早期强化认知功能训练对脑卒中患者神经功能及日常生活能力的影响

Effects of early intensive cognitive function training on neurological function and activities of daily living of patients with cerebral stroke

目的:探讨早期强化认知功能训练对脑卒中(cerebral stoke,CS)患者神经功能及日常生活能力(activity of daily living,ADL)的影响。方法:将我院收治的124例CS患者随机分为接受系统性康复治疗的对照组(62例)和给予早期强化认知功能训练+系统性康复治疗的联合组(62例),比较两组治疗前后神经功能缺损评分(neural function deficient scale,NDS)、改良Barthel指数(modified Barthel index,MBI)、简式Fugl-Meyer运动功能量表(Fugl-Meyer motor assessment,FMA)和Loewenstein认知功能评定量表(loewenstein occupational therapy cognitive assessment,LOTCA)的变化。结果:两组治疗后NDS[(11.53±3.34)分、(19.07±6.11)分]均较治疗前[(26.72±7.13)分、(26.29±7.08)分]显著降低(P<0.05);MBI[(63.85±9.21)分、(47.36±8.93)分]、LOTCA[(69.40±9.33)分、(60.53±8.95)分]、FMA[(69.40±9.33)分、(60.53±8.95)分]评分均较治疗前[(30.65±8.82)分、(31.04±8.86)分,(46.15±8.57)分、(46.48±8.60)分,(21.10±5.34)分、(21.69±5.38)分]显著升高(P<0.05);且联合组NDS、MBI、LOTCA、FMA评分变化幅度均大于对照组(P<0.05)。结论:早期强化认知功能训练可有效改善CS患者预后,改善患者神经功能、认知功能、运动功能,提高ADL,减轻患者家庭负担。

Objective:To explore the effects of early intensive cognitive function training on the neurological function and activities of daily living(ADL)of patients with cerebral stroke(CS).Methods:A total of 124 patients with CS were randomly divided into the control group(given systemic rehabilitation therapy,n=62)and the combined group(given early intensive cognitive function training and systemic rehabilitation therapy,n=62).Scores of neurological deficit scale(NDS),modified Barthel index(MBI),simple Fugl-Meyer motor function assessment(FMA),and Loewenstein Occupational Therapy Cognition Assessment(LOTCA)were compared between the two groups before and after treatment.Results:After treatment,the NDS score[(11.53±3.34)points,(19.07±6.11)points]of the two groups was significantly decreased compared with that before treatment[(26.72±7.13)points,(26.29±7.08)points](P<0.05)while the scores of MBI[(63.85±9.21)points,(47.36±8.93)points],LOTCA[(69.40±9.33)points,(60.53±8.95)points]and FMA[(69.40±9.33)points,(60.53±8.95)points]were significantly increased compared with those before treatment[(30.65±8.82)points,(31.04±8.86)points;(46.15±8.57)points,(46.48±8.60)points;(21.10±5.34)points,(21.69±5.38)points](P<0.05),and the changes in scores of NDS,MBI,LOTCA,and FMA in the combined group were greater than those in the control group(P<0.05).Conclusions:Early intensive cognitive function training can effectively improve the prognosis,the neurological function,cognitive function,motor function,and ADL of patients with CS,and reduce the burden on the family.