中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2015年
5期
344-347
,共4页
非痴呆血管性认知障碍%蒙特利尔认知评估量表%计算机辅助训练%现实环境训练
非癡呆血管性認知障礙%矇特利爾認知評估量錶%計算機輔助訓練%現實環境訓練
비치태혈관성인지장애%몽특리이인지평고량표%계산궤보조훈련%현실배경훈련
Vascular cognitive impairment no dementia%The Montreal cognitive assessment scale%Computer assisted training%Actual environment training
目的 观察计算机辅助训练联合现实环境训练对脑卒中后非痴呆血管性认知障碍的康复疗效.方法 采用随机数字表法将60例脑卒中后非痴呆血管性认知障碍老年患者分为研究组(30例)及对照组(30例).2组患者均给予常规药物治疗及康复训练,研究组患者在此基础上增加计算机辅助训练及现实环境训练,持续治疗2个月.2组患者均于治疗前、治疗2个月后采用蒙特利尔认知评估量表(MoCA)和改良Barthel指数(MBI)量表评定患者认知功能及日常生活活动能力改善情况.结果 经治疗2个月后,发现研究组患者MoCA量表总分及视空间、命名、注意力、语言、抽象思维、延迟记忆、定向力七个子项目评分[分别为(22.80 ±4.63)分、(4.00 ±0.93)分、(2.67±0.62)分、(4.13±0.74)分、(2.33±0.62)分、(1.60±0.83)分、(2.93±0.70)分及(5.13±1.19)分]均显著优于组内治疗前及对照组治疗后水平(P＜0.05);对照组治疗后只有命名、语言、延迟记忆3个子项目评分和总分优于组内治疗前水平(P＜0.05).治疗后研究组及对照组患者MBI评分[(61.53±7.13)、(52.20 ±4.93)分]均较治疗前明显提高(P＜0.05),组间比较发现研究组患者MBI评分改善幅度更显著(P＜0.05).结论 在常规干预基础上辅以计算机训练及现实环境训练,有助于卒中后非痴呆血管性认知功能障碍患者认知功能改善及日常生活活动能力提高,该联合疗法值得临床推广、应用.
目的 觀察計算機輔助訓練聯閤現實環境訓練對腦卒中後非癡呆血管性認知障礙的康複療效.方法 採用隨機數字錶法將60例腦卒中後非癡呆血管性認知障礙老年患者分為研究組(30例)及對照組(30例).2組患者均給予常規藥物治療及康複訓練,研究組患者在此基礎上增加計算機輔助訓練及現實環境訓練,持續治療2箇月.2組患者均于治療前、治療2箇月後採用矇特利爾認知評估量錶(MoCA)和改良Barthel指數(MBI)量錶評定患者認知功能及日常生活活動能力改善情況.結果 經治療2箇月後,髮現研究組患者MoCA量錶總分及視空間、命名、註意力、語言、抽象思維、延遲記憶、定嚮力七箇子項目評分[分彆為(22.80 ±4.63)分、(4.00 ±0.93)分、(2.67±0.62)分、(4.13±0.74)分、(2.33±0.62)分、(1.60±0.83)分、(2.93±0.70)分及(5.13±1.19)分]均顯著優于組內治療前及對照組治療後水平(P＜0.05);對照組治療後隻有命名、語言、延遲記憶3箇子項目評分和總分優于組內治療前水平(P＜0.05).治療後研究組及對照組患者MBI評分[(61.53±7.13)、(52.20 ±4.93)分]均較治療前明顯提高(P＜0.05),組間比較髮現研究組患者MBI評分改善幅度更顯著(P＜0.05).結論 在常規榦預基礎上輔以計算機訓練及現實環境訓練,有助于卒中後非癡呆血管性認知功能障礙患者認知功能改善及日常生活活動能力提高,該聯閤療法值得臨床推廣、應用.
목적 관찰계산궤보조훈련연합현실배경훈련대뇌졸중후비치태혈관성인지장애적강복료효.방법 채용수궤수자표법장60례뇌졸중후비치태혈관성인지장애노년환자분위연구조(30례)급대조조(30례).2조환자균급여상규약물치료급강복훈련,연구조환자재차기출상증가계산궤보조훈련급현실배경훈련,지속치료2개월.2조환자균우치료전、치료2개월후채용몽특리이인지평고량표(MoCA)화개량Barthel지수(MBI)량표평정환자인지공능급일상생활활동능력개선정황.결과 경치료2개월후,발현연구조환자MoCA량표총분급시공간、명명、주의력、어언、추상사유、연지기억、정향력칠개자항목평분[분별위(22.80 ±4.63)분、(4.00 ±0.93)분、(2.67±0.62)분、(4.13±0.74)분、(2.33±0.62)분、(1.60±0.83)분、(2.93±0.70)분급(5.13±1.19)분]균현저우우조내치료전급대조조치료후수평(P＜0.05);대조조치료후지유명명、어언、연지기억3개자항목평분화총분우우조내치료전수평(P＜0.05).치료후연구조급대조조환자MBI평분[(61.53±7.13)、(52.20 ±4.93)분]균교치료전명현제고(P＜0.05),조간비교발현연구조환자MBI평분개선폭도경현저(P＜0.05).결론 재상규간예기출상보이계산궤훈련급현실배경훈련,유조우졸중후비치태혈관성인지공능장애환자인지공능개선급일상생활활동능력제고,해연합요법치득림상추엄、응용.
Objective To observe the effects of computer assisted training combined with the actual environment training on vascular cognitive impairment with no dementia (VCIND) after stoke.Methods Sixty elderly patients with VCIND after stroke were randomly divided into a research group and a control group,each of 30.All patients were given routine medication and rehabilitation training,while the research group was additionally provided with computer assisted training and the actual environment training lasting two months.All patients' cognitive function and activities of daily life (ADL) in both groups were assessed using the Montreal cognitive assessment scale(MoCA) and modified Barthel index(MBI) before and after treatment.Results After two months of treatment,the total score of MoCA (22.80 ± 4.63) and the scores of seven subprojects including visual space (4.00 ± 0.93),naming (2.67±0.62),attention(4.13 ±0.74),language(2.33 ±0.62),abstract thinking(1.60± 0.83),delayed memory(2.93 ±0.70) and orientation(5.13 ± 1.19) in the research group were significantly higher than those before treatment and those of the control group.However,in the control group,only the total score and the scores of naming,language and delayed memory in the control group significantly were higher than those before treatment.After treatment,the scores of MBI in both group were significantly promoted,reaching (61.53 ± 7.13) and (52.20 ± 4.93) for the research and control group respectively,with the former improving more significantly than the latter.Conclusion The computer assisted training combined with the actual environment training helps to improve cognitive function and ADL for patients with VCIND after stoke.Such combined therapy is worth of promoting in clinical practice.
