Marusic Uros, Kavcic Voyko, Pisot Rado, Goswami Nandu
Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.
Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia.
Front Physiol. 2019 Jan 23;9:1864. doi: 10.3389/fphys.2018.01864. eCollection 2018.
Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.
长时间的身体不活动或卧床休息会导致功能和认知功能显著下降。人们已经开发出了不同类型的对策（如离心、营养和有氧运动干预），试图减轻与卧床休息限制相关的负面影响。本报告的目的是概述有关老年人在完全身体不活动期间进行计算机化认知训练（CCT）干预效果的现有证据。使用虚拟迷宫导航任务的CCT似乎是有效的，并且具有长期益处（研究后长达1.5年）。此外，增强的认知（执行控制）可减少长时间卧床休息后执行复杂运动 - 认知双重任务能力的下降。已经证明，对老年人进行CCT管理还可预防与卧床休息压力相关的生理变化[这些组在血管功能方面变化最小，脑源性神经营养因子（BDNF）水平未改变]，而在14天的卧床休息期间，对照组受试者的外周血管化减少，神经营养因子BDNF的血浆水平升高。此外，从脑电皮质研究结果中也可明显看出CCT的效果：CCT组在较低的δ和θ频段功率降低，而对照组受试者在相同的脑电图频谱频段功率显著增加。如果我们将δ频段功率增加视为皮质老化的标志，那么脑电图功率缺乏向较低频段的转变表明CCT在为期2周的卧床休息固定诱导的生理失健过程中对皮质水平具有预防作用。然而，需要在更大的样本上进行重复研究以证实观察到的结果。从这些发现中得出的应用可能适用于卧床患者的医院治疗实施以及预防跌倒计划。
