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The Role of Enhanced Cognition to Counteract Detrimental Effects of Prolonged Bed Rest: Current Evidence and Perspectives

机译:增强的认知对抵消长期卧床休息有害作用的作用:当前证据和观点

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摘要

Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.
机译:长时间不运动或卧床休息会导致功能和认知功能明显下降。已经开发出各种对策(例如,离心,营养和有氧干预)以减轻与卧床休息有关的负面影响。本报告的目的是概述与老年人完全身体不活动期间的计算机认知训练(CCT)干预的有效性有关的当前证据。使用虚拟迷宫导航任务的CCT似乎是有效的,并且具有长期利益(研究后长达1.5年)。此外,增强的认知能力(执行控制)可减少长时间卧床后执行复杂的运动认知双重任务的能力下降。已经证明,在成年人中进行CCT还可以预防与卧床休息有关的生理变化[这些组显示出最小的血管功能变化,并且脑源性神经营养因子(BDNF)的水平保持不变],而对照组则显示出周围血管生成和功能下降。在14天卧床休息期间增加了神经营养蛋白BDNF的血浆水平。此外,CCT的作用也从大脑皮层电刺激的结果中可以明显看出:CCT组显示在较低的δ和theta谱带中功率降低,而在对照组中相同的EEG谱带功率显着增加。如果我们认为三角带能量的增加是皮质衰老的标志,则脑电图能量向低带转移的缺乏表明CCT在2周卧床休息固定引起的生理失调期间对皮质水平的预防作用。但是,需要在更大的样品上进行复制以确认观察到的发现。从这些发现得出的应用可能适合于卧床患者的医院治疗以及预防跌倒的计划。

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