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对脑瘫认知功能有影响的干预措施:一项系统综述

Interventions with an Impact on Cognitive Functions in Cerebral Palsy: a Systematic Review.

作者信息

Blasco Montse, García-Galant María, Berenguer-González Alba, Caldú Xavier, Arqué Miquel, Laporta-Hoyos Olga, Ballester-Plané Júlia, Miralbell Júlia, Jurado María Ángeles

机构信息

Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.

Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.

出版信息

Neuropsychol Rev. 2023 Jun;33(2):551-577. doi: 10.1007/s11065-022-09550-7. Epub 2022 Aug 16.

Abstract

This systematic review aimed at investigating those interventions that impact on cognitive functioning in children and adults with cerebral palsy (CP). A systematic database search was conducted and twenty-eight studies suitable for inclusion were identified, of which only nine were randomized controlled trials (RCTs). Among all the studies included, ten were multi-modal (cognitive and physical tasks), eleven physical, five cognitive, and two alternative and augmentative communication interventions. The evidence suggests that multi-modal and physical interventions improve general cognitive functioning. Multi-modal and cognitive interventions have an impact on visual perception. Both interventions, together with physical interventions have an effect on a specific executive function domain (inhibitory control), and only cognitive interventions improved other executive function domains such as working memory. However, no RCT assessed the effects of all executive function domains. Few studies have looked at interventions to improve memory and language, and there is a scarcity of long-term research. Future RCTs must be of higher quality and better account for age and sex differences, as well as the clinical heterogeneity of CP. To date, there is evidence that multi-modal, cognitive or physical interventions have an impact on general cognitive functioning, visual perception and executive functions in children with CP, which may support their cognitive development.The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42020152616.

摘要

本系统评价旨在调查那些对患有脑瘫(CP)的儿童和成人认知功能有影响的干预措施。进行了系统的数据库检索,确定了28项适合纳入的研究,其中只有9项是随机对照试验(RCT)。在所有纳入的研究中,10项是多模式(认知和身体任务)干预,11项是身体干预,5项是认知干预,2项是替代和辅助沟通干预。证据表明,多模式和身体干预可改善一般认知功能。多模式和认知干预对视觉感知有影响。这两种干预措施以及身体干预对特定的执行功能领域(抑制控制)有作用,只有认知干预改善了其他执行功能领域,如工作记忆。然而,没有RCT评估所有执行功能领域的效果。很少有研究关注改善记忆和语言的干预措施,长期研究也很匮乏。未来的RCT必须具有更高的质量,更好地考虑年龄和性别差异以及CP的临床异质性。迄今为止,有证据表明多模式、认知或身体干预对CP儿童的一般认知功能、视觉感知和执行功能有影响,这可能有助于他们的认知发展。该方案已在国际前瞻性系统评价注册库(PROSPERO)注册:CRD42020152616。

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