脳卒中患者の認知機能に対するデュアルタスクトレーニング効果のメタアナリシス
Ruolin Shi1, Weibo Li2, Xiaolu Liu1,2
1College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, China.
Background:
Post-stroke cognitive impairment (PSCI) affects ~40% of survivors, hindering recovery. Dual-task training (combining cognitive and motor tasks) may help, but its superiority over single-task training or usual care remains unclear. This study examines whether dual-task training improves cognitive function more than (1) single-task training or (2) usual rehab/control, and whether effects vary by intervention duration.
Methods:
Keywords were used to search Chinese and English databases. The search period was up to 15 October 2023. Randomized controlled trial (RCT) studies comparing the effects of dual-task training and single-task training or blank control on improving cognitive impairment in stroke patients were included and the quality of the included studies was evaluated using the Cochrane collaboration's risk assessment tool. The effect indicators were evaluated based on fixed-effects or random-effects models.
Results:
A total of 15 RCT studies were included. The results of the studies showed that there was a significant difference in mini-mental state examination scores in the dual-task training group compared with the control group (p < 0.0001). At intervention time >6 weeks trail making test-A scores were lower compared with controls (p < 0.00001). After intervention time >4 weeks, there was a significant difference in digit span test-backward scores compared with controls (p = 0.0003). There was a significant difference in digit span test-forward scores compared with controls (p = 0.0001) after >4 weeks of intervention. There was a significant difference in Montreal Cognitive Assessment scores compared with controls in elderly patients with insignificant cognitive deficits post-stroke (p < 0.00001) and patients with significant cognitive impairment following a stroke (p < 0.00001).
Conclusion:
Dual-task training is more effective than conventional rehabilitation in improving PSCI, but the aspects of improvement may be limited by the duration of the intervention, the number and quality of included studies and the differences in cognitive function, motor tasks and so on.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO, CRD42023393550.
