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对患有认知障碍的慢性中风幸存者进行短期干预后的心肺适能与认知功能:一项试点研究。

Cardiorespiratory fitness and cognitive functioning following short-term interventions in chronic stroke survivors with cognitive impairment: a pilot study.

作者信息

Blanchet Sophie, Richards Carol L, Leblond Jean, Olivier Charles, Maltais Désirée B

机构信息

aThe Centre for Psychiatry and Neuroscience of the French National Institute of Health and Medical Research, Paris, France bCentre for Interdisciplinary Research in Rehabilitation and Social Integration cDepartment of Rehabilitation, Laval University dPediatric Intervention Centre for Heart Disease Prevention and Rehabilitation, St. Justine University Medical Centre, Montreal City, Canada.

出版信息

Int J Rehabil Res. 2016 Jun;39(2):153-9. doi: 10.1097/MRR.0000000000000161.

Abstract

This study, a quasi-experimental, one-group pretest-post-test design, evaluated the effects on cognitive functioning and cardiorespiratory fitness of 8-week interventions (aerobic exercise alone and aerobic exercise and cognitive training combined) in patients with chronic stroke and cognitive impairment living in the community (participants: n=14, 61.93±9.90 years old, 51.50±38.22 months after stroke, n=7 per intervention group). Cognitive functions and cardiorespiratory fitness were evaluated before and after intervention, and at a 3-month follow-up visit (episodic memory: revised-Hopkins Verbal Learning Test; working memory: Brown-Peterson paradigm; attention omission and commission errors: Continuous Performance Test; cardiorespiratory fitness: peak oxygen uptake during a symptom-limited, graded exercise test performed on a semirecumbent ergometer). Friedman's two-way analysis of variance by ranks evaluated differences in score distributions related to time (for the two groups combined). Post-hoc testing was adjusted for multiple comparisons. Compared with before the intervention, there was a significant reduction in attention errors immediately following the intervention (omission errors: 14.6±21.5 vs. 8±13.9, P=0.01; commission errors: 16.4±6.3 vs. 10.9±7.2, P=0.04), and in part at follow-up (omission errors on follow-up: 3.4±4.3, P=0.03; commission errors on follow-up: 13.2±7.6, P=0.42). These results suggest that attention may improve in chronic stroke survivors with cognitive impairment following short-term training that includes an aerobic component, without a change in cardiorespiratory fitness. Randomized-controlled studies are required to confirm these findings.

摘要

本研究采用准实验性单组前后测设计,评估了为期8周的干预措施(单独有氧运动以及有氧运动与认知训练相结合)对社区中患有慢性中风和认知障碍患者的认知功能和心肺适能的影响(参与者:n = 14,年龄61.93±9.90岁,中风后51.50±38.22个月,每个干预组n = 7)。在干预前后以及3个月的随访时评估认知功能和心肺适能(情景记忆:修订版霍普金斯言语学习测验;工作记忆:布朗-彼得森范式;注意力遗漏和委托错误:连续性能测试;心肺适能:在半卧位测力计上进行的症状限制分级运动测试中的峰值摄氧量)。弗里德曼双向秩方差分析评估了与时间相关的分数分布差异(两组合并)。事后检验针对多重比较进行了调整。与干预前相比,干预后立即出现注意力错误显著减少(遗漏错误:14.6±21.5 vs. 8±13.9,P = 0.01;委托错误:16.4±6.3 vs. 10.9±7.2,P = 0.04),部分在随访时也有减少(随访时的遗漏错误:3.4±4.3,P = 0.03;随访时的委托错误:13.2±7.6,P = 0.42)。这些结果表明,在包括有氧成分的短期训练后,患有认知障碍的慢性中风幸存者的注意力可能会改善,而心肺适能没有变化。需要进行随机对照研究来证实这些发现。

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