Ghai Shashank, Ghai Ishan, Effenberg Alfred O
Institute of Sports Science, Leibniz University, Hannover, Germany; Department of Sports Science, University of Waikato, Hamilton, New Zealand.
School of Engineering & Life Sciences, Jacobs University, Bremen, Germany.
Clin Interv Aging. 2017 Mar 23;12:557-577. doi: 10.2147/CIA.S125201. eCollection 2017.
The use of dual-task training paradigm to enhance postural stability in patients with balance impairments is an emerging area of interest. The differential effects of dual tasks and dual-task training on postural stability still remain unclear. A systematic review and meta-analysis were conducted to analyze the effects of dual task and training application on static and dynamic postural stability among various population groups. Systematic identification of published literature was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, from inception until June 2016, on the online databases Scopus, PEDro, MEDLINE, EMBASE, and SportDiscus. Experimental studies analyzing the effects of dual task and dual-task training on postural stability were extracted, critically appraised using PEDro scale, and then summarized according to modified PEDro level of evidence. Of 1,284 records, 42 studies involving 1,480 participants met the review's inclusion criteria. Of the studies evaluating the effects of dual-task training on postural stability, 87.5% of the studies reported significant enhancements, whereas 30% of the studies evaluating acute effects of dual tasks on posture reported significant enhancements, 50% reported significant decrements, and 20% reported no effects. Meta-analysis of the pooled studies revealed moderate but significant enhancements of dual-task training in elderly participants (95% CI: 1.16-2.10) and in patients suffering from chronic stroke (-0.22 to 0.86). The adverse effects of complexity of dual tasks on postural stability were also revealed among patients with multiple sclerosis (-0.74 to 0.05). The review also discusses the significance of verbalization in a dual-task setting for increasing cognitive-motor interference. Clinical implications are discussed with respect to practical applications in rehabilitation settings.
使用双任务训练范式来增强平衡受损患者的姿势稳定性是一个新兴的研究领域。双任务和双任务训练对姿势稳定性的不同影响仍不明确。进行了一项系统评价和荟萃分析，以分析双任务及训练应用对不同人群静态和动态姿势稳定性的影响。按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，从起始到2016年6月，在在线数据库Scopus、PEDro、MEDLINE、EMBASE和SportDiscus上对已发表文献进行系统识别。提取分析双任务和双任务训练对姿势稳定性影响的实验研究，使用PEDro量表进行严格评价，然后根据修改后的PEDro证据水平进行总结。在1284条记录中，42项研究涉及1480名参与者，符合该评价的纳入标准。在评估双任务训练对姿势稳定性影响的研究中，87.5%的研究报告有显著增强，而在评估双任务对姿势急性影响的研究中，30%的研究报告有显著增强，50%的研究报告有显著下降，20%的研究报告无影响。对汇总研究的荟萃分析显示，双任务训练在老年参与者（95%可信区间：1.16 - 2.10）和慢性中风患者（-0.22至0.86）中产生了中度但显著的增强效果。在多发性硬化症患者中也发现了双任务复杂性对姿势稳定性的不利影响（-0.74至0.05）。该评价还讨论了在双任务环境中言语表达对于增加认知 - 运动干扰的重要性。针对康复环境中的实际应用讨论了临床意义。
