執行減數任務對於健康中老年人姿勢控制的影響

背景與目的：過去研究發現認知為參與姿勢控制的因素之一，而雙重任務方法被用來評估受試者姿勢控制受認知的干擾程度，並且使用雙重任務虧損來表示是否有受到雙重任務的影響，健康中老年人因為認知或平衡任務的難度增加則雙重任務虧損增加。本研究想要了解健康中老年人認知與行走功能及雙重任務虧損的相關性，也想要了解認知任務及平衡任務的難易度使受試者雙重任務表現的變化為何。方法：本研究收入29位健康中老年人(平均年齡63.4±9.6歲)。檢測1.認知功能：迷你心智測驗、數字廣度測驗、史楚普色詞測驗及路徑描繪測驗；2.行走功能：五公尺行走及計時起走測試，使用Pearson相關與迴歸分析檢定相關性。評估執行初階(-1)/高階(-3)減數任務、站立平衡任務及行走任務之單雙任務時的表現為何，並探討雙重任務虧損的變化，使用成對樣本T分析及ANOVA分析檢定差異。結果：行走速度與數字廣度測驗正數最長字數呈中度負相關(PCC=-0.40，P=0.03)及正數T分數呈中度負相關(PCC=-0.41，P=0.03)，雙腳支撐時期與史楚普色詞測驗顏色字最長字數呈低度負相關(PCC=-0.39，P=0.04)及干擾T分數呈中度負相關(PCC=-0.50，P=0.00)，雙腳支撐時期之雙重任務虧損與路徑描繪測驗B部分秒數呈中度正相關(PCC=0.40，P=0.04)。減數答對個數在單任務表現和加入站立平衡任務後的雙任務表現 (P=0.71-0.87)加入行走平衡任務後的雙任務表現(P=0.07-0.16)皆無顯著差異，但是比較站立平衡任務(-6.4±22.9%)和行走平衡任務(71.6±15.8%)的高階減數任務雙重任務虧損指標之間有顯著差異(P=0.05)。加入減數任務後，步頻有差異(P=0.01)；速度(P=0.49)及雙腳支撐時期(P=0.30)則無發現差異，但是有出現速度(2.2±13.8%)、步頻(4.6±9.0%)及雙腳支撐時期(4.6±9.0%)的雙重任務虧損。結論：注意力及執行功能與步態參數之間有低度到中度相關。平衡任務難度增加會影響減數任務的表現並且出現雙重任務虧損，認知任務難易度增加會造成步態雙重任務虧損並且在步頻出現差異。臨床意義：可以了解認知功能步態之間的相關性及比較會影響哪個步態參數。了解健康中老年人認知、步態及雙重任務虧損變化幅度。

關鍵字

健康中老年人；認知；雙重任務虧損；相關

並列摘要

BACKGROUND AND OBJECTIVE: Previous studies found that cognition is one of he factors involved in postural control. Dual task method is used to assess the influence of cognitive on postural control, and use the dual task cost to represent it. In the past, previous studies found that when the difficulty of the dual task increased, the dual task cost increased in healthy elderly. For this study, we want to know the relationships between the cognitive, walking function and the dual task cost in healthy middle-age and older audlts. Methods: In our study, we assessed 1. cognitive function: MMSE、Digit Span Test、Trail Making Test and Stroop Color Word Test, 2. walking function: 5-M walking test and Timed up and go test in 29 healthy middle-age and older audlts(aged 63.4±9.6 years). Pearson’s correlation coefficients were used to assess the outcomes(cognitive, walking function and the dual task cost). Explore change the dual task performance in healthy middle-age and older audlts stroke patients. Paired sample T test were used to assess the differences. Results: The Pearson’s correlation coefficients analysis showed that speed and length of digit span test had moderate negative correlation(PCC = -0.40, P <0.05), and digit span test positive T scores had moderate negative correlation(PCC = -0.41, P <0.05). Double support duration and Stroop color-word test interference T scores had moderate negative correlation (PCC = -0.50, P <0.05), and the longest the Stroop color-word test color-word test had mild negative correlation (PCC = -0.39, P = 0.04), The dual task cost of double support duration and trail making test part B of seconds had moderate positive correlation(PCC = 0.40, P = 0.04), other non-correlation. Comparing the performance of subtraction task in single task and standing balance task had no significant(P =0.71-0.87), Comparing the performance of subtraction task in standing balance task and walking task had no significant(P = 0.06-0.16), but the dual task cost of standing balance tasks (-6.4 ± 22.9%) and walking balance tasks (71.6 ± 15.8%) had significant (P=0.05). Comparing low/high-demand subtraction task, there are differences in cadence (P = 0.01),but speed (P = 0.49), and double support duration( P = 0.30) had no differences. Conclusion: Between attention, executive function and gait parameters had low to moderate correlation.The difficulty of balancing task increased will affect the performance of the subtraction task and the dual task cost, the difficulty of cognitive task increased will cause the dual task cost of gait, and cadence had variance.Clinical significance: To understand and compare the relationships between the gait parameters and cognitive function. To learn the changes of cogntion, gait and the dual task cost in healthy middle-age and older audlts. Keywords: healthy middle-age and older audlts, cognition, dual task cost, correlation.

並列關鍵字

healthy middle-age and older audlts ； cognition ； dual task cost ； correlation

參考文獻

Allali, G., Kressig, R. W., Assal, F., Herrmann, F. R., Dubost, V., & Beauchet, O. (2007). Changes in gait while backward counting in demented older adults with frontal lobe dysfunction. Gait Posture, 26(4), 572-576. doi: 10.1016/j.gaitpost.2006.12.011

Antonia K. Coppin, Anne Shumway-Cook, Jane S. Saczynski, Kushang V. Patel, Alessandro Ble, Luigi Ferrucci, & Guralnik, J. M. (2006). Association of executive function and performance of dual-task physical tests among older adults: analyses from the InChianti study. Age Ageing, 35(6), 619-624. doi: 10.1093/ageing/afl107

Barde, L. H., & Thompson-Schill, S. L. (2002). Models of functional organization of the lateral prefrontal cortex in verbal working memory: evidence in favor of the process model. Journal of Cognitive Neuroscience, 14(7), 1054-1063.

Barros de Oliveira, Clarissa Torres de Medeiros, Ítalo Roberto Frota, Norberto Anizio Ferreira Greters, Mrio Edvin Conforto, & Conforto, A. B. (2008). Balance control in hemiparetic stroke patients: Main tools for evaluation. The Journal of Rehabilitation Research and Development, 45(8), 1215-1226. doi: 10.1682/jrrd.2007.09.0150

Beauchet, O., Dubost, V., Herrmann, F. R., & Kressig, R. W. (2005). Stride-to-stride variability while backward counting among healthy young adults. J Neuroeng Rehabil, 2, 26. doi: 10.1186/1743-0003-2-26

國際替代計量

執行減數任務對於健康中老年人姿勢控制的影響

全文下載

主題瀏覽