본문 바로가기
KERD
논문KCI 등재

동시적 이중과제 훈련이 노인의 실행기능에 미치는 효과: 체계적 고찰 및 메타분석

A Systematic Review and Meta-Analysis of the Effects of Simultaneous Dual-Task Training on Executive Function in Older Adults

박진혁|전유진
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2021.08|재활치료과학 (Therapeutic Science for Rehabilitation)|제10권 제3호|pp. 23-41|DOI https://doi.org/10.22683/tsnr.2021.10.3.023

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

메타분석노인Older adults실행기능Meta-analysisExecutive functionDual-task training이중과제 훈련

초록

목적 : 본 연구는 노인을 대상으로 한 동시적 이중과제 훈련을 적용하였을 때 실행기능의 효과를 알아본연구를 분석하는 것을 목적으로 한다. 연구방법 : PubMed, EMBASE, CoChrane, Web of Science, RISS를 이용하여 지난 10년간 출판된 논문을검색하였고, 선정 및 배제 기준을 통해 최종 7편의 논문을 선정하였다. 선정 논문에 대한 PEDro 질적평가와 메타분석을 시행하였다. 결과 : 선정된 7편의 논문은 모두 무작위 대조군 설계로, PEDro Scale 7점 이상의 높은 편에 속하였다. 이중과제 훈련의 실행기능 효과를 보기 위한 평가도구로 4편의 문헌에서 선로잇기검사(Trail Making Test)를 사용하였고, 2편에서 색선로잇기검사(Color Trail Test)를 사용하였으며, 3편에서 스트룹검사(Stroop test)를 사용하였다. 메타분석을 실시한 결과 전체적인 실행기능의 향상은 0.38로 작은효과크기를 보였으며, 선로잇기검사와 색선로잇기검사는 0.37, 스트룹검사는 0.34로 작은효과크기를 보였다. 전체적인 실행기능 효과와 선로잇기검사, 색선로잇기검사의 효과크기만 통계학적으로 유의하였다(p<0.05). 결론 : 본 연구를 통해 이중과제 훈련이 노인의 실행기능 향상에 효과적임을 확인하였지만, 이중과제훈련의 효과를 높이기 위해서는 훈련의 난이도 설정이 중요하며, 실행기능을 평가하는 다양한 평가도구와 실제 이중과제 조건에서의 수행도를 평가하는 평가도 동시에 이루어져야 함을 알 수 있었다. 이는향후, 노인들의 실행기능 향상 훈련을 하는데 적절한 중재방법으로 사용될 수 있으며, 치매 발현을늦추는데 도움이 될 것이라 사료된다.

Abstract

Objective : The purpose of this study was to analyze the effects of simultaneous dual-task training to assess executive function in older adults. Methods : We searched the PubMed, EMBASE, Cochrane, Web of Science, and RISS databases of publicated studies in the past decade. Seven studies were selected based on the inclusion and exclusion criteria. Qualitative assessment and meta-analysis were performed for the seven studies. Results : A randomized controlled trial design was used in the selected studies, and PEDro Scores above seven were obtained. The Trial Making Test (TMT) evaluated the effects of dual-task training on executive function in four studies. The Color Trail Test (CTT) was used in two studies, and Stroop test was used in three studies. The effect size for total executive function was 0.38, which was small. The effect sizes for TMT and CTT were 0.37. Stroop Test was 0.34, demonstrating that their effect sizes were also small. Only significant effects in total executive function, TMT, and CTT showed significant effects (all p<0.05). Conclusion : This study confirmed that dual-task training was effective in improving executive function in older adults. To improve the effectiveness of dual-task training, the difficulty of the dual-task training should be considered. It is also necessary to implement assessments that can evaluate performance under dual-task conditions as well as conventional test tools for executive function. In the future, dual-task training could be used as an appropriate intervention for executive function in older adults to delay the onset of dementia.

참고문헌 (68)

  1. Amieva, H., "The 9 year cognitive decline before dementia of the Alzheimer type : A prospective population-based study", Brain, 128(5), pp.1093~1101 (2005)[DOI]
  2. Anderson-Hanley, C., "Exergaming and older adult cognition : A cluster randomized clinical trial", American Journal of Preventive Medicine, 42(2), pp.109~119 (2012)[DOI]
  3. Anderson-Hanley, C., "Neuropsychological benefits of neuro-exergaming for older adults : A pilot study of an interactive physical and cognitive exercise system(iPACES)", Journal of Aging and Physical Activity, 25(1), pp.73~83 (2017)[DOI]
  4. Arbuthnott, K., "Trail Making Test, part B as a measure of executive control : Validation using a set-switching paradigm", Journal of Clinical and Experimental Neuropsychology, 22(4), pp.518~528 (2000)[DOI]
  5. Arnett, J. A., "Effect of physical layout in performance of the Trail Making Test", Psychological Assessment, 7(2), pp.220~221 (1995)[DOI]
  6. Bamidis, P. D., "A review of physical and cognitive interventions in aging", Neuroscience & Biobehavioral Reviews, 44, pp.206~220 (2014)[DOI]
  7. Barcelos, N., "Aerobic and Cognitive Exercise(ACE)pilot study for older adults : Executive function improves with cognitive challenge while exergaming", Journal of the International Neuropsychological Society : JINS, 21(10), pp.768~779 (2015)[DOI]
  8. Cahn-Weiner, D. A., "Tests of executive function predict instrumental activities of daily living in community-dwelling older individuals", Applied Neuropsychology, 9(3), pp.187~191 (2002)[DOI]
  9. Cockburn, P. H. J., "Concurrent performance of cognitive and motor tasks in neurological rehabilitation", Neuropsychological Rehabilitation, 8(2), pp.155~170 (1998)[DOI]
  10. Cohen, J., "Statistical power analysis", Current Directions in Psychological Science, 1(3), pp.98~101 (1992)[DOI]
  11. Cornelis, E., "The relationship between basic, instrumental, and advanced activities of daily living and executive functioning in geriatric patients with neurocognitive disorders", International Journal of Geriatric Psychiatry, 34(6), pp.889~899 (2019)[DOI]
  12. de Bruin, E. D., "A randomized controlled pilot study assessing the feasibility of combined motor–cognitive training and its effect on gait characteristics in the elderly", Clinical Rehabilitation, 27(3), pp.215~225 (2013)[DOI]
  13. Diamond, A., "Executive functions", Annual Review of Psychology, 64, pp.135~168 (2013)[DOI]
  14. Doi, T., "Brain activation during dual-task walking and executive function among older adults with mild cognitive impairment : A fNIRS study", Aging Clinical and Experimental Research, 25(5), pp.539~544 (2013)[DOI]
  15. Donoghue, O. A., "Association between timed Up-and-Go and memory, executive function, and processing speed", Journal of the American Geriatrics Society, 60(9), pp.1681~1686 (2012)[DOI]
  16. Egeland, J., "Differentiating malingering from genuine cognitive dysfunction using the Trail Making Test-ratio and Stroop Interference scores", Applied Neuropsychology, 14(2), pp.113~119 (2007)[DOI]
  17. Eggenberger, P., "Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up", Clinical Interventions in Aging, 10, pp.1335~1349 (2015)[DOI]
  18. Eggenberger, P., "Exergame and balance training modulate prefrontal brain activity during walking and enhance executive function in older adults", Frontiers in Aging Neuroscience, 8, pp.1~16 (2016)[DOI]
  19. Egner, T., "The neural correlates and functional integration of cognitive control in a Stroop task", Neuroimage, 24(2), pp.539~547 (2005)[DOI]
  20. Falbo, S., "Effects of physical-cognitive dual task training on executive function and gait performance in older adults : A randomized controlled trial", BioMed Research International, 2016, pp.1~13 (2016)[DOI]
  21. Patrick Fissler, "Novelty Interventions to Enhance Broad Cognitive Abilities and Prevent Dementia", Changing Brains - Applying Brain Plasticity to Advance and Recover Human Ability, pp.403~434 (2013), Elsevier[DOI]
  22. Funahashi, S., "Neuronal mechanisms of executive control by the prefrontal cortex", Neuroscience Research, 39(2), pp.147~165 (2001)[DOI]
  23. Gheysen, F., "Physical activity to improve cognition in older adults : Can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis", International Journal of Behavioral Nutrition and Physical Activity, 15(1), pp.1~13 (2018)[DOI]
  24. Gill, D. P., "The healthy mind, healthy mobility trial : A novel exercise program for older adults", Medicine &Science in Sports & Exercise, 48(2), pp.297~306 (2015)[DOI]
  25. Grober, E., "Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease", Journal of the International Neuropsychological Society, 14(2), pp.266~278 (2008)[DOI]
  26. He, Y., "Dual-task training effects on motor and cognitive functional abilities in individuals with stroke : A systematic review", Clinical Rehabilitation, 32(7), pp.865~877 (2018)[DOI]
  27. Hiyamizu, M., "Effects of dual task balance training on dual task performance in elderly people : A randomized controlled trial", Clinical Rehabilitation, 26(1), pp.58~67 (2012)[DOI]
  28. 황성동, "메타분석에 있어서 출간오류 : 의미와 분석", 인간발달연구, 23(1), pp.1~19 (2016), 한국인간발달학회[DOI]
  29. Knaepen, K., "Neuroplasticity-exercise-induced response of peripheral brain-derived neurotrophic factor", Sports Medicine, 40(9), pp.765~801 (2010)[DOI]
  30. Kortte, K. B., "The Trail Making Test, part B: Cognitive flexibility or ability to maintain set?", Applied Neuropsychology, 9(2), pp.106~109 (2002)[DOI]
  31. Lauenroth, A., "Influence of combined physical and cognitive training on cognition : A systematic review", BMC Geriatrics, 16(1), pp.1~14 (2016)[DOI]
  32. Law, L. L., "Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment : A systematic review", Ageing Research Reviews, 15, pp.61~75 (2014)[DOI]
  33. 이병관, "메타분석 결과에서 통계적 오류의 영향: 헤지스·올킨 방법과 헌터·슈미트 방법의 비교 분석", 헬스커뮤니케이션연구, (15), pp.47~97 (2016), 한국헬스커뮤니케이션학회[DOI]
  34. 문미숙, "노인의 인지기능과 상지기능의 관련성에 관한 체계적 고찰", 재활치료과학, 5(2), pp.23~33 (2016), 대한신경계작업치료학회
  35. Legault, C., "Designing clinical trials for assessing the effects of cognitive training and physical activity interventions on cognitive outcomes : The Seniors Health and Activity Research Program Pilot(SHARP-P)study, a randomized controlled trial", BMC Geriatrics, 11(1), pp.1~14 (2011)[DOI]
  36. Liao, Y., "Effects of virtual reality-based physical and cognitive training on executive function and dual-task gait performance in elderly individuals with mild cognitive impairment : A randomized control trial", Frontiers in Aging Neuroscience, 11, pp.1~10 (2019)[DOI]
  37. Liberati, A., "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : Explanation and elaboration", Journal of Clinical Dpidemiology, 62(10), pp.1~34 (2009)[DOI]
  38. Linde, K., "Single versus combined cognitive and physical activity effects on fluid cognitive abilities of healthy older adults : A 4-month randomized controlled trial with follow-up", Journal of Aging and Physical Activity, 22(3), pp.302~313 (2014)[DOI]
  39. Liu, Y. C., "Cognitive and motor dual task gait training improve dual task gait performance after stroke-A randomized controlled pilot trial", Scientific Reports, 7(1), pp.1~8 (2017)[DOI]
  40. McDaniel, M. A., "Effects of cognitive training with and without aerobic exercise on cognitively demanding everyday activities", Psychology and Aging, 29(3), pp.717~730 (2014)[DOI]
  41. Mercier, L., "Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke", Stroke, 32(11), pp.2602~2608 (2001)[DOI]
  42. Moseley, A. M., "Evidence for physiotherapy practice : A survey of the Physiotherapy Evidence Database(PEDro)", Australian Journal of Physiotherapy, 48(1), pp.43~49 (2002)[DOI]
  43. Mrakic-Sposta, S., "Effects of combined physical and cognitive virtual reality-based training on cognitive impairment and oxidative stress in MCI patients : A pilot study", Frontiers in Aging Neuroscience, 10, pp.1~11 (2018)[DOI]
  44. Nishiguchi, S., "A 12-week physical and cognitive exercise program can improve cognitive function and neural efficiency in community-dwelling older adults : A randomized controlled trial", Journal of the American Geriatrics Society, 63(7), pp.1355~1363 (2015)[DOI]
  45. Ogawa, E. F., "Potential benefits of exergaming for cognition and dual-task function in older adults : A systematic review", Journal of Aging and Physical Activity, 24(2), pp.332~336 (2016)[DOI]
  46. Ohsugi, H., "Differences in dual-task performance and prefrontal cortex activation between younger and older adults", BMC Neuroscience, 14(1), pp.1~9 (2013)[DOI]
  47. Oosterman, J. M., "Assessing mental flexibility : Neuroanatomical and neuropsychological correlates of the Trail Making Test in elderly people", The Clinical Neuropsychologist, 24(2), pp.203~219 (2010)[DOI]
  48. Park, H., "Combined intervention of physical activity, aerobic exercise, and cognitive exercise intervention to prevent cognitive decline for patients with mild cognitive impairment : A randomized controlled clinical study", Journal of Clinical Medicine, 8(7), pp.1~12 (2019)[DOI]
  49. Pellecchia, G. L., "Dual-task training reduces impact of cognitive task on postural sway", Journal of Motor Behavior, 37(3), pp.239~246 (2005)[DOI]
  50. Plummer-D'Amato, P., "Effects of gait and cognitive task difficulty on cognitive-motor interference in aging", Journal of Aging Research, 2012, pp.1~9 (2012)[DOI]
  51. Poulin, V., "Efficacy of executive function interventions after stroke : A systematic review", Topics in Stroke Rehabilitation, 19(2), pp.158~171 (2012)[DOI]
  52. Priest, A. W., "Age-related differences in dual task walking : A cross sectional study", Journal of Neuroengineering and Rehabilitation, 5(1), pp.1~8 (2008)[DOI]
  53. Rahe, J., "Cognitive training with and without additional physical activity in healthy older adults : Cognitive effects, neurobiological mechanisms, and prediction of training success", Frontiers in Aging Neuroscience, 7, pp.1~15 (2015)[DOI]
  54. Raichlen, D. A., "Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults : Results from a pilot randomized controlled trial", BMC Geriatrics, 20(1), pp.1~10 (2020)[DOI]
  55. Rezola-Pardo, C., "Comparison between multicomponent and simultaneous dual-task exercise interventions in long-term nursing home residents : The Ageing-ONDUAL-TASK randomized controlled study", Age and Ageing, 48(6), pp.817~823 (2019)[DOI]
  56. Scarpina, F., "The stroop color and word test", Frontiers in Psychology, 8, pp.1~8 (2017)[DOI]
  57. Schättin, A., "Adaptations of prefrontal brain activity, executive functions, and gait in healthy elderly following exergame and balance training : A randomizedcontrolled study", Frontiers in Aging Neuroscience, 8, pp.1~13 (2016)[DOI]
  58. Schoene, D., "Interactive cognitive-motor step training improves cognitive risk factors of falling in older adults–a randomized controlled trial", PLoS One, 10(12), pp.1~18 (2015)[DOI]
  59. Simes, R. J., "Confronting publication bias : A cohort design for meta‐analysis", Statistics in Medicine, 6(1), pp.11~29 (1987)[DOI]
  60. Smith, A. M., "Voluntary aerobic exercise increases the cognitive enhancing effects of working memory training", Behavioural Brain Research, 256, pp.626~635 (2013)[DOI]
  61. Sterne, J. A., "Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Serie", pp.297~333 (2008)
  62. Sterne, J. A., "Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials", The British Medical Journal, 2011, pp.1~8 (2011)[DOI]
  63. Su, C. Y., "The role of processing speed in post-stroke cognitive dysfunction", Archives of Clinical Neuropsychology, 30(2), pp.148~160 (2015)[DOI]
  64. Tait, J. L., "Influence of sequential vs. simultaneous dual-task exercise training on cognitive function in older adults", Frontiers in Aging Neuroscience, 9, pp.1~10 (2017)[DOI]
  65. Theill, N., "Effects of simultaneously performed cognitive and physical training in older adults", BMC Neuroscience, 14, pp.1~14 (2013)[DOI]
  66. Wadley, V. G., "Mild cognitive impairment and everyday function : Evidence of reduced speed in performing instrumental activities of daily living", The American Journal of Geriatric Psychiatry, 16(5), pp.416~424 (2008)[DOI]
  67. Yokoyama, H., "The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42", 40 ratio in healthy elderly persons : A randomized controlled trial, 2015, pp.15(1), 1~10
  68. Zhu, X., "The more the better? A meta-analysis on effects of combined cognitive and physical intervention on cognition in healthy older adults", Ageing Research Reviews, 31, pp.67~79 (2016)[DOI]

관련 논문AI추천

운동-인지 이중과제가 인지장애를 가진 노인의 인지기능에 미치는 영향: 무작위 실험연구에 대한 체계적 고찰박경영, 신수정중소기업융합학회 · 융합정보논문지2020 · 제10권 제12호경도인지장애와 치매 노인을 대상으로 한 이중과제 훈련의 인지기능 효과: 체계적 고찰남상훈, 배수영, 주유미, 진연주, 홍익표한국노인작업치료학회 · 한국노인작업치료학회지2021 · 제3권 제2호국내 경도인지장애 환자에 적용한 이중과제 프로그램이 인지기능에 미치는 효과: 체계적 문헌 고찰 및 메타분석정재훈대한산업경영학회 · 산업융합연구2023 · 제21권 제12호지역사회 거주 고령자에서 인지기능 향상을 위한 이중 과제 동시 수행의 효과강태우, 김세연, 김솔이, 박경환, 성남주, 신예은, 최말례, 한명일대한신경정신의학회 · 신경정신의학2025 · 제64권 제4호이중과제 훈련이 뇌졸중 환자에게 미치는 영향 : 체계적 고찰 및 메타분석박지혁, 박혜연, 원경아, 임승주대한신경계작업치료학회 · 재활치료과학2020 · 제9권 제2호뇌졸중 환자에게 적용한 이중과제 훈련이 미치는 효과에 대한 체계적 고찰이예진, 정민예대한신경계작업치료학회 · 재활치료과학2016 · 제5권 제1호

이 간행물의 다른 논문 (9건)

메타분석을 통한 뇌졸중 환자의 인지기능에 대한 가상현실 중재 효과 연구권재성pp. 7-22허약노인의 정의 및 허약 선별 평가도구에 관한 체계적 고찰이경아, 박지혁pp. 43-56뇌졸중 작업치료 지침의 질 평가이은영, 박지혁, 한대성pp. 57-69작업치료에서 몰입경험 이해를 위한 이론적 고찰이정훈, 박지혁pp. 71-81개인의 건강과 질병에 영향을 미치는 가족기능 구성요소에 관한 사전연구: 델파이 연구정성우, 김정란, 김아람, 정지인pp. 83-96
원문 보기