體感遊戲訓練對健康中老年人認知功能及心率變異度之影響

Effects of training using an exergame on cognitive function and heart rate variability in healthy middle-aged and older adults

余梓誠(Tzu-Cheng Yu)

指導教授 ： 朱奕華

高雄醫學大學/醫學院/運動醫學系碩士班/碩士(2017年)

摘要

研究背景: 近年來有許多文獻發現，規律運動能改善中老年人的認知功能，亦可能可以預防或延緩失智症的發生，此外，開放式技巧運動 (如球類運動)又比封閉式技巧運動 (如慢跑)更能有效改善認知功能。而體感遊戲被視為一種運動的模式，其遊戲進行的方式與開放式技巧運動相似，因此，進行體感遊戲可能有助於認知功能的改善。然而目前仍缺乏相關的研究。過去的研究指出，心率變異度的改善可能是運動促進認知功能的作用機制之一，但過去運動與認知功能的相關研究中鮮少包含心率變異度的測量。
研究目的: 本研究將以體感遊戲做為運動訓練的模式，探討體感遊戲訓練對中老年人認知功能及心率變異度的影響。並更進一步探討心率變異度與認知功能之間的關係。
研究方法: 本研究為隨機控制實驗，共招募43位符合研究條件之受試者，隨機分配至體感遊戲運動訓練組或控制組，運動訓練為期10週，每週3次，每次50分鐘。控制組則維持原本的生活型態，受試者在介入前後進行認知功能（記憶廣度測驗、倫敦塔測驗）及心電圖測量。
研究結果:在十周的體感遊戲訓練後，運動組之順序記憶廣度(p=0.022)及記憶廣度總分(p=0.006)皆有顯著提高，控制組則無顯著改變，此外，運動組三項記憶廣度測驗成績之改變量皆顯著高於控制組。另一方面，倫敦塔測驗及心率變異度在組內及兩組間皆無顯著差異。認知功能與心率變異度之間沒有顯著的相關性。
結論：本研究發現，使用XBOX Kinect體感遊戲進行運動訓練十周後，可以有效的提升健康中老年人認知功能之注意力、警覺性、聽覺記憶以及短期工作記憶。而倫敦塔測驗之成績在本研究中並沒有被發現到有顯著的差異，顯示了體感遊戲訓練對於中老年人認知功能的影響是有選擇性的。另一方面，體感遊戲訓練對心率變異度之影響在本研究中並沒有被觀察到，本研究也沒有發現心率變異度與認知功能的相關性。

關鍵字

體感遊戲 ； 認知功能 ； 記憶廣度 ； 倫敦塔

並列摘要

Background：
Recently, reserch has shown that regular exercise can improve cognitive function in middle-aged and older adults, and may also prevent or delay the occurrence of dementia. In addition, open-skill exercise (such as basketball) appears to be more effective than closed-skill exercise (such as jogging) in improving cognitive function. Exergame, a new mode of exercise, is similar to an open-skill exercise. Thus, playing exergame may improve cognitive function. However, there is still lake of relevant research. Previous studies have suggested that improvement in heart rate variability (HRV) may be one of the mechanisms by which exercise promote cognitive function, but few studies on exercise and cognitive function in the past include measurements of HRV.
Purpose：
The present study used exergame as an exercise training program to examine the effect of exergame training on cognitive function and HRV in healthy middle-aged and older adults. This study also further explored the correlation between HRV and cognitive function.
Method：
This was a randomized control study. Forty-three participants were recruited and randomly assigned to exergame training group or control group. The exergame group was trained for 10 weeks, 3 times a week, 50 minutes per session. The control group was asked to maintain their usual level of physical activity. Heart rate variability and cognitive function tests (Tower of London test, digit memory span test) were assessed at baseline and 10 weeks later.
Result：
After 10 weeks of exergame training, the score of digit memory span forward (p = 0.022) and total score of digit memory span (p = 0.006) were significantly improved in the exergame group, while no change was found in the control group. In addition, the changes in the three values of digit memory span were significantly different between the exergame and the control group. No changes were found within and between groups in the Tower of London test and HRV. No significant correlation was observed between the cognitive function and HRV.
Conclusion：
The results of this study suggested that a 10-week exergame training program using XBOX Kinect can effectively improve cognitive function of attention, alertness, auditory memory, and short-term working memory in healthy middle-aged and older adults. There was no significant finding in the Tower of London test, suggesting that the exergame training effects may be selective in improving different cognitive function. On the other hand, the effect of exergame training on HRV was not observed in this study, and there was no significant correlation between HRV and cognitive function.

並列關鍵字

Exergame ； Cognition ability ； digit span ； tower of london

參考文獻

1. Best, J.R., Exergaming in Youth: Effects on Physical and Cognitive Health. Z Psychol, 2013. 221(2): p. 72-78.

2. Randers, M.B., et al., Exercise performance and cardiovascular health variables in 70-year-old male soccer players compared to endurance-trained, strength-trained and untrained age-matched men. J Sports Sci, 2014. 32(13): p. 1300-8.

3. Bouchonville, M., et al., Weight loss, exercise or both and cardiometabolic risk factors in obese older adults: results of a randomized controlled trial. Int J Obes (Lond), 2014. 38(3): p. 423-31.

4. Webber, S.C., et al., Cardiovascular responses in older adults with total knee arthroplasty at rest and with exercise on a positive pressure treadmill. Eur J Appl Physiol, 2014. 114(3): p. 653-62.

5. Gluchowski, A., et al., Chronic Eccentric Exercise and the Older Adult. Sports Med, 2015. 45(10): p. 1413-30.