CAJ | 학술논문

目的观察认知功能训练对基底核区脑卒中患者运动及执行功能的影响.方法采用随机数字表法将30例基底核区脑卒中患者分为治疗组和对照组,每组15例.2组患者均给予常规康复训练,治疗组患者在此基础上辅以认知功能训练.于治疗前、治疗2个月后(治疗后)分别采用汉诺塔(TOH)测试、威斯康星卡片分类测试(WCST)及Sroop-3测试对2组患者执行功能情况进行评定,采用Fugl-Meyer评分量表(FMA)、Berg平衡量表(BBS)、改良Barthel指数(MBI)量表及10 m最大步行速度(MWS)对2组患者运动功能及日常生活活动能力进行评定.结果经2个月治疗后,治疗组患者WCST保持反应率[(22.1±4.2)％]及错误率[(47.2±5.5)％]均显著下降,WCST完成分类数(4.81 ±0.39)显著增加,TOH测试时间[(120.74±19.34)s]和TOH步数(12.34±1.98)显著减少,Stroop-3错误率[(3.4±0.3)％]明显下降,与治疗前及对照组间差异均具有统计学意义(P＜0.05)；治疗后治疗组FMA评分[(79.34±8.45)分]、BBS评分[(48.13 ±4.75)分]、MBI评分[(68.45±5.79)分]及MWS[(44.58±5.27) m/min]、对照组FMA评分[(73.21±5.78)分]、BBS评分[(45.43±6.74)分]、MBI评分[(65.65±7.48)分]及MWS[(42.23±6.09) m/min]均较治疗前显著改善(P＜0.05)；并且治疗组上述指标治疗前、后差值均显著大于对照组水平(P＜0.05).结论与工作记忆有关的认知功能训练可显著提高基底核区脑卒中患者执行功能、运动功能及日常生活活动能力.
목적 관찰인지공능훈련대기저핵구뇌졸중환자운동급집행공능적영향.방법 채용수궤수자표법장30례기저핵구뇌졸중환자분위치료조화대조조,매조15례.2조환자균급여상규강복훈련,치료조환자재차기출상보이인지공능훈련.우치료전、치료2개월후(치료후)분별채용한낙탑(TOH)측시、위사강성잡편분류측시(WCST)급Sroop-3측시대2조환자집행공능정황진행평정,채용Fugl-Meyer평분량표(FMA)、Berg평형량표(BBS)、개량Barthel지수(MBI)량표급10 m최대보행속도(MWS)대2조환자운동공능급일상생활활동능력진행평정.결과 경2개월치료후,치료조환자WCST보지반응솔[(22.1±4.2)％]급착오솔[(47.2±5.5)％]균현저하강,WCST완성분류수(4.81 ±0.39)현저증가,TOH측시시간[(120.74±19.34)s]화TOH보수(12.34±1.98)현저감소,Stroop-3착오솔[(3.4±0.3)％]명현하강,여치료전급대조조간차이균구유통계학의의(P＜0.05)；치료후치료조FMA평분[(79.34±8.45)분]、BBS평분[(48.13 ±4.75)분]、MBI평분[(68.45±5.79)분]급MWS[(44.58±5.27) m/min]、대조조FMA평분[(73.21±5.78)분]、BBS평분[(45.43±6.74)분]、MBI평분[(65.65±7.48)분]급MWS[(42.23±6.09) m/min]균교치료전현저개선(P＜0.05)；병차치료조상술지표치료전、후차치균현저대우대조조수평(P＜0.05).결론 여공작기억유관적인지공능훈련가현저제고기저핵구뇌졸중환자집행공능、운동공능급일상생활활동능력.
Objective To observe the effect of cognition training on the motor and executive functioning of patients after a basal ganglia stroke.Methods Thirty patients with basal ganglia stroke were randomly divided into a treatment group and a control group.The control group received standard stroke rehabilitation training,while the treatment group received in addition 2 months of cognitive function training.The executive and motor functions of all of the subjects and their facility in the activities of daily living (ADL) were tested using the Tower of Hanoi,the Wisconsin card sorting test,a Stroop-3 test and the Fugl-Meyer assessment,the Berg balance scale and the modified Barthel index before and at the end of treatment.Results After two months of training,both within-group and between group comparisons showed that the treatment group had improved significantly more in executive function,cognition and motor function.Conclusion Cognition training can improve executive function,motor function and ADL performance after a basal ganglia stroke.