居家精细动作训练对老年人认知功能的影响：一项随机对照试验
Effects of home-based manual dexterity training on cognitive function among older adults: a randomized controlled trial.
作者信息
Seol Jaehoon, Lim Namhoon, Nagata Koki, Okura Tomohiro
机构信息
Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan (JNIOSH), Kawasaki, Japan.
International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.
出版信息
Eur Rev Aging Phys Act. 2023 Apr 22;20(1):9. doi: 10.1186/s11556-023-00319-2.
BACKGROUND
The relationship between manual dexterity and cognitive function among older adults is well known; however, few studies have focused on manual dexterity training that confirms cognitive load of training in older adults through functional near-infrared spectroscopy (fNIRS) and verifies the effect of training. This study examined the effects of home-based manual dexterity training on cognitive function in older adults using a digital trail-making peg test device combining two conventional assessment tools namely, the peg and trail-making tests.
METHODS
For 12 weeks, 57 healthy older adults aged 65-88 years participated in a parallel-group, randomized controlled trial, wherein home-based manual dexterity training was performed for approximately 20 min daily. To quantify the cognitive load in different manual dexterity conditions, we assessed the cortical activation patterns of the prefrontal cortex via a wearable four-channel fNIRS device. Participants in the control group were asked to continue their usual daily routines during the intervention period. Cognitive function was assessed using the Stroop Color and Word and Cognitive Impairment Tests. Manual dexterity was assessed using the Purdue Pegboard Test. All outcomes were estimated before and after the intervention.
RESULTS
We observed significant differences in prefrontal cortical activation between the different manual dexterity conditions. Only the intervention group showed a significant improvement in Stroop interference (169.0-108.9 ms, p = 0.032) and an executive function and assembly task of the Purdue Pegboard Test (22.5-26.4 counts, p < 0.001). Additionally, except the clock drawing task, cognitive function had a larger effect size (Cohen's d) in the intervention group (d = 0.26-0.45) than in the control group (d = 0.11-0.28).
CONCLUSIONS
Home-based manual dexterity training can improve performance in a complex manual dexterity task and executive functioning in older adults.
TRIAL REGISTRATION
UMIN-CTR Clinical Trial, UMIN000047203. Registered 17 March 2022 - Retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000053844&type=summary&language=E.
背景
老年人的手部灵巧性与认知功能之间的关系已为人熟知；然而，很少有研究关注通过功能近红外光谱（fNIRS）确认老年人训练认知负荷并验证训练效果的手部灵巧性训练。本研究使用一种结合了两种传统评估工具（即钉板测试和连线测试）的数字连线钉板测试装置，考察了居家手部灵巧性训练对老年人认知功能的影响。
方法
57名年龄在65 - 88岁的健康老年人参加了一项为期12周的平行组随机对照试验，其中居家手部灵巧性训练每天进行约20分钟。为了量化不同手部灵巧性条件下的认知负荷，我们通过可穿戴四通道fNIRS设备评估前额叶皮层的皮质激活模式。对照组参与者被要求在干预期内继续他们的日常活动。使用Stroop颜色和文字测试以及认知障碍测试评估认知功能。使用普渡钉板测试评估手部灵巧性。所有结果在干预前后进行评估。
结果
我们观察到不同手部灵巧性条件下前额叶皮质激活存在显著差异。只有干预组在Stroop干扰（169.0 - 108.9毫秒，p = 0.032）以及普渡钉板测试的执行功能和组装任务（22.5 - 26.4次计数，p < 0.001）方面有显著改善。此外，除了画钟测试外，干预组认知功能的效应量（Cohen's d）（d = 0.26 - 0.45）大于对照组（d = 0.11 - 0.28）。
结论
居家手部灵巧性训练可以提高老年人在复杂手部灵巧性任务中的表现以及执行功能。
试验注册
UMIN - CTR临床试验，UMIN000047203。2022年3月17日注册 - 回顾性注册，https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000053844&type=summary&language=E。
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