基于远程康复技术的轻度认知障碍老年患者运动认知联合干预研究进展  

Research progress on combined exercise and cognitive intervention among older adults with mild cognitive impairment using telerehabilitation

作　　者：洪晨璐 刘广文 戴德政 关博元 黄玉洁 刘肇瑞[2] 罗雅楠 Chenlu HONG;Guangwen LIU;Takching TAI;Boyuan GUAN;Yujie HUANG;Zhaorui LIU;Yanan LUO(Department of Global Health,School of Public Health,Peking University,Beijing 100191,China;Peking University Sixth Hospital(Institute of Mental Health),National Clinical Research Center for Mental Disorders&Key Laboratory of Mental Health,Ministry of Health(Peking University),Beijing 100083,China;International and Domestic Cooperation Office,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]北京大学公共卫生学院全球卫生学系,北京100191 [2]北京大学第六医院,北京大学精神卫生研究所,国家精神心理疾病临床医学研究中心,国家卫生健康委员会精神卫生重点实验室(北京大学),北京100083 [3]首都医科大学附属北京天坛医院国际国内合作处,北京100070

出　　处：《阿尔茨海默病及相关病杂志》2024年第1期56-63,共8页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：美国中华医学基金会(22-477);首都卫生发展科研专项(首发2020-2Z4116);国家社科基金重大项目(21ZD187)。

摘　　要：运动认知联合干预是一种针对轻度认知障碍(mild cognitive impairment, MCI)老年患者的非药物干预方式,而远程康复技术通过信息和通信技术为MCI患者提供居家干预的途径,提高了干预的依从性和可及性。基于远程康复技术的MCI患者运动认知联合干预可通过设定个性化目标、实施电话督导及家访、提供在线技能培训及视频指导、家人支持等互动技术,提高患者的自我效能及依从性。应用于MCI老年患者运动认知联合干预的远程康复技术平台包括游戏化干预(运动游戏、严肃游戏)、数字和移动应用程序(应用程序、基于计算机网络的程序、视频会议)等。运动认知联合干预形式包括序贯式干预、双任务干预和交互式干预。基于健康行为理论的MCI患者远程康复干预策略强调了强化自我效能、个性化精准干预、提升社会支持、搭建用户友好型框架及增强健康信念等,但远程康复技术仍存在安全性问题、老年人对技术设备的学习障碍等挑战。基于远程康复技术的MCI老年患者运动认知联合干预,在提供灵活、经济、个性化干预方面具有重要的应用前景。未来研究应在健康行为理论的指导下,结合MCI老年患者的特征和偏好,设计用户友好型的远程康复平台,并进行更多针对中国MCI人群的研究,以提供高水平证据支持干预方案的可行性和可推广性。Combined exercise and cognitive intervention is a non-pharmacological approach for older adults with mild cognitive impairment(MCI),and telerehabilitation provides a home-based intervention for MCI patients through information and communication technology,enhancing intervention compliance and accessibility.Telerehabilitation technology,applied to the combined exercise and cognitive intervention for MCI patients,involves setting personalized goals,implementing telephone supervision and home visits,providing online skill training and video guidance,and family support through interactive technologies,thereby enhancing patient self-efficacy and compliance.Platforms for MCI patients'telerehabilitation interventions include gamification(exergames,serious games),digital and mobile applications(applications,web-based programs,videoconference),etc.The combination modes of physical and cognitive intervention include three types:sequential,dual-task and interactive types.Strategies for telerehabilitation of MCI patients based on health behavior theory emphasize strengthening self-efficacy,personalized precision intervention,enhancing social support,building user-friendly frameworks,and strengthening health beliefs,however,challenges such as safety issues and learning barriers for the older adults in using technological devices persist.The latest developments indicate that physical-cognitive interventions for older adults with MCI,based on telerehabilitation technology,hold significant prospects for flexible,economical,and personalized interventions.Future research should design user-friendly telerehabilitation platforms guided by health behavior theory,considering the characteristics and preferences of MCI patients,and conduct more studies targeting the Chinese MCI population to provide high-level evidence supporting the feasibility and generalizability of intervention programs.

关 键 词：远程康复技术 轻度认知障碍 运动认知联合干预 进展 

分 类 号：R749.1[医药卫生—神经病学与精神病学]