Efficacy of tailored computer-based neurorehabilitation for improvement of movement initiation in Parkinson's disease
Efficacy of tailored computer-based neurorehabilitation for improvement of movement initiation in Parkinson's disease
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DOI：
10.1016/j.brainres.2012.02.073
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发表时间：
2012-05-03
期刊：
影响因子：
2.9
通讯作者：
Sigvardt, K. A.
中科院分区：
文献类型：
--
作者：
Disbrow, E. A.;Russo, K. A.;Sigvardt, K. A.
虽然帕金森病（PD）被认为是一种运动障碍，但PD的运动体征可能因认知功能障碍而加剧。我们评估了一个基于计算机的认知康复训练计划，旨在改善运动相关的执行功能的有效性。30名PD患者和21名对照者参加了为期10天的培训。训练包括两个阶段的按钮按压任务。首先，受试者产生一个外部提示（EC）数字序列，键入计算机屏幕上显示的数字。其次，提示受试者在没有数字显示的情况下生成相同的序列（内部表示序列，IR）。自动调整序列长度以保持87%的正确性能。参与者在训练前后使用固定版本的训练任务进行评估，并使用涉及IR运动排序，切换和日常生活活动的措施评估训练的泛化。PD参与者被分为两组，训练前IR运动序列产生受损的参与者（N=14）和表现与对照组相似的参与者（N=16）。训练后，受损的PD组显示出显着更大的减少序列的启动和完成时间和错误率的IR条件相比，未受损的PD和对照组。所有组均改善了Trails B-A，并且训练前Trails B被确定为IR序列完成时间和错误率的基于训练的改善的预测因子。我们的研究结果强调了针对PD患者特定认知缺陷的神经康复的重要性。(C)2012爱思唯尔有限公司版权所有。
While Parkinson's disease (PD) is considered a motor disorder, motor signs of PD can be exacerbated by cognitive dysfunction. We evaluated the efficacy of a computer-based cognitive rehabilitation training program designed to improve motor-related executive function. Thirty people with PD and 21 controls participated in the 10-day training. Training consisted of a two-phase button press task. First, subjects produced an externally cued (EC) digit sequence, typing numbers displayed on the computer screen. Second, subjects were prompted to generate the same sequence in the absence of the number display (internally represented sequence, IR). Sequence length was automatically adjusted to maintain 87% correct performance. Participants were evaluated before and after training using a fixed version of the training task, and generalization of training was assessed using measures involving IR motor sequencing, switching and activities of daily living. PD participants were divided into two groups, those who showed impairment in IR motor sequence production prior to training (N=14) and those whose performance was similar to controls (N=16). Following training the impaired PD group showed significantly greater reduction in sequence initiation and completion time and in error rate for IR conditions compared to the unimpaired PD and control groups. All groups improved on Trails B-A, and pre-training Trails B was identified as a predictor of training-based improvement in IR sequence completion time and error rate. Our findings highlight the importance of neurorehabilitation tailored to the specific cognitive deficits of the PD patient. (C) 2012 Elsevier B.V. All rights reserved.