionally supported exercise interventions during treatment can improve outcomes in AN.
•More research is required to elucidate how exercise facilitates enhanced wellbeing.

Abstract

Anorexia Nervosa (AN) is difficult to treat and rates of patient relapse are high. The poor clinical prognosis of AN should encourage researchers and clinicians to consider alternative treatment approaches. Aim: The aim of this article was to review literature on the impact of exercise training interventions for patients living with AN. Method: Following methodological guidelines outlined by the Cochrane Library, a systematic review of the literature was undertaken on the role of exercise in AN. Findings: The incorporation of exercise into treatment for patients with AN does not have a detrimental impact on body mass index (BMI) or eating disorder symptoms. Exercise also appears to enhance quality of life, psychological wellbeing, and compliance to treatment. Only minimal improvements in fitness and strength were noted, possibly due to insufficient training loads of short duration and small sample sizes. Exercise is feasible and acceptable for patients. Discussion: Evidenced based recommendations for the healthful incorporation of activity into treatment for patients with AN and directions for future research, are proposed. Since nutritionally supported exercise training interventions for medically stable patients with AN appear to be safe, clinicians and researchers may want to consider exercise as an important facet of care.

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