双重任务与单一任务训练对老年人步态和平衡改善效果的Meta分析

doi:10.3761/j.issn.0254-1769.2019.09.024

摘要/Abstract

摘要：

目的比较双重任务训练与单一任务训练对健康老年人步态和平衡的改善效果。方法计算机检索Cochrane Library、Medline、EMBASE、Web of Science、PubMed、Ovid、CINAHL（EBSCO）及中国知网数据库中有关双重任务训练与单一任务训练对健康老年人步态、平衡改善效果的研究。采用RevMan 5.3软件进行Meta分析。结果最终纳入18篇文献,研究对象775例。Meta分析结果显示,双重任务训练对老年人步速和步长的改善效果优于单一任务训练（P<0.05）,2种训练方式对老年人平衡的改善效果差异无统计学意义（P>0.05）。结论双重任务训练比单一任务训练能更好地改善老年人的步速和步长,降低其跌倒风险,对平衡功能的改善效果是否有优势有待进一步探讨。

关键词: 运动训练, 老年人, 步态, 平衡, Meta分析, 老年护理学

Abstract:

Objective To compare the effects of dual-task training and single-task training on gait and balance performance in healthy older adults.Methods Electronic databases including Cochrane Library,Medline,EMBASE,Web of Science,PubMed,Ovid,CINAHL（EBSCO） and China National Knowledge Internet were searched. Randomized controlled trails that assess the effects of dual-task training and single-task training in healthy older adults were included. Meta-analysis was conducted using Revman 5.3.Results Totally 18 studies with a population of 775 were reviewed and pooled for meta-analysis. Dual-task training was superior to single-task training in improving gait speed and step length（P<0.05）,the effects of dual-task training and single-task training were equal in the improvement of balance performance（P>0.05）.Conclusion Compared with the traditional single-task training,the dual-task training can better improve the gait speed and step length of the elderly. The effects of dual-task training on the balance performance needs further discussion.

Key words: Sports Training, Aged, Gait, Balance, Meta-Analysis, Geriatric Nursing

张慧鑫, 陈健新, 张瑞丽, 李慧娟, 吴景梅. 双重任务与单一任务训练对老年人步态和平衡改善效果的Meta分析[J]. 中华护理杂志, 2019, 54(9): 1400-1405.

ZHANG Huixin, CHEN Jianxin, ZHANG Ruili, LI Huijuan, WU Jingmei. A meta-analysis of the effects of dual-task and single-task training on improvement of gait and balance in the elderly[J]. Chinese Journal of Nursing, 2019, 54(9): 1400-1405.

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参考文献 28

[1]	陈艳玫, 刘子锋, 李贤德 , 等. 2015—2050年中国人口老龄化趋势与老年人口预测[J]. 中国社会医学杂志, 2018,35(5):480-483.
[2]	Rubenstein LZ, Josephson KR . Falls and their prevention in elderly people:what does the evidence show?[J]. Med Clin N Am, 2006,90(5):807-824.
[3]	周晓美, 冯璇 . 跌倒风险评估工具的研究进展[J]. 护理学杂志, 2018,33(21):109-112.
[4]	梁雷超, 吕娇娇, 黄灵燕 , 等. 认知-姿势控制双任务在老年人跌倒研究中的应用进展[J]. 中国康复理论与实践, 2016,22(11):1289-1293. DOI
[5]	Smith E, Cusack T, Blake C . The effect of a dual task on gait speed in community dwelling older adults:a systematic review and meta-analysis[J]. Gait Posture, 2016,44:250-258.
[6]	Jadad AR, Moore R, Carroll D , et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials, 1996,17(1):1-12.
[7]	Jehu D, Paquet N, Lajoie Y . Balance and mobility training with or without concurrent cognitive training does not improve posture,but improves reaction time in healthy older adults[J]. Gait Posture, 2017,52:227-232.
[8]	Brustio PR, Rabaglietti E, Formica S , et al. Dual-task training in older adults:the effect of additional motor tasks on mobility performance[J]. Arch Gerontol Geriatr, 2018,75:119-124.
[9]	Hiyamizu M, Morioka S, Shomoto K , et al. Effects of dual task balance training on dual task performance in elderly people:a randomized controlled trial[J]. Clin Rehabil, 2012,26(1):58-67.
[10]	You JH, Shetty A, Jones T , et al. Effects of dual-task cognitive-gait intervention on memory and gait dynamics in older adults with a history of falls:a preliminary investigation[J]. NeuroRehabilitation, 2009,24(2):193-198.
[11]	Wollesen B, Mattes K, Schulz S , et al. Effects of dual-task management and resistance training on gait performance in older individuals:arandomized controlled trial[J]. Front Aging Neurosci, 2017,9:415.
[12]	Plummer-D’Amato P, Cohen Z, Daee NA , et al. Effects of once weekly dual-task training in older adults:a pilot randomized controlled trial[J]. Geriatr Gerontol Int, 2012,12(4):622-629.
[13]	Falbo S, Condello G, Capranica L , et al. Effects of physical-cognitive dual task training on executive function and gait performance in older adults:a randomized controlled rrial[J]. Biomed Res Int, 2016,2016:1-12.
[14]	Theill N, Schumacher V, Adelsberger R , et al. Effects of simultaneously performed cognitive and physical training in older adults[J]. BMC Neurosci, 2013,14:103.
[15]	Ansai JH, de Andrade LP, de Souza Buto MS , et al. Effects of the addition of a dual task to a supervised physical exercise program on older adults’ cognitive performance[J]. J Aging Phys Act, 2017,25(2):234-239.
[16]	Gregory MA, Gill DP, Zou GY , et al. Group-based exercise com-bined with dual-task training improves gait but not vascular health in active older adults without dementia[J]. Arch Gero-ntol Geriatr, 2016,63:18-27.
[17]	Wongcharoen S, Sungkarat S, Munkhetvit P , et al. Home-based interventions improve trained,but not novel,dual-task balance performance in older adults:a randomized controlled trial[J]. Gait Posture, 2017,52:147-152.
[18]	Nematollahi A, Kamali F, Ghanbari A , et al. Improving balance in older people:adouble-blind randomized clinical trial of three modes of balance training[J]. J Aging Phys Act, 2016,24(2):189-195.
[19]	Brach JS, Lowry K, Perera S , et al. Improving motor control in walking:arandomized clinical trial in older adults with subclinical walking difficulty[J]. Arch Phys Med Rehabil, 2015,96(3):388-394.
[20]	Eggenberger P, Theill N, Holenstein S , et al. Multicomponent phy-sical exercise with simultaneous cognitive training to enhance dual-task walking of older adults:a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up[J]. Clin Interv Aging, 2015,10:1711-1732.
[21]	Shin SS, An DH . The effect of motor dual-task balance training on balance and gait of elderly women[J]. J Phys Ther Sci, 2014,26(3):359-361.
[22]	Silsupadol P, Shumway-Cook A, Lugade V , et al. Effects of single-task versus dual-task training on balance performance in older adults:a double-blind,randomized controlled trial[J]. Arch Phys Med Rehabil, 2009,90(3):381-387.
[23]	肖春梅 . 单项任务与双重任务条件下平衡训练提高老年人平衡能力比较研究[J]. 中国体育科技, 2012,48(3):100-103, 128.
[24]	Azadian E, Torbati HR, Kakhki AR , et al. The effect of dual task and executive training on pattern of gait in older adults with balance impairment:a randomized controlled trial[J]. Arch Gerontol Geriatr, 2016,62:83-89.
[25]	王莉, 于卫华 . 步态分析在老年人跌倒中的应用进展[J]. 中华护理杂志, 2016,51(3):347-351.
[26]	Wang XQ, Pi YL, Chen BL , et al. Cognitive motor interference for gait and balance in stroke:a systematic review and meta-analysis[J]. Eur J Neurol, 2015,22(3):537-555.
[27]	Ghai S, Ghai I, Effenberg AO . Effects of dual tasks and dual-task training on postural stability:a systematic review and meta-analysis[J]. Clin Interv Aging, 2017,12:557-577.
[28]	Wang X, Pi Y, Chen P . Cognitive motor interference for preventing falls in older adults:a systematic review and meta-analysis of random[J]. Age Ageing, 2015,44(2):205-212.