medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-2-44-51medsovet-6730Research ArticleКОГНИТИВНЫЕ РАССТРОЙСТВАCOGNITIVE DISRODERSОценка эффективности когнитивно-моторного тренинга в сочетании с медикаментозной терапией у пациентов с умеренными когнитивными расстройствамиEvaluation of the cognitive-motor training effectiveness in combination with drug therapy among patients with moderate cognitive disorders: the own research resultshttps://orcid.org/0000-0002-7375-7560КиндароваА. А.KindarovaA. A.

аспирант кафедры нервных болезней и нейрохирургии Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

 Postgraduate Student of the Department of Nervous Diseases and Neurosurgery

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

abdulmuslimova@gmail.comhttps://orcid.org/0000-0002-9193-1219ФанталисД.FantalisD.

 аспирант кафедры нервных болезней и нейрохирургии Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

 Postgraduate Student of the Department of Nervous Diseases and Neurosurgery 

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

doctor.fant@gmail.comhttps://orcid.org/0000-0002-9097-898XПреображенскаяИ. С.PreobrazhenskayaI. S.

д.м.н., профессор кафедры нервных болезней и нейрохирургии Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

 Dr. Sci. (Med.), Professor of the Department of Nervous Diseases and Neurosurgery 

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

preobrazhenskaya_i_s@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет)РоссияN.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202211032022024451Copyright © Киндарова А.А., Фанталис Д., Преображенская И.С., 20222022Киндарова А.А., Фанталис Д., Преображенская И.С.Kindarova A.A., Fantalis D., Preobrazhenskaya I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6730

Введение. Нелекарственные методы терапии когнитивных нарушений – одно из актуальных направлений неврологии. Когнитивный тренинг может быть полезен для поддержания умственной активности здоровых пожилых пациентов, в то время как больным с деменцией и умеренными когнитивными расстройствами (УКР) больше подойдут занятия когнитивно-моторным тренингом.Цель. Оценить эффективность когнитивно-моторного тренинга, разработанного в Сеченовском университете, у пациентов с УКР.Материалы и методы. В исследование был включен 41 пациент (женщин – 8, мужчин – 33), средний возраст пациентов составил 60,3 ± 8,5 года, средний уровень образования – 14,2 ± 8,7 года, 15 пациентов соответствовали критериям болезни Альцгеймера, 26 – критериям сосудистого когнитивного расстройства. Больным проводилось количественное нейропсихологическое тестирование, оценивался уровень эмоциональных расстройств, а также удовлетворенность качеством жизни, приверженность к терапии. В дальнейшем пациенты были разделены на группу индивидуального и группового когнитивного тренинга. Занятия проходили по стандартной схеме, 30–50 мин в день, в течение 40 дней. Через 3 мес. случайным образом из группы индивидуального тренинга были выбраны 10 пациентов, которые получили дополнительный курс группового когнитивно-моторного тренинга.Результаты. На фоне когнитивного тренинга через 1,5 мес. у пациентов было отмечено достоверное уменьшение выраженности когнитивных расстройств (p < 0,05). Наибольшая положительная динамика была отмечена в отношении уровня внимания (p < 0,05), памяти (в т. ч. первичных модально-неспецифических мнестических расстройств, p < 0,05), логических операций (p < 0,05). У включенных в исследование пациентов также было отмечено достоверное уменьшение выраженности депрессии (p < 0,05). Достоверная положительная динамика была зафиксирована как у пациентов группы индивидуального КТ, так и у пациентов, получавших групповой КТ (p < 0,05). Положительный эффект сохранялся в течение 3 мес. наблюдения. Сравнительный анализ исследуемых пациентов через 6 мес. показал, что пациенты, получившие дополнительные занятияс тренером, сообщали об улучшении самочувствия.Выводы. Отмечена эффективность когнитивно-моторного тренинга у пациентов с УКР. Полученные результаты позволяют рекомендовать этот вид когнитивно-моторного тренинга для использования в клинической практике неврологов, терапевтов и психиатров как дополнительный эффективный метод терапии когнитивных нарушений.

Introduction. Non-drug methods of therapy for cognitive impairment is one of the topical areas of neurology. Studies have shown that cognitive training may be beneficial for maintaining mental alertness in healthy older adults, while patients with dementia and mild cognitive impairment are more likely to benefit from cognitive-motor training or rehabilitation. It is possible that the severity and type of cognitive disorders, as well as patients’ adherence to training, the correct construction of tasks, may affect the effectiveness of non-drug therapy for cognitive disorders.Аim. The aim of this study was to evaluate the effectiveness of cognitive-motor training developed at Sechenov University in patients with moderate cognitive impairment (MCI).Materials and methods. 41 patients were included in the study, including 8 women and 33 men, the average age of patients was 60.3 ± 8.5 years, the average level of education was 14.2 ± 8.7 years, of which 15 patients met the criteria AD, 26 – VCI criteria. Patients underwent quantitative neuropsychological testing, assessment of emotional disorders, and also assessed such indicators as satisfaction with the quality of life, adherence to therapy. Subsequently, the patients were divided into groups of individual and group cognitive training. Classes with patients were held according to the standard scheme, 30–50 minutes a day, for 40 days. After 3 months, 10 patients were randomly selected from the individual training group and received an additional course of group cognitive-motor training.Results. Тhe study showed that after 1.5 months, patients showed a significant decrease in the severity of cognitive disorders (p < 0.05). The greatest positive dynamics was noted in relation to the level of attention (p < 0.05), memory (including primary modal-nonspecific mnestic impairment, p < 0.05), logical operations (p < 0.05). The patients included in the study also showed a significant decrease in the severity of depression (p < 0.05). The analysis showed that significant positive dynamics was recorded both in patients of the individual CT group and in patients who received group CT (p < 0.05). The positive effect on cognitive functions was maintained during the three months of follow-up. Comparative analysis of study patients after 6 months showed that patients who received additional sessions with a trainer reported an additional improvement in well-being. These differences were statistically significant, despite the small number of patients included in the repeat CT group (p < 0.05).Conclusions. The effectiveness of cognitive-motor training in patients with MCI was noted. The results obtained allow us to recommend this type of cognitive-motor training for use in clinical practice by neurologists, therapists and psychiatrists as an additional effective method for the treatment of cognitive impairment.

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The authors declare that there are no conflicts of interest present.