认知-运动控制双重任务训练应用于老年脑卒中后认知障碍的临床价值

Value of Cognitive-Motor Dual Task Training in Elderly Patients with Cognitive Impairment after Stroke

目的探讨认知-运动控制双重任务训练应用于老年脑卒中后认知障碍(PSCI)的临床价值。方法选取郑州大学第一附属医院2018年9月至2019年9月收治的老年PSCI患者131例,按随机数字表法分为2组:对照组65例给予重复经颅磁刺激和基本认知训练,观察组66例在对照组治疗基础上增加认知-运动控制双重任务训练,比较2组干预前后认知功能[蒙特利尔认知评估量表(MoCA)评分、Rivermead行为记忆能力测验(RBMT)评分]、日常生活活动能力[日常生活活动(ADL)能力量表评分、改良Barthel指数(MBI)]。结果2组训练前MoCA、RBMT评分比较,差异无统计学意义(P>0.05);与训练前比较,2组训练后MoCA、RBMT评分均显著升高,且观察组升高更为显著,差异有统计学意义(均P<0.05)。2组训练前ADL、MBI评分比较,差异无统计学意义(P>0.05);与训练前比较,2组训练后(2周末、4周末)ADL、MBI评分均显著升高,且观察组升高更为显著,差异有统计学意义(均P<0.05)。结论认知-运动控制双重任务训练可提升PSCI患者的认知功能和日常生活活动能力。

Objective To investigate the clinical value of cognitive-motor dual task training in elderly patients with poststroke cognitive impairment(PSCI).Methods A total of 131 elderly PSCI patients admitted to the First Affiliated Hospital of Zhengzhou University from September 2018 to September 2019 were randomly divided into control group(65 patients)and observation group(66 patients).Both groups were treated with repetitive transcranial magnetic stimulation and basic cognitive training.Additionally,the observation group was given cognitive-motor dual task training.The cognitive function was assessed using Montreal Cognitive Assessment Scale(MoCA)and Rivermead Behavioral Memory Ability Test(RBMT).The activities of daily living(ADL)were determined by ADL ability scale and modified Barthel index(MBI).Results There were no significant differences in scores of MoCA,RBMT,ADL and MBI between the two groups before treatment(P>0.05).Both MoCA and RBMT scores increased after training in both group,and those in observation group were higher than those in control group(P<0.05).A the end of 2 and 4 weeks of training,both ADL and MBI scores increased in both groups,and the increase in observation group was more obvious than that in control group(P<0.05).Conclusion Cognitive-motor dual task training can improve cognitive function and ADL ability in elderly patients with PSCI.