■确定与健康的老年受试者相比,中风后患者上肢任务期间的双重任务干扰是否增加,并将中风引起的干扰变化的幅度与衰老所解释的变化进行比较。
■我们在MEDLINE进行了系统的文献检索,CINAHL,截至2023年10月,GoogleScholar和PEDro数据库用于研究中风和老年健康受试者的上肢双重任务。确定了11项针对中风患者的上肢双重任务研究和11项针对健康老年受试者的研究,并进行了系统回顾。对包括对照组在内的健康老年受试者的7项中风研究和5项研究进行了荟萃分析。
■大多数中风研究通过运动学测量来研究近端手臂运动,但很少有研究评估手的灵活性。相比之下,在健康的老年受试者中的研究使用了更多的远端(手指敲击)任务。荟萃分析显示,与年龄匹配的健康对照组(Z=2.06,p=0.04)相比,中风患者的双重任务干扰平均增加了19%(CI95%=1.0-37.3)。与年轻受试者相比,年龄较大的健康受试者表现出更大的双重任务干扰(19%以上,CI95%=6.5-31.2,Z=2.98,p=0.003)。
■荟萃分析显示,脑卒中患者上肢运动时双重任务干扰增加,超过与年龄相关的变化,支持卒中后注意力不集中的亚临床损伤的存在,这可能会阻碍运动恢复。
UNASSIGNED: To determine whether dual-task interference during upper limb tasks is increased in patients after stroke compared to healthy older subjects and to compare magnitude of stroke-induced change in interference to that explained by aging.
UNASSIGNED: We conducted a systematic literature search in MEDLINE, CINAHL, Google Scholar and PEDro databases up to October 2023 for studies on upper limb dual-tasks in stroke and elderly healthy subjects. Eleven upper limb dual-task studies in stroke patients and 11 studies in healthy older subjects were identified and systematically reviewed. A meta-analysis was performed on seven stroke studies and on five studies in healthy older subjects that included control groups.
UNASSIGNED: Most stroke studies investigated proximal arm movements with kinematic measures, but few studies evaluated manual dexterity. In contrast, studies in healthy older subjects used more distal (finger tapping) tasks. The meta-analysis showed that stroke patients had on average a 19% (CI 95% = 1.0-37.3) increase in dual-task interference compared to age-matched healthy controls (Z = 2.06, p = 0.04). Older healthy subjects showed greater dual-task interference compared to younger subjects (19% greater, CI 95% = 6.5-31.2, Z = 2.98, p = 0.003).
UNASSIGNED: Meta-analysis revealed an increase in dual-task interference during upper limb movements in stroke patients, exceeding age-related changes, supporting the presence of subclinical impairments in divided attention post-stroke that may impede motor recovery.