双重任务训练对亚急性期脑卒中患者功能的影响

Effect of Dual Task Training on the Function of Patients with Subacute Stroke

目的亚急性期脑卒中患者进行双重任务训练(dual task,DT)及单一任务训练(single task,ST的临床随机对照试验,比较两组患者的认知、平衡、运动等功能的改善情况。方法收集2018年4月至2020年1月在昆明医科大学第二附属医院康复医学部的门诊及住院部符合条件的亚急性期脑卒中患者30例进行为期3周的训练。随机分配到实验组15例进行DT训练,以及对照组15例进行ST训练,同时进行临床功能评估。主要的评估量表包括:简易精神状态检查量表(mini-mental state examination,MMSE);Berg平衡量表(berg balance scale,BBS)、运动功能评定量表(fugl-meyer assessment,FMA)、改良生活指数评定(modified barthel index,MBI)、汉密尔顿抑郁量表(hamilton depression scale,HAMD)。结果经过3周的康复训练,两组治疗后的认知、平衡、运动功能、生活能力及抑郁情绪与治疗前相比均有明显改善(P <0.05)。与对照组相比,实验组经过DT训练后的平衡功能显著改善(P <0.001),运动功能、生活能力改善,差异有统计学意义(P <0.05),认知功能和抑郁水平改善,差异无统计学意义(P> 0.05)。结论 DT训练在改善亚急性期脑卒中患者的平衡功能、运动功能及生活能力方面的效果优于ST训练。

Objective To conduct clinically randomized controlled trials of dual task(DT) training and single task(ST) training for patients with subacute stroke, and to compare the improvement of cognitive,balance,and exercise functions of the two groups of patients. Methods From April 2018 to January 2020, 30 eligible subacute stroke patients in the outpatient department and inpatient department of the Second Affiliated Hospital of Kunming Medical University were collected for 3 weeks of training. 15 cases were randomly assigned to the experimental group for DT rehabilitation training, and 15 cases for the control group were given ST rehabilitation training and clinical function evaluation. The main assessment scales include: MMSE;BBS, Motor FMA, MBI,and HAMD. Results After 3 weeks of rehabilitation training, the cognitive, balance, motor function, life ability and depression of the two groups after treatment were significantly improved compared with situations before treatment(P < 0.05). Compared with the control group, the balance function of the experimental group after DT training was significantly improved(P < 0.001), the improvement of motor function and living ability was statistically significant(P < 0.05), and the improvement of cognitive function and depression level were not statistically significant(P > 0.05). Conclusion DT training is better than ST training in improving the balance function, motor function and living ability of patients with subacute stroke.