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双重任务和哌甲酯对注意缺陷多动障碍儿童步态的影响。

Effects of dual tasking and methylphenidate on gait in children with attention deficit hyperactivity disorder.

作者信息

Möhring Wenke, Klupp Stephanie, Grob Alexander

机构信息

University of Basel, Department of Psychology, Missionsstrasse 62, 4055 Basel, Switzerland.

University of Basel, Department of Psychology, Missionsstrasse 62, 4055 Basel, Switzerland.

出版信息

Hum Mov Sci. 2018 Dec;62:48-57. doi: 10.1016/j.humov.2018.09.007. Epub 2018 Sep 19.

Abstract

Effects of dual tasking on motor processes such as gait have been mainly investigated with healthy adults and clinical older samples whereas studies with clinical samples of children with attention deficit hyperactivity disorder (ADHD) are rare. Similarly, even though methylphenidate (MPH) is the most often prescribed medication for children with ADHD, the influence of MPH on children's gait under single-task and dual-task situations remains poorly understood. In the current study, children diagnosed with ADHD (n = 26) came twice to the laboratory, once without and once with MPH medication. They were asked to walk over an electronic walkway without a concurrent task (motor single task) and while solving different cognitive tasks (motor-cognitive dual task). Gait variability and cognitive performance were measured. Children's performance was compared to an age- and sex-matched control sample of typically developing children (n = 26) who were also tested twice. Results indicated considerable effects of dual tasking on children's gait irrespective of group (ADHD vs. controls), with children diagnosed with ADHD showing more pronounced gait alterations in dual-task situations as compared to controls. Furthermore, MPH medication in children with ADHD enabled them to substantially decrease their stride time variability to a level that was comparable to the level of typically developing children. Overall, our findings support the notion that higher cognitive processes such as attention and executive functions influence gait and that MPH can positively affect cognitive and motor processes such as gait.

摘要

双重任务对诸如步态等运动过程的影响,主要是在健康成年人和临床老年样本中进行研究的,而针对患有注意力缺陷多动障碍(ADHD)的儿童临床样本的研究却很少。同样,尽管哌甲酯(MPH)是最常用于治疗ADHD儿童的药物,但MPH在单任务和双任务情况下对儿童步态的影响仍知之甚少。在本研究中,被诊断为ADHD的儿童(n = 26)两次来到实验室,一次未服用MPH药物,一次服用了MPH药物。他们被要求在没有并发任务的情况下走过一条电子步道(运动单任务),以及在解决不同认知任务时走过该步道(运动 - 认知双任务)。测量了步态变异性和认知表现。将儿童的表现与年龄和性别匹配的正常发育儿童对照样本(n = 26)进行比较,该对照样本也进行了两次测试。结果表明,无论组别(ADHD组与对照组)如何,双重任务对儿童步态都有显著影响,与对照组相比,被诊断为ADHD的儿童在双任务情况下表现出更明显的步态改变。此外,ADHD儿童服用MPH药物后,能够大幅降低其步幅时间变异性,使其达到与正常发育儿童相当的水平。总体而言,我们的研究结果支持这样一种观点,即诸如注意力和执行功能等更高层次的认知过程会影响步态,并且MPH可以对诸如步态等认知和运动过程产生积极影响。

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