双任务干预改善健康老年人平衡功能效益的系统综述

Benefits of dual-task intervention on balance function for healthy aged people:a systematic review

目的系统综述双任务干预对健康老年人平衡功能干预的有效性。方法检索Web of Science核心合集、PubMed、CNKI和万方数据库,搜索双任务干预健康老年人平衡功能影响的随机对照试验(RCTs),检索时间2010年1月至2022年11月。利用物理治疗证据数据库(PEDro)量表评价文献质量。由两名研究人员根据纳入、排除标准进行文献筛选、数据提取和风险偏倚评估。结果最终纳入14篇双任务干预健康老年人平衡功能的RCTs研究,来自10个国家,共涉及1279例健康老年人,来源于运动心理、运动康复、老年人康复等研究领域。PEDro量表平均分为7.85分。老年人平衡功能干预中的双任务模式主要有运动-认知、运动-运动和认知-认知3种类型。其中运动干预方式为平衡训练和力量训练等体适能类、姿势控制和步态练习等运动技能类。运动-认知双任务干预是在运动干预的基础上同步进行认知干预,如记忆、注意和执行功能等;运动-运动双任务干预是在运动干预的基础上同步进行持物练习、日常事务等次要运动干预;认知-认知双任务干预要求被试同时执行两项认知任务。双任务干预老年人平衡功能主要表现在3个方面。①平衡功能:保持站姿和移动自身。②平衡功能相关的体适能:下肢肌力功能等。③平衡功能相关的心理和整体健康功能:单任务步行、双任务步行、日常事务、跌倒频率、跌倒恐惧、平衡信心等。结论双任务和单任务干预模式均能够改善健康老年人平衡功能和相关体适能,提高站姿稳定性和自身移动能力,改善下肢力量和下肢活动功能,降低跌倒风险和恐惧心理感。特别是双任务干预模式在提高双任务平衡控制表现方面优于单任务干预模式,更能够提升日常生活能力和整体健康发展。

Objective To conduct systematic review on the benefits of dual-task intervention on balance function for healthy aged people.Methods The Web of Science core collection,PubMed,CNKI,and Wanfang database were searched for randomized controlled trial(RCTs)on the effects of dual-task interventions on balance function in healthy aged people from January 1st,2010,to November,2022.The quality of the literature was evaluated with the Physiotherapy Evidence Database(PEDro)scale.Literature screening,data extraction,and risk bias assessment were performed by two researchers based on inclusion and exclusion criteria.Results Fourteen RCTs of dual-task interventions for balance function in healthy older adults from ten countries with a total of 1279 healthy aged people from the research fields of sport psychology,exercise rehabilitation,and geriatric rehabilitation were finally included.The mean score of the PEDro scale was 7.85.The main types of dual-task modalities for balance function interventions for aged people were motor-cognitive,motor-motor and cognitivecognitive.Within these,the main motor intervention modalities were physical fitness such as balance training and strength training,and motor skill such as postural control and gait exercises.Motor-cognitive dual-task interventions referred to simultaneously performing motor and cognitive skills exercises,such as memory,attention and executive functions.Motor-motor dual-task interventions referred to simultaneously performing motor and second motor exercises,such as object-holding exercises and daily routines.Cognitive-cognitive dual-task interventions referred to simultaneously performing two cognitive exercises.The efftects of dual-task intervention model on balance function of aged people might be in three aspects.(1)Balance function:maintaining standing posture and moving oneself.(2)Balance function-related physical fitness:lower limb muscle strength functions,etc.(3)Balance function-related mental and overall health functioning:single-task walking,dual-task walking,daily life,falling possibility,fear of falling,balance confidence,etc.Conclusion Both dual-task and single-task intervention modes could improve the balance function and related physical fitness of healthy aged people,improve the stability of standing posture and self-mobility,improve the strength and function of lower limbs,and reduce the risk of falls and psychological fear.In particular,the dual-task intervention model is superior to the single-task intervention model in improving dual-task balance control performance,and was more able to improve the ability of daily living and overall health development.