研究緣由
在醫院復健科工作，最常接觸到中樞神經受損的個案，反思著除了現有的臨床技巧之外，還有什麼方法能協助到臨床急性期的人，臨床上常見介入手法，例如：侷限誘發療法、鏡像治療、雙側任務訓練、任務導向訓練、經顱電刺激(RTMS)….，考量現實環境與預算，與指導老師吳菁宜教授討論後，我們以有氧運動結合電腦化認知訓練方式，介入在有認知受損的穩定期中風個案，這一個多中心隨機試驗，跨足多個研究單位，而我負責的是東部地區醫院的收案，其他夥伴是在北部醫院，2014~2017年這段期間，我一邊上班一邊完成碩士學位，在碩論口試告一段落後，想了解並整合在不同醫院收案結果，主動跟指導教授提出，希望能參與後續整理的作業流程，我主要負責是跑統計、跟博後學姐討論結果。花了二個多月，來回長庚大學、東部醫院，總算整併好並如期完成，後續學姐再接手將討論、結論部份完成!
以下截錄研究Clinical efficacy of aerobic exercise combined with computer based cognitive training in stroke: a multicenter RCT (中風的有氧運動結合電腦化認知訓練：多中心隨機試驗) 的大綱，希望幫助到有需求的人
Purpose
The objectives are to evaluate the effects of a sequential combination of aerobic exercise and cognitive training, compared with exercise or cognitive training alone, on cognitive function, physical function, daily function, quality of life, and social participation in stroke survivors with cognitive impairment.
Methods
This is a single-blind, parallel, randomized controlled trial. Stroke patients with mild cognitive impairment (n = 56) were randomly assigned to 3 groups.
Aerobic exercise training (n = 18), computerized cognitive training (n = 18), sequential combination of aerobic exercise and computerized cognitive training (n = 20), All groups underwent training 60 min/day, 3 days/week, for a total of 12 weeks.
| The primary outcomes | Secondary outcomes |
|---|---|
| Montreal Cognitive Assessment Wechsler Memory Scale-Third Edition Stroop color-word test | Timed Up and Go test 6-Minute Walk Test Functional Independence Measure Lawton Instrumental Activities of Daily Living Scale Community Integration Questionnaire Stroke Impact Scale |
Results
56 participants completed the trial.
Compared with a single type of aerobic exercise or cognitive training, the combined training group showed significant improvement in MoCA (P < .05, η2 = 0.13), and two sub-tests in WMS-III (both P’s < 0.05) following the intervention.
However, no between-group differences were observed for physical functions, daily function, quality of life, and social participation measures.
Conclusions
The findings provide evidence for the potential synergistic intervention in stroke survivors.
Future studies investigating the transfer effects and the optimal training parameters with a larger sample is needed.
