丰富环境对脑卒中患者神经功能康复的效果

doi:10.3969/j.issn.1006-9771.2017.03.016

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (3): 323-325.doi: 10.3969/j.issn.1006-9771.2017.03.016

丰富环境对脑卒中患者神经功能康复的效果

金信浩, 郑兵, 吴雪莲, 李长清, 牛陵川

1.重庆医科大学附属第二医院,a.神经内科; b.康复科,重庆市 400010。

收稿日期:2016-12-08 出版日期:2017-03-05 发布日期:2017-03-31
作者简介:金信浩(1991-),男,汉族,浙江台州市人,硕士研究生,主要研究方向：脑血管病。通讯作者：牛陵川,女,博士,副主任医师。E-mail: niulingchuan99@163.com。
基金资助:
1.国家自然科学基金项目(No.81201506); 2.重庆市卫生局医学科研项目(No.2012-1-037)

Effects of Environmental Enrichment on Neurological Functions of Patients with Stroke

JIN Xin-hao, ZHENG Bing, WU Xue-lian, LI Chang-qing, NIU Ling-chuan

1. a. Department of Neurology; b. Department of Rehabilitation, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China

Received:2016-12-08 Published:2017-03-05 Online:2017-03-31
Contact: Correspondence to NIU Ling-chuan. E-mail: niulingchuan99@163.com

摘要/Abstract

摘要： 目的探讨丰富环境对于脑卒中患者神经功能恢复的作用。方法2013年5月至2015年11月,本院76例脑卒中患者随机分成对照组(n=39)和丰富环境组(n=37),两组患者均进行常规康复训练及药物治疗,丰富环境组在此基础上进行丰富环境干预。治疗前后采用简式Fugl-Myer评定量表(FMA)、蒙特利尔认知评估量表(MoCA)和改良Barthel指数(MBI)进行评价。结果治疗后,两组FMA、MoCA、MBI评分均提高(t>2.339, P<0.05),丰富环境组MoCA、MBI评分高于对照组(t>2.187, P<0.05)。结论丰富环境能进一步促进脑卒中后患者认知功能的改善,提高其日常生活能力。

关键词: 脑卒中, 丰富环境, 认知, 运动, 日常生活活动, 康复

Abstract: ObjectiveTo investigate the effects of environmental enrichment (EE) on the neurological functions in patients with stroke. MethodsFrom May, 2013 to November, 2015, 76 patients with stroke were selected and randomly divided into control group (n=39) and EE group (n=37). Both groups received routine therapy and the EE group received EE in addition. They were assessed with simplified Fugl-Meyer Assessment (FMA), Montreal Cognitive Assessment (MoCA) and modified Barthel Index (MBI) before and after treatment. ResultsThe scores of FMA, MoCA and MBI increased in both groups after treatment (t>2.339, P<0.05), and the scores of MoCA and MBI increased more in the EE group than in the control group (t>2.187, P<0.05). ConclusionEE could promote the recovery of cognitive function and activities of daily living in patients with stroke.

Key words: stroke, environmental enrichment, cognition, motor, activities of daily living, rehabilitation

中图分类号:

R743.3

金信浩, 郑兵, 吴雪莲, 李长清, 牛陵川. 丰富环境对脑卒中患者神经功能康复的效果[J]. 《中国康复理论与实践》, 2017, 23(3): 323-325.

JIN Xin-hao, ZHENG Bing, WU Xue-lian, LI Chang-qing, NIU Ling-chuan. Effects of Environmental Enrichment on Neurological Functions of Patients with Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(3): 323-325.

参考文献

[1] 张晓龙,张金涛,彭颖,等. 不同亚型缺血性脑卒中临床特征及出院结局[J]. 中国公共卫生, 2012, 28(2): 243-244.
[2] Hannan AJ. Environmental enrichment and brain repair: harnessing the therapeutic effects of cognitive stimulation and physical activity to enhance experience-dependent plasticity [J]. Neuropathol Appl Neurobiol, 2014, 40(1): 13-25.
[3] Livingston-Thomas J, Nelson P, Karthikeyan S, et al. Exercise and environmental enrichment as enablers of task-specific neuroplasticity and stroke recovery [J]. Neurotherapeutics, 2016, 13(2): 395-402.
[4] Kuptsova K, Kvist E, Nitzsche F, et al. Combined enriched environment/atipamezole treatment transiently improves sensory functions in stroke rats independent from neurogenesis and angiogenesis [J]. Rom J Morphol Embryol, 2015, 56(1): 41-47.
[5] 李娴,谢斌. 丰富环境与脑卒中康复[J]. 中国康复理论与实践, 2012, 18(1): 47-52.
[6] 吴长鸿,刘斌. 第四届全国脑血管病学术会议[J]. 中华医学信息导报, 1996, 4(6): 4.
[7] Kwakkel G, Wagenaar RC, Koelman TW, et al. Effects of intensity of rehabilitation after stroke. A research synthesis [J]. Stroke, 1997, 28(8): 1550-1556.
[8] 吴培香,许翠萍,汤继芹,等. 推拿结合现代康复训练对脑卒中患者康复效果的影响[J]. 解放军护理杂志, 2012, 29(9): 22-25.
[9] Sahota P, Savitz SI. Investigational therapies for ischemic stroke: neuroprotection and neurorecovery [J]. Neurotherapeutics, 2011, 8(3): 434-451.
[10] Skibo GG, Nikonenko AG. Brain plasticity after ischemic episode [J]. Vitam Horm, 2010, 82: 107-127.
[11] Ma DK, Jang MH, Guo JU, et al. Neuronal activity-induced Gadd45b promotes epigenetic DNA demethylation and adult neurogenesis [J]. Science, 2009, 323(5917): 1074-1077.
[12] Novaes LS, Dos SN, Batalhote RF, et al. Environmental enrichment protects against stress-induced anxiety: Role of glucocorticoid receptor, ERK, and CREB signaling in the basolateral amygdala [J]. Neuropharmacology, 2016, 113(Pt A): 457-466.
[13] Bernhardt J, Dewey H, Thrift A, et al. Inactive and alone: physical activity within the first 14 days of acute stroke unit care [J]. Stroke, 2004, 35(4): 1005-1009.
[14] De Wit L, Putman K, Dejaeger E, et al. Use of time by stroke patients: a comparison of four European rehabilitation centers [J]. Stroke, 2005, 36(9): 1977-1983.
[15] Leger M, Paizanis E, Dzahini K, et al. Environmental enrichment duration differentially affects behavior and neuroplasticity in adult mice [J]. Cereb Cortex, 2015, 25(11): 4048-4061.
[16] Verina T, Rohde CA, Guilarte TR. Environmental lead exposure during early life alters granule cell neurogenesis and morphology in the hippocampus of young adult rats [J]. Neuroscience, 2007, 145(3): 1037-1047.
[17] Novkovic T, Mittmann T, Manahan-Vaughan D. BDNF contributes to the facilitation of hippocampal synaptic plasticity and learning enabled by environmental enrichment [J]. Hippocampus, 2015, 25(1): 1-15.
[18] Mosaferi B, Babri S, Mohaddes G, et al. Post-weaning environmental enrichment improves BDNF response of adult male rats [J]. Int J Dev Neurosci, 2015, 46: 108-114.
[19] Bayat M, Sharifi MD, Haghani M, et al. Enriched environment improves synaptic plasticity and cognitive deficiency in chronic cerebral hypoperfused rats [J]. Brain Res Bull, 2015, 119(Pt A): 34-40.
[20] 朱虹,章军建,孙慧敏,等. 丰富环境可改善慢性脑低灌注的认知功能[J]. 中国医学前沿杂志(电子版), 2012, 4(10): 20-27.
[21] Mileva GR, Bielajew C. Environmental manipulation affects depressive-like behaviours in female Wistar-Kyoto rats [J]. Behav Brain Res, 2015, 293: 208-216.
[22] Hajheidari S, Miladi-Gorji H, Bigdeli I. Effects of environmental enrichment during induction of methamphetamine dependence on the behavioral withdrawal symptoms in rats [J]. Neurosci Lett, 2015, 605: 39-43.
[23] Ahmadalipour A, Sadeghzadeh J, Vafaei AA, et al. Effects of environmental enrichment on behavioral deficits and alterations in hippocampal BDNF induced by prenatal exposure to morphine in juvenile rats [J]. Neuroscience, 2015, 305: 372-383.
[24] Acklin CJ, Gault RA. Effects of natural enrichment materials on stress, memory and exploratory behavior in mice [J]. Lab Anim (NY), 2015, 44(7): 262-267.
[25] Young J, Pionk T, Hiatt I, et al. Environmental enrichment aides in functional recovery following unilateral controlled cortical impact of the forelimb sensorimotor area however intranasal administration of nerve growth factor does not [J]. Brain Res Bull, 2015, 115: 17-22.

丰富环境对脑卒中患者神经功能康复的效果

Effects of Environmental Enrichment on Neurological Functions of Patients with Stroke

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