CAJ | 학술논문

目的观察作业疗法对急性脑梗死患者认知功能及其事件相关电位(ERP) P300的影响.方法根据简易精神状况量表(MMSE)评分选取98例伴有认知功能障碍的急性脑梗死患者,采用随机数字表法将其分为观察组(49例)及对照组(49例).2组患者均给予常规康复训练,观察组患者在此基础上辅以作业治疗.于治疗前、治疗8周后分别采用洛文斯顿作业疗法认知评定量表(LOTCA)、改良Barthel指数(MBI)对2组患者认知功能及日常生活活动(ADL)能力进行评定,同时对2组患者事件相关电位(P300)进行检测.结果入选时2组患者LOTCA评分、MBI评分、P300潜伏期及波幅等指标组间差异均无统计学意义(P＞0.05);治疗8周后发现2组患者上述指标均较治疗前有一定程度改善,并以观察组患者LOTCA评分[(99.4±8.4)分]、MBI评分[(80.7±5.9)分]、P300潜伏期[(373.45±52.13) ms]及波幅[(7.87土2.63)μV]的改善幅度较显著,与治疗前及对照组间差异均具有统计学意义(P＜0.05).结论在常规康复训练基础上辅以作业治疗,可进一步提高脑梗死后认知功能障碍患者ADL能力,改善其认知功能,该联合疗法值得临床推广、应用.
목적 관찰작업요법대급성뇌경사환자인지공능급기사건상관전위(ERP) P300적영향.방법 근거간역정신상황량표(MMSE)평분선취98례반유인지공능장애적급성뇌경사환자,채용수궤수자표법장기분위관찰조(49례)급대조조(49례).2조환자균급여상규강복훈련,관찰조환자재차기출상보이작업치료.우치료전、치료8주후분별채용락문사돈작업요법인지평정량표(LOTCA)、개량Barthel지수(MBI)대2조환자인지공능급일상생활활동(ADL)능력진행평정,동시대2조환자사건상관전위(P300)진행검측.결과 입선시2조환자LOTCA평분、MBI평분、P300잠복기급파폭등지표조간차이균무통계학의의(P＞0.05);치료8주후발현2조환자상술지표균교치료전유일정정도개선,병이관찰조환자LOTCA평분[(99.4±8.4)분]、MBI평분[(80.7±5.9)분]、P300잠복기[(373.45±52.13) ms]급파폭[(7.87토2.63)μV]적개선폭도교현저,여치료전급대조조간차이균구유통계학의의(P＜0.05).결론 재상규강복훈련기출상보이작업치료,가진일보제고뇌경사후인지공능장애환자ADL능력,개선기인지공능,해연합요법치득림상추엄、응용.
Objective To explore the effect of occupational therapy on the cognitive function and P300 event-related potentials (ERPs) of patients with acute cerebral infraction.Methods Ninety-eight acute cerebral infarction patients with cognitive impairment were selected using the mini-mental state examination (MMSE).They were randomly divided into an observation group (n =49) who received occupational therapy plus routine rehabilitation treatment and a control group (n =49) who received only the routine rehabilitation treatment.Before and after 8 weeks of treatment,the patients' cognitive function and their ability in the activities of daily living(ADL) were evaluated using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel index (MBI),respectively.P300 ERPs were also detected.Results There was no significant difference between the two groups with regard to various scores before the treatment (P ＞ 0.05).After 8 weeks of treatment,the LOTCA and MBI scores and the latency and amplitude of ERPs were significantly better than those before treatment in both groups (P ＜ 0.05).In the observation group,the scores of LOTCA (99.4 ± 8.4),MBI (80.7 ± 5.9) and the latency and amplitude of ERPs [(373.45 ± 52.13) ms and (5.87 ± 2.63) μV,respectively] were significantly better than those in the control group(P ＜ 0.05).Conclusion Occupational therapy program based on conventional rehabilitation training can promote the ADL ability and cognitive function of patients with acute cerebral infraction.It is worth applying in clinical practice.