体感游戏联合高频重复经颅磁刺激在卒中后轻度认知功能障碍患者康复中的应用

Rehabilitation study of somatosensory game combined with high frequency repetitive transcranial magnetic stimulation on mild cognitive impairment after stroke

目的探讨体感游戏联合高频重复经颅磁刺激对卒中后轻度认知功能障碍患者认知功能康复的影响。方法采用便利抽样法,选取2021年1—6月温州医科大学附属第一医院康复科收治的64例卒中后认知障碍(PSCI)患者为研究对象,根据入院顺序,按照1∶1的配对原则,随机分成对照组和观察组,每组各32例。对照组患者予以高频重复经颅磁刺激与常规的认知康复训练,观察组在对照组的基础上实施体感游戏训练。比较两组患者干预前后美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分、简易智力状况检查法(MMSE)评分以及改良Barthel指数(MBI)评分。结果干预20 d后,观察组NIHSS评分低于对照组,差异具有统计学意义(P<0.05);观察组MoCA、MMSE和MBI评分均高于对照组,差异具有统计学意义(P<0.05);观察组康复治疗依从率高于对照组,两组比较差异有统计学意义(χ^(2)=4.267,P=0.039)。结论体感游戏联合高频重复经颅磁刺激可以提高PSCI患者认知能力,提高患者的康复锻炼依从率,有助于患者康复。

Objective To explore effects of somatosensory games combined with high frequency repetitive transcranial magnetic stimulation on cognitive function rehabilitation in patients with mild cognitive impairment after stroke.Methods Using the convenience sampling method,a total of 64 patients with post stroke cognitive impairment(PSCI)admitted to Rehabilitation Department of the First Affiliated Hospital of Wenzhou Medical University from January to June 2021 were selected as the research objects.According to the order of admission and the 1∶1 matching principle,they were randomly divided into the control group and the observation group,with 32 cases in each group.The patients in the control group received high-frequency repetitive transcranial magnetic stimulation and conventional cognitive rehabilitation training,while the observation group received somatosensory game training on the basis of the control group.Scores of National Institute of Health Stroke Scale(NIHSS),Montreal Cognitive Assessment(MoCA),Mini-mental State Examination(MMSE)and Modified Barthel Index(MBI)were compared between the two groups before and after the intervention.Results After 20 days of intervention,the NIHSS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The scores of MoCA,MMSE and MBI in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The compliance rate of rehabilitation therapy in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(χ^(2)=4.267,P=0.039).Conclusions Somatosensory games combined with high-frequency repetitive transcranial magnetic stimulation can improve the cognitive ability of patients with PSCI,improve the compliance rate of patients with rehabilitation exercises and help patients recover.