Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
Clin Rehabil. 2024 Apr;38(4):443-456. doi: 10.1177/02692155231216621. Epub 2023 Nov 27.
OBJECTIVE: To summarize the effect of dual-task training on cognitive, physical function, and dual-task performance in people with mild cognitive impairment or dementia. DATA SOURCES: Embase, PEDro, PsycINFO, PubMed, CINAHL, The Cochrane Library, and a forward search conducted via Web of Science have been searched from inception to July 2023. REVIEW METHODS: Good-quality randomized controlled trials compared dual-task training with no/placebo intervention or single-task training among people with a primary diagnosis of mild cognitive impairment or dementia were included. The PEDro scale was used to evaluate the methodological quality of individual studies. The Grading of Recommendations, Assessment, Development and Evaluations system was adopted to appraise the quality of evidence for each outcome. RESULTS: Eighteen trials (1325 participants) were included, and 17 provided data for meta-analysis. Comparing with no intervention, dual-task training led to significant improvements on attention (mean difference (MD) = -20.66, 95%CI [-39.42, -1.90]), functional mobility (MD = -2.73; 95%CI [-3.98, -1.49]). Compared with single-task training, dual-task training had greater effects on overall cognitive function (standardized mean difference (SMD) = 0.29, 95%CI [0.09, 0.49]), balance (SMD = 0.78, 95%CI [0.40, 1.15]) and functional mobility (MD = -1.17; 95%CI [-1.77, -0.58]). Its effect on dual-task performance remains inconclusive due to the inconsistent results reported. CONCLUSION: Low- to moderate-quality evidence supports that dual-task training has beneficial effects on cognitive function and physical function in individuals with dementia or mild cognitive impairment. The optimal training protocol of dual-task training on cognitive and physical functions, and dual-task performance remains uncertain. Well-designed, randomized studies with large enough sample sizes are warranted.
目的:总结双重任务训练对轻度认知障碍或痴呆患者认知、身体功能和双重任务表现的影响。
资料来源:从建库到 2023 年 7 月,对 Embase、PEDro、PsycINFO、PubMed、CINAHL、The Cochrane Library 以及通过 Web of Science 进行的正向搜索进行了检索。
综述方法:纳入了将双重任务训练与无/安慰剂干预或单一任务训练进行比较的高质量随机对照试验,这些试验的主要诊断为轻度认知障碍或痴呆。使用 PEDro 量表评估各个研究的方法学质量。采用推荐评估、制定与评价系统对每个结局的证据质量进行评估。
结果:纳入了 18 项试验(1325 名参与者),其中 17 项提供了用于荟萃分析的数据。与无干预相比,双重任务训练可显著改善注意力(均数差值(MD)=-20.66,95%置信区间[-39.42,-1.90])和功能性移动(MD=-2.73;95%置信区间[-3.98,-1.49])。与单一任务训练相比,双重任务训练对整体认知功能(标准化均数差值(SMD)=0.29,95%置信区间[0.09,0.49])、平衡(SMD=0.78,95%置信区间[0.40,1.15])和功能性移动(MD=-1.17;95%置信区间[-1.77,-0.58])的影响更大。由于报告的结果不一致,其对双重任务表现的影响仍不确定。
结论:低到中等质量的证据支持双重任务训练对痴呆或轻度认知障碍患者的认知功能和身体功能有有益的影响。双重任务训练对认知和身体功能以及双重任务表现的最佳训练方案仍不确定。需要进行设计良好、样本量足够的随机研究。
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