Department of Neurology, Hospital of the University of Basel, Basel, Switzerland,
Department of Neurology, Hospital of the University of Basel, Basel, Switzerland.
Dement Geriatr Cogn Disord. 2021;50(4):372-386. doi: 10.1159/000519122. Epub 2021 Oct 28.
The objective of this study is to compare 2 different rhythmic, high-intensive interventions, that is, rhythmic speech-language therapy (rSLT) versus rhythmic balance-mobility training (rBMT), against a no-therapy (NT) condition in patients with Parkinson's disease and against healthy controls (HCs) with regard to the change in or enhancement of cognitive abilities.
The 4 groups (rSLT: N = 16; rBMT: N = 10; NT: N = 18; and HC: N = 17) were matched for age, sex, and educational level and were tested in 6 cognitive domains: working memory, executive function, visuo-construction, episodic memory, attention, and word retrieval. Assessments took place at baseline, at 4 weeks (T1), and at 6 months (T2). Rhythmic interventions were provided 3 times per week for 4 weeks in total. To analyze true intervention effects between groups and across time, statistical analyses included reliable change index. Intergroup differences were assessed with multivariate assessment of variance, while differences within groups were assessed with 95% confidence intervals of mean difference.
The rSLT improved working memory and word retrieval (p < 0.05), possibly a beneficial transfer effect of the training method per se. In contrast, the NT group worsened in phonemic and semantic shifting (p < 0.01). Observed improvements in flexibility and in episodic memory in the HC may be linked to training effects of retesting.
Rhythmic cues are resistant to neurodegeneration and have a strong motivating factor. As thus, these may facilitate high-intensive and demanding training. Although both trainings were superior to NT, the improvement of cognitive abilities depends on the specific training method. Further, therapy may be more effective when delivered by a therapist rather than by an impersonal computer program.
本研究旨在比较两种不同的节奏、高强度干预措施,即节奏语言治疗(rSLT)与节奏平衡-运动训练(rBMT),与帕金森病患者的无治疗(NT)条件以及健康对照组(HC)相比,在认知能力的变化或增强方面。
4 组(rSLT:N = 16;rBMT:N = 10;NT:N = 18;HC:N = 17)在年龄、性别和教育程度上相匹配,并在 6 个认知领域进行测试:工作记忆、执行功能、视觉结构、情景记忆、注意力和单词检索。评估在基线、4 周(T1)和 6 个月(T2)进行。节奏干预总共进行 3 次/周,共 4 周。为了分析组间和跨时间的真正干预效果,统计分析包括可靠变化指数。采用多变量方差评估进行组间差异评估,而采用均值差 95%置信区间进行组内差异评估。
rSLT 改善了工作记忆和单词检索(p < 0.05),可能是训练方法本身的有益转移效应。相比之下,NT 组在语音和语义转换方面恶化(p < 0.01)。HC 中灵活性和情景记忆的观察到的改善可能与重测的训练效应有关。
节奏线索具有抗神经退行性和强大的激励因素。因此,这些因素可能有助于高强度和高要求的训练。尽管两种训练都优于 NT,但认知能力的提高取决于特定的训练方法。此外,由治疗师而不是非个人计算机程序提供的治疗可能更有效。