精准璟云平台认知训练治疗认知障碍合并失语症病例报告

Case Report of Jingyun Platform’s Cognitive Training on Cognitive Impairment with Aphasia

目的:观察精准璟云平台认知训练对认知障碍合并失语症的治疗效果。方法:收集1例认知障碍合并失语症的患者,采取ABBA模式对个案进行被试内设计,传统认知训练阶段为A阶段,是根据个案认知障碍点人工制定认知训练内容并执行,精准璟云平台认知训练阶段为B阶段,则是根据个案的功能障碍采用精准认知训练设计,进行自动化、智能化及趣味化训练。采用ABBA平衡顺序对个案进行干预,干预过程分为6个阶段,即治疗前、传统认知训练阶段、璟云平台认知训练阶段、空白阶段、璟云平台认知训练阶段、传统认知训练阶段。治疗前即入院时检查,传统认知训练阶段进行传统认知训练,璟云平台认知训练阶段进行精准璟云平台认知训练,空白阶段停止认知训练。传统认知训练每周5 d,璟云平台认知训练时间由研究人员经网络监督,每个阶段均为1周,每次30 min,每天2次,共持续6周。记录6个阶段中蒙特利尔认知评估(MoCA)总分、MoCA中亚项分值、记忆及延迟回忆正确个数、评测MoCA总耗时及记忆耗时变化。结果:①璟云平台认知训练后患者MoCA总分高于传统认知训练,特别是在注意、延迟回忆、定向亚项上有改善。语言无明显改善,视空间与执行、命名在各阶段始终处于正常。与传统认知训练第一阶段比较,璟云平台认知训练第一阶段中MoCA的第一次记忆正确个数提高,传统认知训练及璟云平台认知训练第二阶段中第一、第二次记忆处于正常水平,且精准璟云平台认知训练第一、二阶段中延迟回忆(不提示)均高于传统认知训练阶段。②与治疗前比较,传统认知训练及精准璟云平台认知训练后患者记忆及延迟回忆均改善。③与治疗前比较,传统认知训练及璟云平台认知训练MoCA总耗时、第一次记忆及延迟回忆(不提示)耗时均缩短,且璟云平台认知训练较传统认知训练在MoCA评估总耗时、第一次记忆及延迟回忆(不提示)耗时缩短改善更明显。结论:传统认知训练及精准璟云平台认知训练对个案的认知康复均有改善。较之传统认知训练,精准璟云平台认知训练对个案的认知障碍的改善更有效,尤其在注意、延迟回忆、定向亚项改善方面具有一定优势。

Objective:To observe the curative effect of Jingyun platform’s cognitive training on cognitive impairment with aphasia.Methods:A case of cognitive impairment with aphasia was collected,and ABBA model was used to design a case in-subject.Traditional cognitive training stage was A stage,and the traditional cognitive training was based on the artificial development and implementation of the cognitive training content according to the cognitive impairment points of the case.Jingyun platform’s cognitive training stage was B stage,the cognitive training design was adopted according to the functional impairment of the case,and the automatic,intelligent and interesting training was conducted.The ABBA balance sequence was used for the intervention of the case,and the intervention process was divided into six stages,including pre-treatment,traditional cognitive training,Jingyun platform cognitive training,blank stage,Jingyun platform cognitive training and traditional cognitive training.Patients received admission examination before treatment,received the traditional cognitive training in stage of traditional cognitive training for five days a week,received Jingyun platform’s cognitive training in stage of Jingyun platform’s cognitive stage,and stopped the cognitive training in blank stage.The time of Jingyun platform cognitive training was supervised by researchers via network.Each stage lasts for six weeks,30 minutes at a time,twice a day.The total score of MoCA,subitem score in MoCA,the correct number of words in memory and delayed recall,total time of Mo CA evaluation and time-consuming changes in memory were calculated.Results:Compared with before treatment,the memory and delayed recall in traditional cognitive training stage and Jingyun platform cognitive training stage were improved.After the cognitive training of Jingyun platform,the MoCA total score was higher than that of traditional language cognitive training stage,especially in attention,delayed recall and directional subitems.There was no significant improvement in the language,and visual space,execution and naming which remained normal in all stages.Compared with the first stage of traditional cognitive training,the correct number of the first memory of MoCA was improved in the first stage of cognitive training of Jingyun platform,and the first and second memory were at normal level in the second stage of traditional cognitive training and Jingyun platform cognitive training.Moreover,delayed recall(no hint)in the first and second stages of the cognitive training of Jingyun platform was higher respectively than that of traditional cognitive training stage.Compared with before treatment,the total time of MoCA,and the time-consuming of memory(the first time)and delayed recall(no hint)in traditional cognitive training stage and Jingyun platform cognitive training stage were shortened.Moreover,compared with traditional cognitive training stage,the total time-consuming in MoCA evaluation,memory(the first time)and delayed recall(no hint)in Jingyun platform cognitive training stage were significantly shortened.Conclusion:Both traditional cognitive training and Jingyun platform cognitive training can improve the cognitive rehabilitation in the case.Compared with traditional cognitive training,Jingyun platform is move effective in improving the cognition with its precise training system,and has certain advantages in response,attention,memory and in the directional improvement.