计算机辅助认知训练对脑卒中后认知障碍的效果

Clinical effect of computer-assisted cognitive training on post-stroke cognitive impairment

目的探讨计算机辅助认知训练对脑卒中后认知障碍(PSCI)的临床疗效。方法将30例PSCI患者随机分为计算机组和对照组各15例。对照组只接受常规药物治疗及人工认知训练,计算机组在常规药物治疗及人工认知训练基础上增加基于六六脑?脑康复云系统的计算机辅助认知训练,1次/d,30 min/次,5次/周,于治疗前、治疗12周后对各组患者的认知功能、日常生活能力和独立能力进行疗效评估,采用蒙特利尔认知评估量表(MoCA)、改良Barthel指数量表(MBI)和功能独立评定量表(FIM)评分法。结果(1)认知功能变化:治疗12周后,两组MoCA评分较治疗前均明显提高(P<0.05),其中计算机组命名、注意力、抽象能力、延迟回忆和定向力项目评分和对照组延迟回忆项目评分均明显高于治疗前(P<0.05),计算机组MoCA总分要高于对照组且组间差异有统计学意义(P<0.05)。(2)日常生活和独立能力:计算机组MBI、FIM评分比治疗前明显提高(P<0.05),而对照组MBI、FIM评分与治疗前比较差异无统计学意义(P>0.05),治疗后计算机组MBI、FIM评分明显高于对照组(P<0.05)。结论基于六六脑?脑康复云系统的计算机辅助认知训练对改善脑卒中后认知功能有明显的积极作用,与传统人工训练结合应用的临床疗效优于单用人工认知训练。

Objective To investigate the clinical effect of computer - assisted cognitive training on post - stroke cognitive impairment ( PSCI). Methods Thirty patients with PSCI were randomly divided into computer group and con- trol group ( n = 15). The control group only received routine medical therapy and artificial cognitive training,while the computer group received routine medical therapy and artificial cognitive training aided computer - assisted cognitive train- ing on the basis of 66 brain training system. The treatment effectiveness was assessed by montreal cognitive assessment scale ( MoCA),modified barthel index ( MBI) and functional independence measure ( FIM). The evaluation was per- formed before and at the 12 weeks after the treatment. Results After treatment,the results of MoCA were significantly improved in both groups ( P < 0. 05),and the scores of nomination,abstract ability,attention,delayed recall and orienta- tion items in the computer group and the scores of the delayed recall item in the control group were significantly higher than before ( P < 0. 05),and the total score of MoCA in the computer group was significantly higher than that in the control group ( P < 0. 05). The scores of MBI and FIM in the computer group were significantly higher than before ( P < 0. 05). After treatment,the scores of MBI and FIM in the computer group were significantly higher than those in the control group ( P < 0. 05). Conclusion Computer - assisted cognitive training has a positive effect on improving PSCI. The treatment effect combined with the traditional artificial training is obviously better than the artificial cognitive training alone.