身体活动改善注意缺陷多动障碍儿童认知神经功能的系统综述

doi:10.3969/j.issn.1006-9771.2021.12.007

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (12): 1422-1429.doi: 10.3969/j.issn.1006-9771.2021.12.007

• 专题身体活动与健康及ICF应用 • 上一篇下一篇

身体活动改善注意缺陷多动障碍儿童认知神经功能的系统综述

许明超,蒋长好()

首都体育学院运动脑成像研究中心,北京市 100191

收稿日期:2021-11-21 修回日期:2021-11-29 出版日期:2021-12-25 发布日期:2021-12-29
通讯作者: 蒋长好 E-mail:jiangchanghao@cupes.edu.cn
作者简介:许明超(1990-),男,汉族,河南浚县人,硕士研究生,主要研究方向：脑科学与运动认知。
基金资助:
1.北京市社会科学基金项目(19YTA001);2.国家蛋白中心(北京)-北大分中心课题(KF-20212);3.北京舞蹈学院委托项目(153221019)

Effects of Physical Activity on Cognitive and Neurological Function of Attention Deficit Hyperactivity Disorder Children: A Systematic Review

XU Ming-chao,JIANG Chang-hao()

Center of Sports and Brain Imaging, Capital University of Pysical Education and Sports, Beijing 100191, China

Received:2021-11-21 Revised:2021-11-29 Published:2021-12-25 Online:2021-12-29
Contact: JIANG Chang-hao E-mail:jiangchanghao@cupes.edu.cn
Supported by:
Beijing Social Science Foundation Project(19YTA001);National Protein Science Center(Beijing)-Peking University Branch Project(KF-20212);Beijing Dance Academy Project(153221019)

摘要/Abstract

摘要：

目的分析身体活动干预对注意缺陷多动障碍(ADHD)儿童认知神经功能的影响。方法采用主题检索的方式,在PubMed、Embase、Web of Science、中国知网、万方数据库中检索与ADHD儿童身体活动干预和认知神经功能康复相关文献,检索时间为1990年1月至2021年7月,提取作者、国家、发表时间、研究对象和年龄、研究方法、干预方法、测量工具和干预效果等文献特征。基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论建立术语和研究架构,对ADHD儿童的身体活动干预方案和认知神经功能的干预效果进行系统综述。结果共返回文献1995篇,最终纳入12篇,来自6个国家,主要来源于临床医学、运动康复、心理治疗等相关期刊,发表时间主要集中在2015年后。研究设计包括随机对照试验、前后测设计和准实验设计三种类型,研究对象为4~16岁ADHD儿童。涉及的身体活动类型包括运动游戏、体育活动、学校体育课程和康复训练等。干预效果的评估包括行为测验、问卷调查和脑影像测量等。身体活动干预能提高ADHD儿童抑制控制能力、工作记忆和认知灵活性,也能改善ADHD儿童的运动功能和活动参与。结论身体活动干预有助于改善ADHD儿童的认知神经能力、运动能力和情绪社会能力。但这一效应的量效关系、影响因素及神经机制尚待进一步研究。

关键词: 注意缺陷多动障碍, 儿童, 身体活动, 神经认知功能, 系统综述

Abstract:

Objective To analyze the effect of physical activity intervention on the cognitive and neural functions of attention deficit hyperactivity disorder (ADHD) children. Methods Literatures related to physical activity intervention and functional rehabilitation of ADHD children in PubMed, EMBASE, Web of Science, CNKI and Wanfang data were searched from January, 1990 to July, 2021. The authors, countries, publication time, subjects and ages, research methods, intervention methods, measurement tools, results and conclusions of the included literatures were extracted. Based on the theory of the International Classification of Functioning, Disability and Health (Children and Adolescents Version) (ICF-CY), the terminology and research framework were established to systematically analyze physical activity intervention programs and intervention effects in the cognitive neural function of ADHD children. Results A total of 1995 literatures were returned, twelve of them were finally included. These studies came from six countries, mainly from clinical medicine, sports rehabilitation, psychotherapy and other related journals, published mainly after 2015. The study design included randomized controlled trial, pre- and post-test design, and quasi-experimental design. Subjects were ADHD children aged four to 16 years. The physical activities included sport games, sport activities, school physical education courses and rehabilitation training. The measurement methods mainly included cognitive task, scale, questionnaire and electroencephalogram, etc. Physical activity intervention can improve ADHD children's inhibitory control, working memory and cognitive flexibility, as well as improve their motor function, and activity and participation. Conclusion Physical activity intervention can improve the cognitive neural ability, motor ability and emotion-social ability of ADHD children. However, the dose-effect relationship, influencing factors and neural mechanism need further research.

Key words: attention deficit hyperactivity disorder, children, physical activity, neurocognitive function, systematic review

中图分类号:

许明超,蒋长好. 身体活动改善注意缺陷多动障碍儿童认知神经功能的系统综述[J]. 《中国康复理论与实践》, 2021, 27(12): 1422-1429.

XU Ming-chao,JIANG Chang-hao. Effects of Physical Activity on Cognitive and Neurological Function of Attention Deficit Hyperactivity Disorder Children: A Systematic Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(12): 1422-1429.

图/表 4

表1

表2

图1

表3

纳入文献基本特征"

作者	国家	研究对象	年龄(岁)	男性占比（%）	研究设计	干预活动形式	干预地点	干预强度/频率	功能康复效果	测量工具
Benzing等^[15](2019)	瑞士	ADHD儿童	8~12	82.40	RCT	技能类：运动游戏	社区	中等强度/每次30 min,每周3次,共8周	抑制控制能力增强(b164)、运动协调控制能力增强(b760)	Simon task、Flanker task、Color span backwards task、 German Motor Test
Ziereis等^[16](2015)	德国	ADHD儿童	7~12	74.42	RCT	运动项目类：球类	医院和实验室	中等强度/每次60 min,每周1次,共12周	工作记忆能力增强(b164)、运动协调控制能力增强(b760)	Digit span backward task、Letter-number-sequencing task、M-ABC2、Corsi block tapping test
Ludyga等^[17](2020)	瑞士	ADHD儿童、正常儿童	11~16	61.11	随机交叉实验	体适能类：功率自行车	实验室	中等强度/单次20 min	认知灵活性增强(b164)	Alternate Uses Task、心电图
Hoza等^[18](2015)	美国	ADHD儿童、正常儿童	平均4.4~8.9	53.96	RCT	技能类：运动游戏	社区	中等强度/每次31 min,每天1次,共12周	改善情绪调节功能(b152)	PMC、ADHD-IV
Benzing 等^[19] (2018)	瑞士	ADHD儿童、正常儿童	8~12	82.61	RCT	技能类：运动游戏	社区	中等至高强度/单次15 min	抑制控制能力增强(b164)、工作记忆能力增强(b164)	Flanker task、Color span backwords task
Silva等^[20](2020)	巴西	ADHD儿童	11~14	70.00	RCT	技能类：游泳运动	社区	中等强度/每次45 min,每周2次,共8周	改善情绪调节功能(b152)、运动协调控制能力增强(b760)、选择性注意能力增强(b140)	CDI、BAI、PSS、儿童身体协调能力测验、TAC取消注意测验、Sit-and-reach test
Pan等^[21](2015)	中国	ADHD儿童、正常儿童	6~12	100.00	RCT	运动项目类：乒乓球	社区	中等强度/每次70 min,每周2次,共12周	运动协调控制能力增强(b760)、抑制控制能力增强(b164)、认知灵活性增强(b164)	TGMD-2、Stroop Color-Word task、WCST
Ludyga等^[22](2017)	瑞士	ADHD儿童、正常儿童	11~16	58.33	随机交叉实验	体适能类：功率自行车	实验室	中等强度/每次20 min,每天1次,共3 d	抑制控制能力增强(b164)、P300振幅显著增加	Flanker task、事件相关电位
Chou等^[23](2017)	中国	ADHD儿童	8~12	77.55	RCT	运动项目类：瑜伽	社区	中等强度/每次40 min,每周2次,共8周	选择性注意能力增强(b140)、持续注意能力增强(b140)	视觉追踪测试、辨别测试
Meßler等^[24](2018)	德国	ADHD儿童	8~13	100.00	RCT	体适能类：HIIT	医院	高强度/每次30 min,每周3次,共3周	运动协调控制能力增强(b760)、人际交往能力增强d720)	M-ABC-II、FBB-HKS、SBB-HKS、KINDL
García-Gómez等^[25](2016)	西班牙	ADHD儿童	7~14	66.67	前后测设计	运动项目类：马术	社区	中等强度/每次45 min,每周2次,共3个月	人际交往能力增强d720)	BASC
Huang等^[26](2018)	中国	ADHD儿童、正常儿童	7~12	100.00	随机交叉实验	运动项目类：跑步	实验室	中等强度/单次30 min	抑制控制能力增强(b164)、θ/β比值更小	Go/No-Go task、脑电图

表3

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分类	内容定义
体能类	肌肉力量体能活动,如仰卧起坐、深蹲、俯卧撑、引体向上等;肌肉耐力体能活动,如长跑、游泳、自行车等;心肺耐力体能活动,如健步走、慢跑等各类有氧活动;柔韧性体能活动,如瑜伽、舞蹈等
技能类	粗大/精细技能活动,如举起、拾起、推、拉、搬运、抓住等;基本动作技能活动,如走、跑、跳、投、攀、爬等;移动/转移技能活动,如步行、移动自身、交通往来等
运动项目类	包括竞技类和休闲类。竞技类包括篮球、足球、排球、网球、乒乓球、羽毛球、游泳、自行车等;休闲类包括徒步、瑜伽、普拉提、健身体操、太极拳、跑步、飞镖、毽球、台球、保龄球、高尔夫、马术、户外活动、日常生活活动等

ICF-CY类别		功能康复效果
b1精神功能	b140注意力功能	持续注意能力增强选择性注意能力增强
	b164执行功能	抑制控制能力增强工作记忆能力增强认知灵活性增强
	b152情感功能	改善情绪调节能力
b7运动功能	b760随意运动控制功能	运动协调能力增强运动技能增强
d7人际交往和人际关系	d720复杂人际交往	人际交往能力增强

身体活动改善注意缺陷多动障碍儿童认知神经功能的系统综述

Effects of Physical Activity on Cognitive and Neurological Function of Attention Deficit Hyperactivity Disorder Children: A Systematic Review

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