文章摘要
底宁,祝志辉,闫瑾,等.多组分运动联合虚拟现实训练在认知衰弱高龄人群中的应用[J].中国临床保健杂志,2025,28(5):610-617.
多组分运动联合虚拟现实训练在认知衰弱高龄人群中的应用
The application of multicomponent exercise combined with virtual reality training in older adults with cognitive frailty
投稿时间：2025-06-11  
DOI：10.3969/J.issn.1672-6790.2025.05.005
中文关键词: 认知衰弱  运动疗法  虚拟现实  认知功能  肌,骨骼  老年人,80以上
英文关键词: Cognitive frailty  Exercise therapy  Virtual reality  Cognitive function  Muscle,skeletal  Aged,80 and over 〖FL
基金项目:军队后勤科研项目(20BJZ30,24BJZ26)；国家老年疾病临床医学研究中心开放项目(NCRCG-PLAGH-2022008)
作者单位E-mail
底宁 宁夏大学体育学院,银川 750021
保定理工学院,河北保定 071000 		a1175371803@126.com 
祝志辉 衢州市实验学校教育集团,浙江衢州 324000  
闫瑾 中国人民解放军总医院研究生院,北京 100853  
刘健 北京卫戍区海淀第四十七离职干部休养所,北京 100142  
白骁 北京西城第三退休干部休养所,北京 100032  
陈荣霞 北京卫戍区海淀第五十一离职干部休养所,北京 100142  
李艳伟 北京卫戍区西城第二离职干部休养所,北京 100032  
李泽楠 解放军北京老干部活动中心,北京 100039  
胡亦新 中国人民解放军总医院第二医学中心保健四科,北京 100853
国家老年疾病临床医学研究中心解放军总医院,北京 100853 		 
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中文摘要:
      目的 探讨多组分运动(ME)结合虚拟现实(VR)训练对认知衰弱老年人认知功能、骨骼肌质量指数(SMI)、身体功能及运动自我效能感的影响。方法 采用随机对照研究。选取北京市社区48例认知衰弱老年人,年龄(87.0±2.6)岁,通过1∶1比例随机分组,将48例受试者随机分为ME+VR组和ME组,各24例。ME+VR组接受多组分运动(抗阻、有氧、平衡、柔韧训练)结合VR训练方案,每周2次,共12周；ME组仅接受相同总时长和频次的多组分运动训练。干预前后采用蒙特利尔认知评估量表(MoCA)、连线测验A(TMT-A)、生物电阻抗法四肢骨骼肌质量指数(SMI)测定、6 m步行速度、5次起坐试验、握力、抓背试验以及中国版运动自我效能感量表(SEE-C)进行评估。结果 干预12周后,ME+VR组在MoCA评分和TMT-A完成时间等认知功能指标较干预前显著改善(P＜0.05),且改善幅度优于ME组(P＜0.05)。2组SMI较基线差异均无统计学意义(P＞0.05)。2组老年人多项身体功能指标较基线显著提高(P＜0.05),其中ME+VR组下肢功能(如5次起坐时间、6 m步行速度等)的改善幅度均优于ME组(P＜0.05)。2组握力等部分指标虽差异有统计学意义(P＜0.05),但ME+VR组改善幅度略低于ME组。2组SEE-C评分较干预前均显著提高(P＜0.05),且ME+VR组增幅大于ME组(P＜0.05)。结论 多组分运动联合虚拟现实训练可有效改善高龄认知衰弱老年人的认知功能和身体功能,增强其运动自我效能感,提高训练依从性。相较单纯运动干预,综合方案在提升执行功能、上肢灵活性等方面更具优势。
英文摘要:
      Objective To investigate the effects of multicomponent exercise (ME) combined with virtual reality training (VR) on cognitive function,skeletal muscle index,physical function,and exercise self-efficacy in older adults with cognitive frailty.Methods Randomized controlled trial.Forty-eight community-dwelling older adults with cognitive frailty in Beijing,with a age of (87.0±2.6) years,were randomly assigned to either the ME+VR group (n=24) or the ME group (n=24).The ME+VR group received a 12-week intervention consisting of multicomponent exercise (resistance,aerobic,balance,and flexibility training) combined with VR training,administered twice weekly.The ME group received multicomponent exercise alone,matched for total duration and frequency,without VR.Assessments were conducted before and after the intervention using the Montreal Cognitive Assessment (MoCA),Trail Making Test Part A (TMT-A),skeletal muscle index (via bioelectrical impedance analysis),6-meter walking speed,Five-Times-Sit-to-Stand test,grip strength,Back Scratch test,and the Chinese version of the Exercise Self-Efficacy Scale (SEE-C).Results After the 12-week intervention,the ME+VR group showed significant improvements in cognitive function measures,including MoCA scores and TMT-A completion time compared to baseline (P<0.05).The extent of improvement in these cognitive measures was greater in the ME+VR group than that in the ME group (P<0.05).No significant changes in skeletal muscle index were observed from baseline in either group (P>0.05).Both groups demonstrated significant improvements in multiple physical function indicators compared to baseline (P<0.05).The ME+VR group showed superior improvements in lower limb function (e.g.,Five-Times-Sit-to-Stand time,6-meter walking speed) compared to the ME group (P<0.05).For some measures,such as grip strength,although a statistically significant difference was found between the groups (P<0.05),the improvement in the ME+VR group was slightly less than that in the ME group.SEE-C scores increased significantly in both groups post-intervention (P<0.05),with a greater increase observed in the ME+VR group compared to the ME group (P<0.05).Conclusions Multicomponent exercise combined with virtual reality training effectively improved cognitive function,physical function,and exercise self-efficacy,and enhanced training adherence in very old adults with cognitive frailty.Compared to exercise intervention alone,this combined regimen demonstrated greater advantages in improving executive function and upper limb flexibility.
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