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Development and feasibility of a virtual, synchronous mind-body resiliency intervention for fathers of children and youth with special healthcare needs 为有特殊医疗保健需求的儿童和青少年的父亲制定虚拟同步身心复原干预措施及其可行性
Pub Date : 2024-01-01 DOI: 10.1016/j.bbii.2024.100052
Daniel L. Hall , Lucy Fell , Giselle K. Perez , Michaela Markwart , Craig Cammarata , Yan Si , Audrey Cantillon , Elyse R. Park , Karen Kuhlthau

Background

Fathers of children and youth with special healthcare needs (FCYSHCN) are an overlooked population at risk for chronic stress. Mind-body practices offer a patient-centered approach to foster coping and resiliency, yet low engagement from fathers in existing programs suggests adaptation is needed. This multiphase study examines the feasibility of a synchronous, virtual mind-body intervention adapted for FCYSHCN.

Methods

31 FCYSHCN were recruited online via community partners and recruitment portals in an academic medical center in Boston, MA. Phase 1 consisted of individual interviews (N = 17) to determine fathers’ stressors, coping strategies, program needs, and suggested adaptations to the intervention protocol. The Phase 2 single arm pilot feasibility trial (N = 14) consisted of eight weekly 60-minute group sessions delivered virtually. Primary feasibility metrics were attendance (benchmark: mean=6 sessions) and electronic survey completion at baseline and post-intervention. Acceptability was assessed using post-session ratings of program satisfaction (4-point Likert scale; scores ≥3 coded as helpful) and helpfulness (e.g., group structure). Exploratory outcomes included validated measures of stress coping, resiliency, parental stress, depression, anxiety, which were analyzed using paired-samples t-tests (alpha=.05) to generate effect sizes (η2).

Results

In Phase 1, FCYSHCN discussed primary stressors (e.g., perceived inadequacy as a father) and multifaceted impacts of these stressors on physical, cognitive, emotional, and social wellbeing. Fathers also described coping strategies deemed helpful (e.g., humor) and unhelpful (e.g., “shutting down” from others). Qualitative findings informed intervention modifications. In Phase 2, most FCYSHCN (79%) attended ≥ 6 intervention sessions (mean=7). Follow-up survey completion was high (86%). Session satisfaction was high, with 7/8 sessions rated as helpful by most fathers. Program components deemed most helpful were the group structure, virtual delivery, exposure to a variety of relaxation and meditation skills, and the length of sessions. Although we were not powered to observe pre-post change, stress coping improved (p = .02, η2 = 0.42) and confidence increased in applying relaxation (p = .04, η2 = 0.34) and assertiveness techniques (p = .05, η2 = 0.31).

Conclusions

The first mind-body resiliency program for FCYSHCN is feasible and acceptable. Further testing is warranted in randomized trials with diverse samples of fathers, an appropriate comparison arm, and longitudinal assessments of psychosocial and biobehavioral outcomes.

背景有特殊医疗保健需求的儿童和青少年(FCYSHCN)的父亲是一个被忽视的群体,他们面临着慢性压力的风险。身心疗法提供了一种以患者为中心的方法来促进应对和恢复能力,但现有项目中父亲的参与度较低,这表明需要进行调整。这项多阶段研究探讨了针对家庭、青少年和健康儿童的同步、虚拟身心干预的可行性。方法31 通过社区合作伙伴和马萨诸塞州波士顿市一家学术医疗中心的招聘门户在线招募家庭、青少年和健康儿童。第一阶段包括个人访谈(N = 17),以确定父亲的压力源、应对策略、计划需求以及对干预方案的调整建议。第二阶段的单臂试点可行性试验(N = 14)包括每周八次、每次 60 分钟的小组课程,以虚拟方式进行。主要的可行性指标是基线和干预后的出席率(基准:平均=6 节课)和电子调查完成率。可接受性通过课后对课程满意度(4 点李克特量表;分数≥3 为有帮助)和帮助性(如小组结构)的评分进行评估。探索性结果包括压力应对、复原力、父母压力、抑郁、焦虑等方面的有效测量,使用配对样本 t 检验(α=.05)对这些结果进行分析,以得出效应大小(η2)。结果在第一阶段,家庭、青少年和儿童健康网讨论了主要压力源(例如,作为父亲的不足感)以及这些压力源对身体、认知、情感和社会福祉的多方面影响。父亲们还描述了他们认为有用(如幽默)和无用(如对他人 "封闭")的应对策略。定性研究结果为干预措施的修改提供了依据。在第二阶段,大多数家庭、青少年和儿童健康网(79%)参加了≥ 6 次干预课程(平均=7 次)。后续调查的完成率很高(86%)。对课程的满意度很高,大多数父亲认为 7/8 次课程都很有帮助。认为最有帮助的项目内容包括小组结构、虚拟传递、接触各种放松和冥想技巧以及疗程长度。虽然我们没有能力观察前后的变化,但应对压力的能力有所提高(p = .02, η2 = 0.42),应用放松(p = .04, η2 = 0.34)和自信技巧(p = .05, η2 = 0.31)的信心也有所增强。需要在随机试验中进行进一步测试,试验应包括不同的父亲样本、适当的对比组,以及对社会心理和生物行为结果的纵向评估。
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引用次数: 0
Traditional Chinese medicine: What does modern immunology have to do with it? 传统中医学:现代免疫学与之有何关系?
Pub Date : 2024-01-01 DOI: 10.1016/j.bbii.2023.100044
Yong Ming Li, Keith W. Kelley
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引用次数: 0
Influence of gut microbiota on autoimmunity: A narrative review 肠道微生物群对自身免疫的影响:叙述性综述
Pub Date : 2024-01-01 DOI: 10.1016/j.bbii.2024.100046
Abhay Sai , Geetha B. Shetty , Prashanth Shetty , Nanjeshgowda H L

Gut microbiota consists a majority of bacteriodetes, firmicutes, actinobacteria, proteobacteria, fusobacteria, verrucomicrobiota which has evolved a long way alongside humans where it helps in digestion and even other complex functions which include development of gut lymphoid tissue, vitamin synthesis, polarization of specific immune responses, prevention of colonization by pathobionts. Innate and adaptive immunity has been set in the body in contrast to gut microbiota involving helper T cells and cytotoxic cells along with immunoglobulins. Hence immunomodulatory action of gut microbiota is already been studied and explained along with mast cell degranulation. A few factors like age, diet, antibiotics, and others shape normal gut flora into dysbiosis possibly through translocation of microbes, molecular mimicry, and altered metabolite production bringing unfavoured immunological actions like imbalance in helper T cells and improper gut permeability in the body causing, autoimmunity. Changes in microbes from phylum like bacteriodetes, firmicutes, actinobacteria, and proteobacteria bring the changes that lead to various autoimmune diseases like multiple sclerosis, type 1 diabetes mellitus, rheumatoid arthritis etc. This review explains the possible mechanisms along with causes leading to autoimmunity.

肠道微生物群主要由细菌、坚固菌、放线菌、蛋白菌、镰刀菌和疣状微生物群组成,它们与人类一起经历了漫长的进化过程,帮助消化,甚至还有其他复杂的功能,包括肠道淋巴组织的发育、维生素的合成、特异性免疫反应的极化、防止病原菌的定植等。人体的先天性免疫和适应性免疫与肠道微生物群形成了鲜明对比,其中包括辅助性 T 细胞和细胞毒性细胞以及免疫球蛋白。因此,人们已经对肠道微生物群的免疫调节作用以及肥大细胞脱颗粒作用进行了研究和解释。年龄、饮食、抗生素等一些因素可能会通过微生物的转运、分子模拟和代谢产物的产生改变,将正常的肠道菌群转变为菌群失调,从而带来不利的免疫作用,如辅助性 T 细胞失衡和肠道在体内的不正常渗透性,导致自身免疫。细菌门、坚固菌门、放线菌门和蛋白菌门等微生物的变化导致各种自身免疫性疾病,如多发性硬化症、1 型糖尿病、类风湿性关节炎等。这篇综述解释了导致自身免疫的可能机制和原因。
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引用次数: 0
Traditional Chinese medicine research on attention deficit hyperactivity disorder: Theory, treatment and mechanism 注意缺陷多动障碍的中医药研究:理论、治疗和机制
Pub Date : 2024-01-01 DOI: 10.1016/j.bbii.2024.100049
Congxiao Zhou , Junhong Wang

Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that affects a significant number of children and adults worldwide. Traditional Chinese medicine (TCM) has shown promising results in the treatment of ADHD, serving as an important complementary therapy alongside conventional approaches. This review aims to provide a comprehensive understanding of the theoretical foundations, treatment modalities, and underlying mechanisms of TCM in the management of ADHD. The concept of ADHD from a TCM perspective emphasizes on the role of imbalances in yin and yang. The treatment encompasses pattern identification, common patterns, pharmacological and non-pharmacological interventions, as well as relevant clinical trials. For mechanism, this review explores the impact of TCM compound formulas on neuroimmunology and neurotransmitters, highlighting the potential modulation of microglia, cytokines, dopamine, norepinephrine, and serotonin.

注意缺陷多动障碍(ADHD)是一种复杂的神经发育障碍,影响着全球众多儿童和成年人。传统中医药(TCM)在治疗注意力缺陷多动障碍(ADHD)方面取得了可喜的成果,成为传统疗法的重要补充疗法。本综述旨在全面了解中医药治疗多动症的理论基础、治疗方式和内在机制。中医多动症的概念强调阴阳失衡的作用。治疗方法包括辨证论治、常见证型、药物和非药物干预以及相关临床试验。在机理方面,本综述探讨了中药复方对神经免疫学和神经递质的影响,强调了对小胶质细胞、细胞因子、多巴胺、去甲肾上腺素和血清素的潜在调节作用。
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引用次数: 0
Identifying potential scalp acupuncture targets for chronic pain and comorbid disorders using functional and anatomical connectivity of critical deep brain structures 利用大脑深部关键结构的功能和解剖连接,确定治疗慢性疼痛和合并症的潜在头皮针灸靶点
Pub Date : 2024-01-01 DOI: 10.1016/j.bbii.2024.100050
Qiao Kong, Sierra Hodges, Amy Katherine Ursitti, Sveta Reddy, Meixuan Zhu, Jian Kong

Scalp acupuncture is an innovative approach that integrates acupuncture needling stimulation with the modern understanding of brain function. In recent decades, scalp acupuncture has been applied to treat chronic pain and has achieved promising results. This study aimed to identify potential brain surface targets for scalp acupuncture based on the functional and anatomical connectivity of the hippocampus, amygdala, and nucleus accumbens, three deep brain structures that are believed to play an important role in the pathophysiology of chronic pain, as well as multiple comorbid psychiatric and neurological disorders. Resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) datasets from 119 healthy participants were included in our analysis. We found that the medial prefrontal cortex (mPFC), corresponding to the acupoints EX-HN3 (Yintang) / BL2 (Cuanzhu), is functionally and anatomically connected to all three subcortical regions, while the precuneus, corresponding to the acupoints GV19 (Houding) / GV20 (Baihui) and the MS12 scalp acupuncture line, is connected to the hippocampus and amygdala. Our results suggest that the mPFC and precuneus, two key hubs of the default mode network (DMN), and other cortical areas distributed at the prefrontal, parietal, and temporal cortices may hold potential as novel targets for scalp acupuncture in the treatment of chronic pain and its comorbidities. These identified locations may also be used for the treatment of psychiatric and neurological disorders, such as anxiety, depression, insomnia, and cognitive decline, in which the three corresponding deep brain structures play a crucial role.

头皮针灸是一种创新方法,它将针刺刺激与现代对大脑功能的理解结合在一起。近几十年来,头皮针被应用于治疗慢性疼痛,并取得了可喜的成果。本研究旨在根据海马、杏仁核和伏隔核的功能和解剖连接性,确定头皮针灸的潜在脑表面靶点,这三个深层脑结构被认为在慢性疼痛以及多种合并精神和神经疾病的病理生理学中发挥重要作用。我们分析了 119 名健康参与者的静息态功能磁共振成像(fMRI)和弥散张量成像(DTI)数据集。我们发现,穴位EX-HN3(印堂)/BL2(攒竹)对应的内侧前额叶皮层(mPFC)在功能和解剖上与所有三个皮层下区域相连,而穴位GV19(后庭)/GV20(百会)和MS12头皮针灸线对应的楔前皮层与海马和杏仁核相连。我们的研究结果表明,默认模式网络(DMN)的两个关键枢纽 mPFC 和楔前区,以及分布在前额叶、顶叶和颞叶皮层的其他皮层区域可能是头皮针治疗慢性疼痛及其合并症的新靶点。这些确定的位置还可用于治疗精神和神经疾病,如焦虑、抑郁、失眠和认知能力下降,在这些疾病中,三个相应的深层大脑结构起着至关重要的作用。
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引用次数: 0
Mind-body techniques on stress-induced gut microbiota dysbiosis in Asthmatics: A narrative review 身心疗法对哮喘患者因压力引起的肠道微生物群失调的影响:叙述性综述
Pub Date : 2024-01-01 DOI: 10.1016/j.bbii.2023.100040
Monalisa Das , Nooruddin Thajuddin , Sanjib Patra , Megha Pundir

Asthma is more common when a particular type of pathogenic gut microbiota is present, whereas the presence of some beneficial bacteria lowers the frequency of asthma attacks. Cortisol levels rise when the HPA axis is activated by stress. The diversity of the gut microbiota and the permeability of the digestive system may be interfered with by an activated HPA axis. Additionally, stress affects peripheral mononuclear cell activity, lymphocyte proliferation, natural killer cell activity, and IgA antibody levels. Intestinal microbial dysbiosis and leaky gut can be caused by low IgA concentration, low polymorphonuclear cell count, and active NK cells, and lymphocytes. Asthma is brought on by intestinal microbiota dysbiosis and bacterial translocation, which are associated with low-grade inflammation. Mind-body medicine is an alternative form of therapy, including yoga, and mindfulness practices. For instance, Qigong meditation has also been shown to reduce HPA axis activity, improve immune function, and reduce asthma symptoms. Pro-inflammatory cytokines including IL-6, IL-7, and TNF-alpha have been shown to decrease with the use of mind-body medicine techniques. In order to prevent microbial translocation, yoga can boost IgA, CD4 + cells, and NK cell concentrations. Mind-body medicine can reduce CRH and cortisol levels as well as stop microbial dysbiosis. In this review, we want to emphasize how these practices reduce stress, inhibit the activation of the HPA axis, prevent gut microbial dysbiosis, encourage the proliferation of antiasthmatic bacteria, and decrease the diversity of pathogenic, and opportunistic asthmatic bacteria.

当肠道微生物群中存在特定类型的致病菌时,哮喘的发病率更高,而一些有益菌的存在则会降低哮喘发作的频率。当 HPA 轴被压力激活时,皮质醇水平会升高。肠道微生物群的多样性和消化系统的渗透性可能会受到激活的 HPA 轴的干扰。此外,压力还会影响外周单核细胞活性、淋巴细胞增殖、自然杀伤细胞活性和 IgA 抗体水平。肠道微生物菌群失调和肠漏可导致 IgA 浓度低、多形核细胞数量少、NK 细胞和淋巴细胞活跃。哮喘是由肠道微生物群失调和细菌易位引起的,而肠道微生物群失调和细菌易位与低度炎症有关。心身医学是一种替代疗法,包括瑜伽和正念练习。例如,气功冥想也被证明可以减少 HPA 轴活动,改善免疫功能,减轻哮喘症状。使用心身医学技术后,包括 IL-6、IL-7 和 TNF-α 在内的促炎细胞因子均有所减少。为了防止微生物转移,瑜伽可以提高 IgA、CD4 + 细胞和 NK 细胞的浓度。身心医学可以降低 CRH 和皮质醇水平,并阻止微生物菌群失调。在这篇综述中,我们想强调这些做法如何减轻压力、抑制 HPA 轴的激活、预防肠道微生物菌群失调、促进抗哮喘细菌的增殖,以及减少致病性和机会性哮喘细菌的多样性。
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引用次数: 0
Psychobiotic potential of Lactiplantibacillus plantarum: Current perspective in neurodegeneration and geriatric therapies 植物乳杆菌的精神生物潜力:神经变性和老年疗法的当前前景
Pub Date : 2023-12-09 DOI: 10.1016/j.bbii.2023.100038
Nishant Gupta , Ashok Kumar Agarwal , M. Al-Dossari , N.S. Abd EL-Gawaad

Management of neurodegenerative disease can be challenging when there is limited access to effective treatment options. Recent studies indicate that human gut microbiota may influence neurodegenerative diseases and the aging process. Gut microbiota dysbiosis is one of the exacerbating factors associated with the interrupted gut-brain axis and neurodegenerative diseases. According to preclinical evidence, targeting gut microbiota by probiotic Lactiplantibacillus plantarum (LBP) may be a promising approach to improve altered gut microbiota and several neurodegenerative hallmarks. LBP has been a popular probiotic model but its psychobiotic potential is little understood so far. LBP can modulate altered gut microbiota and maintain intestinal homeostasis, resulting in induced levels of SCFAs, GABA, and other neurotransmitter. LBP-associated signaling agents induce the gut-brain axis (GBA) and stimulate intracellular antioxidant and anti-inflammatory pathways in the nerve cells. LBP-based probiotic supplements may reduce various neurodegenerative hallmarks such as β-amyloid formation, tau phosphorylation, microgliosis, infiltrated blood-brain barrier, neuroinflammation, and influence the morphology of grey matter in several neurodegenerative animal models such as Alzheimer’s disease, autism spectrum disorder, multiple sclerosis, and Parkinson’s disease. This review suggests LBP may be an important psychobiotic agent to modulate perturbed gut microbiota associated neurodegenerative disease. LBP administration may enhance the existed neurodegenerative treatment, especially associated with gut microbiota dysbiosis and geriatric conditions.

当获得有效治疗方案的机会有限时,神经退行性疾病的管理可能具有挑战性。最近的研究表明,人类肠道微生物群可能影响神经退行性疾病和衰老过程。肠道菌群失调是与肠-脑轴中断和神经退行性疾病相关的加剧因素之一。根据临床前证据,利用益生菌植物乳杆菌(LBP)靶向肠道微生物群可能是改善肠道微生物群改变和一些神经退行性标志的一种有希望的方法。LBP一直是一种流行的益生菌模型,但其心理生物学潜力迄今为止知之甚少。LBP可以调节改变的肠道微生物群,维持肠道内稳态,导致诱导SCFAs、GABA和其他神经递质水平。lbp相关信号剂诱导肠-脑轴(GBA)并刺激神经细胞内的抗氧化和抗炎通路。基于lbp的益生菌补充剂可以减少各种神经退行性特征,如β-淀粉样蛋白形成、tau磷酸化、小胶质细胞增生、浸润性血脑屏障、神经炎症,并影响几种神经退行性动物模型(如阿尔茨海默病、自闭症谱系障碍、多发性硬化症和帕金森病)的灰质形态。这一综述表明LBP可能是一种重要的精神生物制剂,可以调节与神经退行性疾病相关的肠道微生物群紊乱。LBP给药可以增强现有的神经退行性治疗,特别是与肠道微生物群失调和老年疾病相关的治疗。
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引用次数: 0
The impact of a focused behavioral intervention on brain cannabinoid signaling and interoceptive function: Implications for mood and anxiety 集中行为干预对脑大麻素信号和内感受功能的影响:对情绪和焦虑的影响
Pub Date : 2023-12-01 DOI: 10.1016/j.bbii.2023.100035
Otto Muzik , Timothy Mann , John Kopchick , Asadur Chowdury , Mario Yacou , Jamie Vadgama , Daniel Bonello , Vaibhav A. Diwadkar

The Wim Hof method (WHM) is a behavioral intervention technique that consists of deep breathing exercises, cold exposure and meditation. In light of the crucial role of the cannabinoid system in modulating neurotransmitter release through a negative feedback mechanism that aims at the maintenance of network homeostasis, our study investigated changes in cannabinoid type 1 (CB1) receptor binding following a longitudinal (6 weeks) WHM intervention in 4 male controls using the F18]FMPEP-d2 PET tracer, an inverse CB1 receptor agonist. Results revealed a global increase in CB1 receptor binding of ∼20%, with largest increases found in brain regions associated with the interoceptive network such as the anterior cingulate, the orbitofrontal cortex OFC), the anterior insular cortex (AIC) and the brainstem. Furthermore, in the same participants a whole-body cold-stress paradigm was used to systematically evoke sympathetic and parasympathetic responses. Post-intervention, participants showed increased engagement of regions like the anterior insula and the orbitofrontal cortex that have been respectively classified as belonging to the brain’s interoceptive (AIC) and executive (OFC) sub-networks. Our results suggest that a relatively short 6-week WHM intervention positively impacts brain markers that have been associated with stress resistance, mood, anxiety and interoceptive function.

威姆霍夫方法(WHM)是一种行为干预技术,包括深呼吸练习、寒冷暴露和冥想。鉴于大麻素系统通过负反馈机制调节神经递质释放的关键作用,旨在维持网络稳态,我们的研究调查了4名男性对照者在使用F18]FMPEP-d2 PET示踪剂(一种逆CB1受体激动剂)纵向(6周)WHM干预后大麻素1型(CB1)受体结合的变化。结果显示,CB1受体结合的全球增加了约20%,其中与内感受网络相关的大脑区域增加最多,如前扣带、眶额皮质OFC、前岛皮质(AIC)和脑干。此外,在相同的参与者中,使用全身冷应激范式系统地唤起交感和副交感神经反应。干预后,参与者的脑岛前部和眼窝额叶皮层等区域的活动增加,这两个区域分别属于大脑的内感受(AIC)和执行(OFC)子网络。我们的研究结果表明,相对较短的6周WHM干预对与应激抵抗、情绪、焦虑和内感受功能相关的大脑标志物产生了积极影响。
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引用次数: 0
Modulation of inflammatory response and pain by mind-body therapies as meditation 通过冥想等身心疗法调节炎症反应和疼痛
Pub Date : 2023-11-30 DOI: 10.1016/j.bbii.2023.100036
Juan J. Moreno

In the last decade, meditation practice has been extended and is becoming increasingly popular whereas, the research to understand the effects of meditation on the health is growing. The aim of this review/commentary is explored how meditation can modulate stress and stress effects on brain-endocrine-immune axis to understand the main genomic/metabolomic elements and mechanisms involved in the effects of meditation on the inflammatory process including the modulation of the pain. World Health Organization considers that by 2030 depression and stress-related disorders will be the most widespread health problems, closely followed by inflammatory processes such as autoimmune diseases, allergy and diseases associated to chronic low-grade inflammation. Thus, this review contributes to the evidence-based integration of meditation practices into clinical care for reducing the burden of chronic diseases and lowering the overall cost of healthcare; and analysing the limitations, safety, and possible contraindications.

在过去的十年中,冥想练习已经扩展并变得越来越受欢迎,而了解冥想对健康影响的研究也越来越多。这篇综述/评论的目的是探讨冥想如何调节压力和压力对脑内分泌-免疫轴的影响,以了解冥想对炎症过程(包括疼痛调节)影响的主要基因组/代谢组学因素和机制。世界卫生组织认为,到2030年,抑郁症和与压力有关的疾病将成为最普遍的健康问题,紧随其后的是自身免疫性疾病、过敏和与慢性低度炎症相关的疾病等炎症过程。因此,本综述有助于以证据为基础的冥想实践整合到临床护理中,以减轻慢性病的负担和降低医疗保健的总体成本;并分析其局限性、安全性和可能的禁忌症。
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引用次数: 0
Finger exercise effects on cognitive functions in older adults with MCI/AD/dementia: A systematic review and meta-analysis of randomized controlled trials 手指运动对老年MCI/AD/痴呆患者认知功能的影响:随机对照试验的系统回顾和荟萃分析
Pub Date : 2023-11-14 DOI: 10.1016/j.bbii.2023.100034
Jianghong Liu , Haoer Shi

Objective

This study aimed to evaluate the effects of finger exercise on cognitive function and activities of daily living (ADL) through a systematic review and meta-analysis of randomized controlled trials (RCTs).

Methods

A comprehensive search was conducted in four English databases (PubMed, Google Scholar, EMBASE, Cochrane Library) and two Chinese databases (Wanfang, China National Knowledge Infrastructure) from inception to June 2023. The inclusion criteria focused on RCTs evaluating the impact of finger exercise on cognitive function. The quality of the included studies was assessed using the Cochrane Collaboration's risk of bias tool. Data synthesis was performed using random-effects models, calculating weighted mean differences (WMDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity.

Results

Twelve studies were included in the review, with 11 (covering 1215 participants) eligible for meta-analysis. The results demonstrated that a positive effect of finger exercise on general cognitive function and ADL. Subgroup analysis revealed significant effects in individuals with mild cognitive impairment (MCI) but less pronounced effects in patients with dementia or Alzheimer's disease (AD), particularly at moderate to severe stages. Population, exercise hours, and age were identified as significant moderators for the pooled effects.

Conclusions

This systematic review and meta-analysis provide evidence supporting the positive effects of finger exercise in improving cognitive decline. However, the majority of reviewed studies were conducted in the Chinese population, thus warranting more rigorous studies in diverse populations to validate and strengthen these findings. Further investigation into the optimal exercise routines and frequency may position finger exercises as a cost-effective and convenient intervention against cognitive decline in healthy or MCI older adults.

本研究旨在通过随机对照试验(RCTs)的系统回顾和荟萃分析,评估手指锻炼对认知功能和日常生活活动(ADL)的影响。全面检索了4个英文数据库(PubMed、Google Scholar、EMBASE、Cochrane Library)和2个中文数据库(万方、中国国家知识基础设施),检索时间为成立至2023年6月。纳入标准侧重于评估手指运动对认知功能影响的随机对照试验。采用Cochrane Collaboration的偏倚风险工具评估纳入研究的质量。采用随机效应模型进行数据综合,以95%置信区间(ci)计算加权平均差(wmd)或标准化平均差(SMDs)。进行亚组分析和meta回归来探索异质性的潜在来源。本综述纳入了12项研究,其中11项(覆盖1215名参与者)符合meta分析的条件。结果表明,手指运动对一般认知功能和ADL有积极的影响。亚组分析显示,对轻度认知障碍(MCI)患者有显著影响,但对痴呆或阿尔茨海默病(AD)患者的影响不太明显,特别是在中度至重度阶段。人口、锻炼时间和年龄被确定为综合效应的显著调节因子。本系统综述和荟萃分析提供证据支持手指锻炼在改善认知衰退方面的积极作用。然而,大多数被回顾的研究都是在中国人群中进行的,因此需要在不同人群中进行更严格的研究来验证和加强这些发现。对最佳锻炼程序和频率的进一步研究可能会将手指锻炼定位为一种经济有效且方便的干预措施,以防止健康或轻度认知障碍老年人的认知能力下降。
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Brain Behavior and Immunity Integrative
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