计算机辅助认知训练联合作业治疗对脑卒中认知障碍患者的康复研究

Rehabilitation study of computer-assisted cognitive training combined with occupational therapy on patients with cognitive impairment after stroke

目的探讨计算机辅助认知训练联合作业治疗在脑卒中认知障碍患者康复中的作用。方法选取2018-11—2020-05郑州人民医院收治的120例脑卒中认知障碍患者为研究对象,随机分为观察组(60例)和对照组(60例)。对照组给予计算机辅助认知训练,观察组在对照组基础上增加作业治疗。于治疗前及治疗12周后通过蒙特利尔认知评估量表(MoCA)评估整体认知功能,采用数字广度(DS)、数字警觉测试(DVT)、数字符号测试(SDMT)评估注意力,采用连线测试(TMT)评估执行能力,采用MBI和FIM评分法评估日常生活能力和独立能力。结果治疗前2组MoCA、DS、DVT、SDMT、TMT、MBI及FIM比较差异无统计学意义(P>0.05)。治疗后2组MoCA、DS、DVT、SDMT、MBI及FIM评分均有所上升,而TMT评分有所下降(P<0.05),且相较于对照组,观察组MoCA、DS、DVT、SDMT、MBI及FIM评分更高,TMT评分更低(P<0.05)。结论计算机辅助认知训练联合作业治疗对脑卒中认知障碍患者的认知功能具有积极作用,可改善注意力、执行力、日常生活能力及独立能力。

Objective To explore the effect of computer-assisted cognitive training combined with occupational therapy in the rehabilitation of patients with cognitive impairment after stroke.Methods A total of 120 stroke patients with cognitive impairment admitted to our hospital from November 2018 to May 2020 were selected as the research objects,and they were randomly divided into observation group(60 cases)and control group(60 cases).The control group was given computer-assisted cognitive training,and the observation group added occupational therapy on the basis of the control group.Before treatment and 12 weeks after treatment,overall cognitive function was assessed by the Montreal cognitive assessment scale(MoCA)scale,and attention was assessed by digital breadth(DS),digital vigilance test(DVT),and digital sign test(SDMT).The connection test(TMT)was used to evaluate the execution ability,and the modified Barthel index(MBI)and the functional independence rating scale(FIM)were used to evaluate the ability of daily living and independence.Results Before treatment,there was no significant difference between the two groups in MoCA,DS,DVT,SDMT,TMT,MBI and FIM(P>0.05).After treatment,the MoCA,DS,DVT,SDMT,MBI and FIM scores of the two groups increased,while the TMT score decreased(P<0.05).Compared with the control group,the observation group MoCA,DS,DVT,SDMT,MBI and FIM scores were higher,while TMT scores were lower(P<0.05).Conclusion Computer-assisted cognitive training combined with occupational therapy has obvious positive effects on the cognitive function of patients with cognitive impairment in stroke,and can improve the patients'attention,execution,ability of daily living and independence.