虚拟情景训练对卒中后认知障碍伴摄食吞咽困难患者的疗效观察

Effect of virtual reality therapy on cognitive problems and swallowing problems in stroke patients

目的:探讨虚拟情景训练对卒中后认知障碍伴摄食吞咽困难患者的吞咽功能康复的临床效果。方法:选取经简易精神状态量表(MMSE)评估为认知障碍和吞咽造影检查(VFSS)诊断为吞咽障碍的脑卒中患者40例,按照随机数字法分为观察组与对照组,每组20例。对照组患者给予常规的吞咽功能训练和认知功能训练,观察组给予常规的吞咽功能训练和虚拟情景训练。2组患者接受3周治疗后,对其认知功能、吞咽功能分别进行评定分析。结果:治疗后,2组患者MMSE评分较治疗前提高(P<0.05),观察组评分高于对照组(P<0.05);治疗后,2组吞咽障碍造影量表(VDS)评分较治疗前降低(P<0.05),观察组评分较对照组降低明显(P<0.05);治疗后,2组口腔运送时间(OTT)、软颚上抬时间(SET)相比治疗前时间缩短(P<0.05),同时观察组较对照组明显缩短(P<0.05)。结论:虚拟情景训练较常规认知训练,可更好地改善卒中后认知障碍伴摄食吞咽困难患者的认知及吞咽功能。

Objective:To explore the clinical effect of virtual reality therapy on the rehabilitation of swallowing function in patients with post-stroke cognitive impairment accompanied by dysphagia.Methods:Totally,40 stroke patients who were assessed as cognitive impairment by Mini-mental state examination(MMSE)and diagnosed as dysphagia by swallowing angiography(VFSS)were selected and divided into experimental group and control group(n=20 each)according to the random number method.The control group was given routine swallowing and cognitive guidance training,and the experimental group was subjected to virtual reality therapy besides routine treatment and rehabilitation measures.After three weeks of treatment,the cognition and swallowing of the two groups were evaluated and analyzed respectively.Results:There were no significant differences in MMSE score,video fluoroscopic dysphagia scale(VDS)score,oral transit time(OTT),soft palate elevation between the two groups before treatment.After treatment,MMSE score in two groups was increased as compared with that before treatment(P<0.05),and that in the experimental group was higher than that in the control group(P<0.05).After treatment,the VDS score in the two groups was lower than that before treatment(P<0.05),and that in the experimental group was significantly lower than that in the control group after treatment(P<0.05).OTT and SET time in the two groups were shorter than those before treatment,and those in the experimental group was significantly shorter than in the control group(P<0.05).Conclusion:The virtual reality therapy can better improve the cognitive and swallowing functions of patients with post-stroke cognitive impairment accompanied by dysphagia than conventional cognitive training.