镜像视觉反馈训练对合并认知障碍的脑卒中后吞咽障碍患者的影响

Efficacy of Mirror Visual Feedback Training for Dysphagia in Patients with Post-stroke Cognitive Impairment

目的:探讨镜像视觉反馈训练在合并认知障碍的脑卒中吞咽障碍患者吞咽功能康复中的临床效果。方法:选取经蒙特利尔认知评估量表(MoCA)筛选合并认知障碍的脑卒中吞咽障碍患者40例,随机分成镜像组和对照组各20例。对照组接受常规吞咽康复训练,镜像组在此基础上给予镜像视觉反馈训练。比较治疗前后临床吞咽功能与认知水平。结果:治疗2周后,2组的标准吞咽功能评价量表(SSA)评分较治疗前明显降低(P<0.05),MoCA评分较治疗前明显提高(P<0.05),且镜像组明显高于对照组(P<0.05);2组简单反应时均较治疗前明显缩短(均P<0.05),且镜像组明显快于对照组(P<0.05)。结论:镜像视觉反馈训练能改善脑卒中后认知障碍合并吞咽困难患者的吞咽功能和注意力、执行力。

Objective:To investigate the clinical effects of the mirror neuron system based mirror visual feedback(MVF)training on dysphagia in stroke patients with cognitive impairment.Methods:Forty cases of stroke were randomly divided into the control group(n=20)and the treatment group(n=20).Both groups were given routine swallow rehabilitation training,and the treatment group accepted MVF training in addition.The differences in the swallowing function and cognitive level were compared between two groups before and after intervention.Results:Two weeks after treatment,the scores of Montreal cognitive assessment(MoCA)were increased as compared with those before treatment,and sub items such as visual spatial execution,attention of both groups were increased notably as compared with those before treatment(all P<0.05),more significantly in observation group than in control group(P<0.05).The reaction time was markedly reduced after treatment as compared with that before treatment(P<0.05),more significantly in observation group than in control group(P<0.05).The scores of Standardized Swallowing Assessment(SSA)were notably decreased after treatment as compared with those before treatment(P<0.05),more significantly in observation group than in control group(P<0.05).Conclusion:MVF based on routine rehabilitation may improve the swallowing function,attention and execution for stroke patients.