Sorek Gilad, Shaklai Sharon, Meyer Shirley, Katz-Leurer Michal
a Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
b Physiotherapy Department, Alyn Children's Hospital and Rehabilitation Center , Jerusalem , Israel.
Brain Inj. 2018;32(6):770-775. doi: 10.1080/02699052.2018.1450993. Epub 2018 Mar 13.
Adolescents with acquired brain injury (ABI) present a range of physical and cognitive as well as cardiac autonomic control system (CACS) dysfunctions.
To examine the CACS response to an executive task, a physical task and a combined physical and executive task, in adolescents with ABI and typically developed (TD) controls.
Included were two groups: The first group consisted of 17 adolescents (11-18 years) with ABI, during the in-patient or out-patient rehabilitation period. All were independent walkers. The second group consisted of 18-year-olds age and gender-matched TD adolescents. A Polar RS800CX device was used to assess heart rate (HR) and heart rate variability (HRV). Walking velocity was assessed by average speed on the 6-Minute Walk Test, and executive cognitive function was assessed by the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire. The physical task was walking for 5 minutes on a treadmill. The cognitive task was the Digit Span Backward test. The study included four stages divided into rest state with and without cognitive task and walking state with and without cognitive task.
Adolescents with ABI presented higher HR and lower HRV measures at rest (p-value < 0.01). A significant 'group' and 'activity' interaction effect on HRV was found; change in the activity level had significantly smaller effects on HRV parameters in adolescents with ABI as compared to controls. An interaction effect of 'cognitive' and 'activity' on HR and HRV was noted, with no significant difference between groups; at rest, performing a cognitive task was associated with reduced HRV, while during walking HRV increased.
While ABI was associated with a reduced HRV at rest and less adaptive cardiac autonomic system to activity, ABI adolescent's response to a cognitive demand during an activity task such as walking was similar to the response of TD adolescents. Accordingly, we may say that adding a cognitive task to a walking task can improve the CACS function of ABI adolescents.
患有后天性脑损伤（ABI）的青少年存在一系列身体、认知以及心脏自主控制系统（CACS）功能障碍。
研究ABI青少年和发育正常（TD）的对照组青少年在执行任务、体力任务以及体力与执行任务相结合的任务时CACS的反应。
研究包括两组：第一组由17名（年龄在11至18岁之间）处于住院或门诊康复期的ABI青少年组成。他们均为独立行走者。第二组由年龄和性别匹配的18岁TD青少年组成。使用Polar RS800CX设备评估心率（HR）和心率变异性（HRV）。通过6分钟步行测试的平均速度评估步行速度，并通过执行功能行为评定量表（BRIEF）问卷评估执行认知功能。体力任务是在跑步机上行走5分钟。认知任务是数字倒背测试。该研究包括四个阶段，分为有和没有认知任务的休息状态以及有和没有认知任务的行走状态。
ABI青少年在休息时心率较高且心率变异性较低（p值<0.01）。发现“组”和“活动”对心率变异性有显著的交互作用；与对照组相比，活动水平的变化对ABI青少年心率变异性参数的影响明显较小。注意到“认知”和“活动”对心率和心率变异性有交互作用，两组之间无显著差异；在休息时，执行认知任务与心率变异性降低有关，而在行走时心率变异性增加。
虽然ABI与休息时心率变异性降低以及心脏自主系统对活动的适应性较差有关，但ABI青少年在诸如行走等活动任务期间对认知需求的反应与TD青少年的反应相似。因此，可以说在行走任务中增加认知任务可以改善ABI青少年的CACS功能。
