Malmberg Gavelin Hanna, Eskilsson Therese, Boraxbekk Carl-Johan, Josefsson Maria, Stigsdotter Neely Anna, Slunga Järvholm Lisbeth
a Department of Psychology , Umeå University , Umeå , Sweden.
b Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.
Stress. 2018 Jul;21(4):279-291. doi: 10.1080/10253890.2018.1461833. Epub 2018 Apr 25.
Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.
与压力相关的疲惫与选择性和持续性的认知障碍有关。然而，对于如何在压力康复中解决认知缺陷以及这如何随时间影响压力恢复，我们知之甚少。这项开放标签、平行随机对照试验（ClinicalTrials.gov：NCT03073772）的目的是研究12周的认知训练或有氧运动训练对被诊断为疲惫障碍（ED）患者的认知功能、心理健康和工作能力的长期影响。132名参与多模式压力康复的患者（111名女性）被随机分配接受额外的认知训练（n = 44）、额外的有氧运动训练（n = 47）或不接受额外训练（n = 41）。在干预前、干预后立即和干预后一年评估治疗效果。主要结局是整体认知功能。次要结局包括特定领域的认知、自我报告的倦怠、抑郁、焦虑、疲劳和工作能力、有氧能力以及病假水平。意向性分析显示，认知训练组的整体认知功能有小但持续的改善，同时在一项经过训练的更新任务上有很大改善。有氧运动训练组在训练后立即显示出有氧能力和情景记忆的改善，但没有长期益处。观察到心理健康和工作能力有总体改善，各干预组之间没有差异。我们的研究结果表明，认知训练可能是解决ED患者认知障碍的一种可行方法，而在有限时间段内进行有氧运动对认知的影响可能更有限。讨论了对支持ED患者坚持治疗的临床实践的启示。
