Chinese Journal of Tissue Engineering Research ›› 2024, Vol. 28 ›› Issue (14): 2282-2289.doi: 10.12307/2024.235
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Effects of high-intensity interval training with different intervention durations on cognitive function in older adults: a Meta-analysis
Liu Xinxin1, Geng Zhizhong2, Chen Jian1
- 1School of Sports Medicine, Wuhan Sports University, Wuhan 430079, Hubei Province, China; 2School of Health Sciences, Shanghai University of Sport, Shanghai 200438, China
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Received:2023-02-11Accepted:2023-03-14Online:2024-05-18Published:2023-07-28 -
Contact:Chen Jian, MD, Associate professor, School of Sports Medicine, Wuhan Sports University, Wuhan 430079, Hubei Province, China -
About author:Liu Xinxin, Master candidate, School of Sports Medicine, Wuhan Sports University, Wuhan 430079, Hubei Province, China
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Liu Xinxin, Geng Zhizhong, Chen Jian. Effects of high-intensity interval training with different intervention durations on cognitive function in older adults: a Meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(14): 2282-2289.
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2.1 文献检索结果 通过检索策略初步检索获得177篇文献，剔除重复发表文献83篇，经阅读文题以及摘要后初步纳入12篇。通过对文献全文进一步阅读后最终纳入8篇[4，10，15，18-19，21-23]，包括7篇英文文献，1篇中文文献，共369例受试者。文献具体筛选流程见图 2。"
2.2 纳入文献的基本特征 纳入文献的具体基本特征见表1。针对纳入文献的结局指标，其中6篇文献探究了HIIT对老年人执行能力的影响[4，15，18，21-23]，3篇文献探究了HIIT对老年人记忆力的影响[4，18-19]，4篇文献探究了HIIT对老年人VO2 max的影响[4，10，15，22]，3篇文献探究了HIIT对老年人脑源性神经营养因子的影响[4，10，23]。针对干预周期，5篇文献HIIT干预周期≥6周[4，10，15，21-22]，3篇文献仅进行了单次HIIT干预[18-19，23]。"
2.3 纳入文献的质量评价结果 采用改良的Jadad量表对8篇纳入的随机对照试验的偏倚风险进行评估，其中低质量文献4篇，高质量文献4篇，纳入研究整体质量尚可，见图3，4和表2。"
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2.4 Meta分析结果 2.4.1 HIIT与MICT对老年人认知能力影响的Meta分析结果 (1)各组执行能力差异：文章对执行能力的Meta分析共纳入6篇文献。执行能力包括抑制、转换和刷新3个子功能，其中5篇文献研究了抑制功能[4，15，21-23]，2篇文献研究了转换功能[15，18]，2篇文献研究了刷新功能[15，18]。由于文章异质性较高(I2=53%)，故采用随机效应模型分析。此外，由于各数据测量单位不同，故采用SMD值作为效应尺度指标。研究表明，与MICT组相比，HIIT在提高老年人的执行能力方面无显著性差异(SMD=0.18，95%CI：-0.01-0.38，P=0.07)，见图5。"
根据干预周期，对执行功能进行亚组分析，亚组分析后各研究间异质性较低，故采用固定效应模型分析，结果表明长期运动干预(干预周期≥6周)，HIIT与MICT相比能够显著提高老年人的执行能力(SMD=0.36，95%CI：0.20-0.52，P < 0.000 1)和抑制能力(SMD=0.35，95%CI：0.17-0.52，P < 0.000 1)。但是在急性运动干预下，与HIIT相比，MICT能够有效提高老年人的执行能力(SMD=-0.25，95%CI：-0.49至-0.02，P=0.03)和抑制能力(SMD=-0.47，95%CI：-0.78至-0.16，P=0.003)，其他子功能Meta分析结果详见表3。"
(2)各组记忆力差异：文章对记忆力的Meta分析共纳入3篇文献。其中3篇文献研究了即时记忆[4，18-19]，2篇文献研究了延迟记忆[18-19]。由于文章异质性较低(I2=18%)，故采用固定效应模型分析。此外，由于各数据测量单位不同，故采用SMD作为效应尺度指标。研究表明，与MICT组相比，HIIT对老年人记忆力的改善无显著性差异(SMD=0.14，95%CI：-0.03-0.31，P=0.12)，其他子功能Meta分析结果见图6。"
根据干预周期，对记忆力进行亚组分析，亚组分析后研究数据间无异质性(I2=0%)，故采用固定效应模型分析，详见表3。结果表明急性运动干预下，HIIT与MICT相比对老年人记忆力的改善无显著性差异(SMD=0.07，95%CI：-0.11-0.24，P=0.44)。 (3)各组最大摄氧量变化：文章对VO2 max的Meta分析共纳入4篇文献[4，10，15，22]。由于文章异质性较高(I2=56%)，故采用随机效应模型分析。此外，由于文章各数据测量单位相同，故采用WMD作为效应尺度指标。研究表明，HIIT比MICT能够有效提高老年人的VO2 max (WMD=2.72，95%CI：0.50-4.95，P=0.02)，其他子功能Meta分析结果见图7。"
对VO2 max指标纳入的文献进行逐个数据剔除方法进行敏感性分析，结果发现剔除KOVACEVIC等[4]学者的研究后异质性发生改变(I2=0%)，采用固定效应模型分析。结果仍表明，与MICT组相比，HIIT能够有效提高老年人的VO2 max (WMD=3.78，95%CI：2.79-4.77，P < 0.000 01)。 (4) 各组脑源性神经营养因子水平差异：文章对脑源性神经营养因子的Meta分析共纳入3篇文献[4，10，23]。由于文章异质性较高(I2=80%)，故采用随机效应模型分析。由于各数据测量单位不同，故采用SMD作为效应尺度指标。与MICT组相比，HIIT对增加老年人的脑源性神经营养因子释放无显著性差异(SMD=-0.23，95%CI：-1.14-0.69，P=0.63)。通过亚组分析显示长期干预，两组仍无显著性差异(SMD=0.23，95%CI：-0.29-0.75，P=0.38)，其他子功能Meta分析结果见图8。"
文章对脑源性神经营养因子指标纳入文献采用逐个数据剔除方法进行敏感性分析，研究异质性未发生改变，结果表明脑源性神经营养因子的Meta分析结果较为稳健。 2.4.2 HIIT与对老年人认知能力影响的Meta分析结果 (1)各组执行功能的差异：文章对执行能力的Meta分析共纳入5篇文献。其中4篇文献研究了抑制功能[4，15，21，23]，2篇文献研究转换功能[15，18]，2篇文献研究刷新功能[15，18]。由于文章异质性较高(I2=81%)，故采用随机效应模型分析。由于各数据测量单位不同，故采用SMD作为效应尺度指标。结果表明，HIIT组与对照组相比能够有效提高老年人的执行能力(SMD=0.87，95%CI：0.52-1.22，P < 0.000 01)和抑制能力(SMD=0.89，95%CI：0.46-1.33，P < 0.000 1)，其他子功能Meta分析结果见图9。"
根据干预周期，对执行功能进行亚组分析，亚组分析后各研究间异质性较高，故采用随机效应模型分析，其他子功能Meta分析结果详见表4。结果表明，长期运动干预(干预周期≥6周)下，HIIT与对照组相比能够有效提高老年人的执行能力(SMD=0.75，95%CI：0.41-1.09，P < 0.000 1)、抑制能力(SMD=0.50，95%CI：0.19-0.81，P=0.002)以及转换能力(SMD=1.65，95%CI：0.86-2.44，P < 0.000 1)。同时急性运动干预下，与对照组相比，HIIT能够有效提高老年人的执行能力(SMD=1.25，95%CI：0.39-2.11，P=0.004)和抑制能力(SMD=2.40，95%CI：0.87-3.92，P=0.002)。"
(2)各组记忆力差异：文章对记忆力的Meta分析共纳入3篇文献[4，18-19]，此3篇文献均研究了即时记忆[4，18-19]，其中2篇文献同时研究了延迟记忆[18-19]。由于文章无异质性(I2=0%)，故采用固定效应模型分析。此外，由于各数据测量单位不同，故采用SMD作为效应尺度指标。研究表明，HIIT与对照组相比能够有效提高老年人的记忆力(SMD=0.20，95%CI：0.03-0.37，P=0.02)，其他子功能Meta分析结果见图10。"
根据干预周期，对记忆力进行亚组分析，亚组分析后各研究间无异质性(I2=0%)，故采用固定效应模型分析，详见表4。结果表明，急性运动干预下，HIIT与对照组相比，对老年人记忆力的改善无显著性差异(SMD=0.14，95%CI：-0.04-0.31，P=0.13)。 (3)各组最大摄氧量变化：文章对VO2 max的Meta分析共纳入3篇文献[4，10，15]。由于文章异质性较高(I2=69%)，故采用随机效应模型分析。此外，由于文章各数据测量单位相同，故采用WMD作为效应尺度指标。研究表明，HIIT比CON能显著提高老年人的VO2 max(WMD=6.75，95%CI：4.20-9.29，P < 0.000 01)，其他子功能Meta分析结果见图11。"
对VO2 max指标纳入的文献进行逐个数据剔除方法进行敏感性分析，结果发现剔除KOVACEVIC等[4]学者的研究后异质性发生改变(I2=0%)，采用固定效应模型分析。结果仍表明，与对照组相比，HIIT能够有效提高老年人的VO2 max (WMD=5.58，95%CI：4.70-6.47，P < 0.000 01)。 (4)各组脑源性神经营养因子水平的差异：文章对脑源性神经营养因子的Meta分析共纳入3篇文献[4，10，23]。由于文章异质性较高(I2=83%)，故采用随机效应模型分析。由于文章各数据测量单位不同，故采用SMD值作为效应尺度指标。与对照组相比，HIIT对增加老年人脑源性神经营养因子的释放无显著性差异(SMD=1.09，95%CI：-0.00-2.19，P=0.05)。通过亚组分析显示长期干预，两组脑源性神经因子水平仍无显著性差异(SMD=0.54，95%CI：-0.12-1.20，P=0.11)，见图12。"
对脑源性神经营养因子指标纳入文献采用逐个数据剔除方法进行敏感性分析，研究异质性未发生改变，结果表明脑源性神经营养因子 Meta分析结果较为稳健。 2.5 发表偏倚分析结果 因文章中包含VO2 max以及脑源性神经营养因子指标纳入文献较少，故仅对包含执行能力以及记忆力指标的纳入研究进行漏斗图评估潜在发表偏倚。结果发现漏斗图较为对称，但仍存在节点散落于漏斗图外，表明研究可能存在发表偏倚，见图13。通过Egger法与Begg法结果显示，HIIT组与MICT组执行能力Egger检验z=1.89，P=0.058，Begg检验t=-1.36，P=0.184，均无显著性意义(P > 0.05)；HIIT组与MICT组记忆力Egger检验z=0.59，P=0.553，Begg检验t=0.70，P=0.495，均无显著性意义(P > 0.05)；HIIT组与对照组执行能力Egger检验z=0.04，P=0.659，Begg检验t=-1.15，P=0.261，均无显著性意义(P > 0.05)；HIIT组与对照组记忆力Egger检验z=3.17，P=0.002，Begg检验t=0.04，P=0.965，当Egger与Begg检验结果不一致时以Egger检验结果为准[24]，表明均无显著性意义(P > 0.05)。这与视觉观察判断结果不一致，则以统计学检验结果为准，提示文章各组内不存在发表偏倚。"
2.6 敏感性分析结果 研究结果表明HIIT组与MICT组以及HIIT组与对照组的执行能力、记忆力指标各项研究数值均在可信区间范围内，表明各组间的研究结果较为稳健，见图14。"
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