Fritz Nora E, Cheek Fern M, Nichols-Larsen Deborah S
Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Maryland.
J Neurol Phys Ther. 2015 Jul;39(3):142-53. doi: 10.1097/NPT.0000000000000090.
Deficits in motor-cognitive dual tasks (eg, walking while talking) are common in individuals with neurologic conditions. This review was conducted to determine the effectiveness of motor-cognitive dual-task training (DTT) compared with usual care on mobility and cognition in individuals with neurologic disorders.
Databases searched were Biosis, CINAHL, ERIC, PsychInfo, EBSCO Psychological & Behavioral, PubMed, Scopus, and Web of Knowledge. Eligibility criteria were studies of adults with neurologic disorders that included DTT, and outcomes of gait or balance were included. Fourteen studies met inclusion criteria. Participants were subjects with brain injury, Parkinson disease (PD), and Alzheimer disease (AD). Intervention protocols included cued walking, cognitive tasks paired with gait, balance, and strength training and virtual reality or gaming. Quality of the included trials was evaluated with a standardized rating scale of clinical relevance.
Results show that DTT improves single-task gait velocity and stride length in subjects with PD and AD, dual-task gait velocity and stride length in subjects with PD, AD, and brain injury, and may improve balance and cognition in those with PD and AD. The inclusion criteria of the studies reviewed limited the diagnostic groups included.
While the range of training protocols and outcome assessments in available studies limited comparison of the results across studies motor-cognitive dual-task deficits in individuals with neurologic disorders appears to be amenable to training. Improvement of dual-task ability in individuals with neurologic disorders holds potential for improving gait, balance, and cognition.Video Abstract available for additional insights from the authors (Supplemental Digital Content, http://links.lww.com/JNPT/A104).
运动认知双重任务（如边走路边说话）能力缺陷在神经系统疾病患者中很常见。本综述旨在确定与常规护理相比，运动认知双重任务训练（DTT）对神经系统疾病患者的活动能力和认知功能的有效性。
检索的数据库有Biosis、CINAHL、ERIC、PsychInfo、EBSCO心理与行为数据库、PubMed、Scopus和Web of Knowledge。纳入标准为针对患有神经系统疾病的成年人的研究，其中包括DTT，且纳入步态或平衡方面的结果。14项研究符合纳入标准。参与者为脑损伤、帕金森病（PD）和阿尔茨海默病（AD）患者。干预方案包括提示步行、将认知任务与步态、平衡及力量训练相结合，以及虚拟现实或游戏。采用临床相关性标准化评定量表评估纳入试验的质量。
结果显示，DTT可提高PD和AD患者的单任务步态速度和步幅，改善PD、AD和脑损伤患者的双任务步态速度和步幅，并且可能改善PD和AD患者的平衡能力及认知功能。所综述研究的纳入标准限制了所涵盖的诊断组。
尽管现有研究中训练方案和结果评估的范围限制了各研究结果之间的比较，但神经系统疾病患者的运动认知双重任务缺陷似乎适合进行训练。改善神经系统疾病患者的双重任务能力有望改善步态、平衡和认知功能。作者提供了视频摘要，以便获取更多见解（补充数字内容，http://links.lww.com/JNPT/A104）。
