双任务下轻度认知功能障碍老年人执行功能与步态的关系  

The relationship between executive function and gait in mildly mentally-impaired persons

作　　者：沈龙彬 尹晓娜 欧阳辉[1] 欧建林 郑国强 陈卓铭[1] Shen Longbin;Yin Xiaona;Ouyang Hui;Ou Jianlin;Zheng Guoqiang;Chen Zhuoming(Department of Rehabilitation Medicine,The First Affiliated Hospital of Jinan University,Guangzhou 510000,China;Shenzhen Longhua Maternal and Child Health Hospital,Shenzhen 518000,China)

机构地区：[1]暨南大学附属第一医院康复医学科,广州510000 [2]深圳市龙华区妇幼保健院,深圳518000

出　　处：《中华物理医学与康复杂志》2022年第12期1074-1078,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：国家重点研发计划(2020YFC2005700)。

摘　　要：目的探讨遗忘型轻度认知功能障碍(aMCI)患者执行功能与步态间的关系。方法将就诊于我院康复医学科的20例aMCI患者纳入观察组,同期在广州市公共场所招募20例正常老年人纳入对照组。入组后2组受试者先完成Tinetti测试,再完成"正常步行"单任务测试及"正常步行+Go/No-go"双任务测试。各测试观察指标包括步速、步宽、跨步长、Go/No-go任务反应时及正确率等。结果在单任务下2组受试者步速、步宽组间差异均无统计学意义(P>0.05),但观察组跨步长[(1.11±0.04)m]明显不及对照组(P<0.001)。在双任务下,观察组步速[(0.96±0.08)m/s]、跨步长[(1.02±0.06)m]均明显不及对照组(P<0.001),而步宽[(0.11±0.02)m]则明显超过对照组(P<0.001)。2组受试者执行单任务Go/No-go测试的反应时(RT)基线均值[分别为(481.55±38.06)s与(468.85±38.66)s]组间差异无统计学意义(P=0.060);但执行双任务时观察组RT正确均值[(639.75±37.72)s]较对照组明显增加(P<0.001);观察组执行正确率[(61.90±8.35)%]明显低于对照组(P<0.001),而错误率[(22.45±6.49)%]与漏报率[(15.65±5.33)%]则显著高于对照组(P<0.001)。结论aMCI患者跨步长出现早期退变,其执行功能对行走步速、步宽等具有明显影响。Objective To explore the relationship between executive function and gait in cases of mild amnestic cognitive impairment(aMCI).Methods Twenty aMCI hospital patients formed an observation group,while 20 healthy counterparts were the control group.Both groups underwent the Tinetti test,followed by the"normal walking"single-task test and the"normal walking+Go/No-go"dual-task test.The pace,step width,stride length,Go/No-go task response time and accuracy rate were recorded.Results In the single-task test,there was no significant difference in pace or stride width between the two groups,but the average stride length of the observation group(1.11±0.04)cm was significantly shorter than that of the control group.However,in the dual-task test,the average pace time(0.96±0.08)sec and stride length(1.02±0.06)cm of the observation group were significantly smaller than the control group′s averages,while their step width(0.11±0.02)cm was significantly wider.There was no significant difference between the two groups in the response time in a single(Go/No-go)task,but in the dual-task test,the observation group′s average time was significantly longer than the control group′s and the accuracy was significantly poorer.Both the error rate and the non-response rate were significantly higher than among the control group.Conclusions Mild amnestic cognitive impairment reduces stride length and pace when walking and impairs executive function.

关 键 词：执行功能 抑制控制 双任务 遗忘型轻度认知障碍 步态 

分 类 号：R749.1[医药卫生—神经病学与精神病学]