认知干预对脑卒中偏瘫患者平衡功能的影响

Cognition training in balance rehabilitation after stroke

目的研究认知干预对脑卒中偏瘫患者平衡功能的影响。方法共选取45例脑卒中偏瘫患者，根据洛文斯顿作业疗法认知评定成套测验（LOTCA）结果，发现所有患者均患有认知功能障碍，将上述患者随机分为治疗组及对照组。所有人选患者均接受常规运动、作业等治疗，治疗组患者在此基础上进行有针对性的认知干预，疗程为6周。于治疗前、治疗6周后分别采用LOTCA、Brahel平衡量表（BBA）、Berg平衡量表（BBS）对患者认知功能及平衡功能进行评定。结果2组患者分别经相应治疗后，发现其平衡功能、认知功能均较治疗前明显提高（P〈0．05）；进一步分析后发现，治疗组患者平衡功能、认知功能的改善幅度均明显优于对照组（P〈0．05）。结论认知是影响脑卒中患者平衡功能的重要因素之一，认知干预对改善脑卒中偏瘫患者平衡功能具有显著促进作用。

Objective To investigate the effect of cognition training on the recovery of balance after stroke. Methods forty-five hemiplegic stroke patients with cognition deficit were recruited and assigned into an experimental group and a control group according to the results of an assessment with Loewenstein＇s Occupational Therapy Cognition Assessment battery （LOTCA）. The patients in the two groups followed routine systematic rehabilitation programs. The patients in the experimental group received pertinent cognition training 5 days/week for 6 weeks. LOTCA, Brunel＇s Balance Assessment （BBA） , the Berg Balance Scale （BBS） and Brunnstrom functional categories were employed to evaluate the patients before and after treatment with regard to their cognition, balance control and motor function in their lower limbs. Results After treatment, there were statistically significant differences between preand post-treatment BBA and BBS scores in all groups. Average BBA, BBS and LOTCA scores in the experimental group were significantly higher than in the control group. The improvements in BBS, BBA and LOTCA scores in the experimental group were significantly greater than in control group. Conclusion Cognition treatment can contribute significantly to improving balance and postural control among stroke survivors.