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中国循证儿科杂志

中国循证儿科杂志 ›› 2023, Vol. 18 ›› Issue (5): 393-398.DOI: 10.3969/j.issn.1673-5501.2023.05.011

• 论著 • 上一篇    下一篇

运动结合认知训练对健康儿童执行功能影响的系统综述

王俊宇1,2,杨永3,郭学军2,葛嘉川2,谢婷4,庄洁1,5   

  1. 1 上海体育大学运动健康学院 上海，200438；2 中国人民武装警察部队警官学院 成都，610000；3 巢湖学院体育学院 巢湖，238024；4 成都市新桥小学校成都，610000；5 上海市学生体质健康研究中心 上海，200438
  • 收稿日期:2023-08-31 修回日期:2023-10-25 出版日期:2023-10-25 发布日期:2023-10-25
  • 通讯作者: 庄洁

Effect of exercise combined cognitive training on executive function in healthy children: A systematic review

WANG Junyu1,2, YANG Yong3, GUO Xuejun2, GE Jiachuan2, XIE Ting4, ZHUANG Jie1,5   

  1. 1 School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; 2 Officers College of People's Armed Police, Chengdu 610000, China; 3 School of Physical Education, Chaohu University, Chaohu 238024, China; 4 Chengdu Xinqiao Primary School, Chengdu 610000, China; 5 Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai 200438, China

  • Received:2023-08-31 Revised:2023-10-25 Online:2023-10-25 Published:2023-10-25
  • Contact: ZHUANG Jie

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摘要： 背景：儿童的执行功能（EFs）对其未来的身体和心理健康发展至关重要，运动是提高儿童EFs的经济有效方式。有研究显示，涉及较高认知参与度的运动即运动结合认知训练（ECT），对儿童EFs的提升效果更显著，但目前已有的相关研究结论并不一致。 目的：系统评价ECT对EFs的干预效果。 设计：系统综述。 方法：系统检索PubMed、Web of Science、Cochrane、Embase、Google Scholar和中国知网数据库，检索时间为建库至2023年10月17日。文献纳入标准：①RCT或NRCT；②研究对象为健康儿童；③试验组的干预措施为ECT，干预方案同时包含运动组件和至少1个明确的认知任务组件；④对照组的干预措施为除认知参与外的任何运动方式或传统体育课（PE）；⑤运动干预的持续时间＞6周；⑥结局指标至少包括1项EFs的相关评估；⑦文献语言为中文或英文。采用2010版物理治疗证据数据库（PEDro）量表进行文献偏倚风险评估。提取或计算每项结局指标干预前后的变化比［（后测-前测）/前测×100%］。通过差异有统计学意义（P＜0.05）的结果在所有纳入文献中的占比来评估该指标的整体效应大小，＞2/3认为干预策略有显著性效果。 主要结局指标：EFs指标在干预前后的变化比。 结果：纳入9篇英文文献，RCT 7篇，NRCT 2篇，研究对象均为学龄期儿童，研究场所为学校7篇，体育中心和课后托管中心各1篇。ECT组干预措施：2篇为战术策略相关体育游戏，7篇为根据信号和变化规则完成动作；4篇设有氧运动（AE）为对照组，8篇设PE为对照组；干预周期为6~40周，干预频率为每周1~10次，单次运动时间为10~150 min。PEDro量表评分：5分3篇，6分5篇，7分1篇。数据整合结果显示，经ECT干预后，EFs中的工作记忆（8/8篇）、抑制控制（7/8篇）和认知灵活性（4/5篇）均得以改善，改善程度分别为1.9%~33.9%、2.9%~15.1%和2.5%~20.3%。ECT组工作记忆的改善较PE组更显著，组间有效性为71.4%（5/7篇）；ECT组认知灵活性的改善较AE组和PE组均更显著，组间有效性分别为100%（2/2篇）和75%（3/4篇）；ECT组抑制控制的改善与AE组和PE组相比不显著。 结论：ECT对学龄期健康儿童的EFs有明显的改善效果，其对认知灵活性的改善优于AE和PE，对工作记忆的改善优于PE，对抑制控制的改善与AE和PE相当。

关键词: 运动结合认知训练, 执行功能, 儿童, 干预, 系统综述

Abstract: Background: Executive functions (EFs) are crucial for the physical and psychological development of children, and exercise is a cost-effective method to enhance EFs in children. Studies have shown that exercise combined with cognitive training (ECT), which involves higher cognitive engagement, may have a more significant effect on children's EFs. However, existing research conclusions are inconsistent. Objective: To systematically analyzed the intervention effect of ECT on EFs in children. Design: Systematic review. Methods: A systematic search was conducted on PubMed, Web of Science, Cochrane, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI) databases from the inception to October 17, 2023. Inclusion criteria were: randomized controlled trials (RCT) or non-randomized controlled trials（NRCT）; healthy child participants; ECT intervention with both exercise and at least one explicit cognitive task component for the experimental group; any form of exercise other than cognitive engagement or traditional physical education (PE) for the control group; intervention duration longer than 6 weeks; at least one EF-related assessment outcome; articles in Chinese or English. Risk of bias was assessed using the 2010 Physiotherapy Evidence Database (PEDro) scale. The percentage change in each outcome measure before and after the intervention ［(post-test-pre-test) / pre-test × 100%］ was extracted or calculated, with a P-value < 0.05 indicating significant results. The overall effect size of the indicator was evaluated by the proportion of significant results in all included literature, with > 2/3 indicating a significant effect of the intervention strategy. Main outcome measures: Percentage change in EF indicators before and after the intervention. Results: Nine English articles were included. Four articles had aerobic exercise (AE) control groups, and 8 had PE control groups. The intervention lasted from 6 to 40 weeks with 1 to 10 times per week and 10 to 150 minutes for single exercise. PEDro scale scores were 5 in 3 articles, 6 in 5 articles and 7 in 1 article.The improvement in working memory in the ECT group was more significant than that in PE group, with an effectiveness of 71.4%. Improvement in cognitive flexibility were more significant in the ECT group compared to both AE and PE groups, with effectiveness of 100% and 75%, respectively. Conclusions: ECT significantly improves EFs in school-aged healthy children, with a greater enhancement in cognitive flexibility compared to AE and PE, an improvement in working memory superior to PE, and equivalent improvement in inhibitory control when compared to AE and PE.

Key words: Exercise combined with cognitive training, Executive functions, Children, Intervention, Systematic review