《中国康复理论与实践》

中国康复理论与实践 >

2016 , Vol. 22 >Issue 12: 1430 - 1429

DOI: https://doi.org/10.3969/j.issn.1006-9771.2016.12.014

临床研究

视觉扫描阅读训练对脑卒中偏侧忽略患者认知功能及日常生活活动能力的影响

  • 程凯 ,
  • 杨婷 ,
  • 李雪萍 ,
  • 林强 ,
  • 陈安亮 ,
  • 俞长君
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  • 南京医科大学附属南京医院(南京市第一医院)康复医学科，江苏南京市 210006。
程凯(1978-)，男，汉族，江苏南京市人，主治医师，主要研究方向：神经康复。

收稿日期: 2016-09-30

  网络出版日期: 2017-01-15

基金资助

南京市医学科技发展计划青年人才启动项目(QYK11171)。

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Effect of Visual Exploration Therapy on Cognitive Function and Activities of Daily Living of Stroke Patients with Unilateral Neglect 　

  • CHENG Kai ,
  • YANG Ting ,
  • LI Xue-ping ,
  • LIN Qiang ,
  • CHEN An-liang ,
  • YU Chang-jun
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  • Rehabilitation Department, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing First Hospital, Nanjing, Jiangsu 210006, China

Received date: 2016-09-30

  Online published: 2017-01-15

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摘要

目的　观察视觉扫描阅读训练对脑卒中偏侧忽略患者认知功能及日常生活活动能力的影响。方法　2012年1月~2014年6月在本科住院的脑卒中偏侧忽略患者24例，随机分为对照组(n=12)和观察组(n=12)。对照组接受常规康复训练，观察组另外接受视觉扫描阅读训练，共3周。采用简易精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)、改良Barthel指数(MBI)和中国行为性忽略测试-香港版(CBIT-HK)进行评价。结果　两组各评分均在治疗后显著提高(t>5.375, P<0.001)；除MMSE(P>0.05)外，治疗组各评分均高于对照组(t>2.120, P<0.05)。结论　视觉扫描阅读训练不仅能提高脑卒中患者的偏侧忽略症状，还能改善患者的认知功能和日常生活活动能力。

关键词： 脑卒中; 偏侧忽略; 视觉扫描训练; 认知功能; 日常生活活动能力

本文引用格式

程凯 , 杨婷 , 李雪萍 , 林强 , 陈安亮 , 俞长君 . 视觉扫描阅读训练对脑卒中偏侧忽略患者认知功能及日常生活活动能力的影响[J]. 中国康复理论与实践, 2016 , 22(12) : 1430 -1429 . DOI: 10.3969/j.issn.1006-9771.2016.12.014

Abstract

Objective To evaluate whether visual exploration therapy could lead to the recovery of cognitive function and activities of daily living (ADL) of stroke patients with unilateral neglect.Methods From January, 2012 to June, 2014, 24 stroke patients with unilateral neglect were randomly divided into control group (n=12) and observaton group (n=12). The control group received conventional rehabilitation therapy, and the observation group received visual exploration therapy additionally. They were evaluated with Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), modified Barthel index (MBI) and Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK).Results All the scores improved after treatment in both groups (t>5.375, P<0.001), and were higher in the observation group than in the control group (t>2.120, P<0.05), except MMSE (P>0.05).Conclusion Visual exploration therapy could not only facilitate the recovery of unilateral neglect in stroke patients, but also improve their cognitive function and activities of daily living.

Key words： stroke; unilateral neglect; visual exploration therapy; cognitive function; activities of daily living

参考文献

[1] Heilman KM, Watson RT, Valenstein E. Neglect and Related Disorders Clinical Neuropsychology [M]. New York: Oxford University Press, 1993: 243-294.
[2] 宋为群,李永忠,杜博琪,等. 低频重复经颅磁刺激治疗视觉空间忽略的临床研究[J]. 中国康复医学杂志, 2007, 22(6): 483-486.
[3] 张艳明,胡洁,钱龙,等. 脑损伤后单侧空间忽略的康复治疗进展[J]. 中国康复医学杂志, 2011, 26(5): 496-500.
[4] Ringman JM, Saver JL, Woolson RF, et al. Frequency, risk factors, anatomy, and course of unilateral neglect in an acute stroke cohort [J]. Neurology, 2004, 63(3): 468-474.
[5] Stone SP, Patel P, Greenwood RJ, et al. Measuring visual neglect in acute stroke and predicting its recovery：the visual neglect recovery index [J]. J Neurol Neurosurg Psychiatry, 1992, 55(6): 431-436.
[6] Di Monaco M, Schintu S, Dotta M, et al. Severity of unilateral spatial neglect is an independent predictor of functional outcome after acute inpatient rehabilitation in individuals with right hemispheric stroke [J]. Arch Phys Med Rehabil, 2011, 92(8): 1250-1256.
[7] 恽晓平. 康复疗法评定学[M]. 北京:华夏出版社, 2005: 448-461.
[8] 岳月红,齐亚超,赵永波,等. 偏侧空间忽略发生的相关解剖位点研究[J]. 中国康复医学杂志, 2015, 30(11): 1125-1130.
[9] Lee BH, Kim EJ, Ku BD, et al. Cognitive impairments in patients with hemispatial neglect from acute right hemisphere stroke [J]. Cogn Behav Neurol, 2008, 21(2): 73-76.
[10] Mok VC, Wong A, Lam WW, et al. Cognitive impairment and functional outcome after stroke associated with small vessel disease [J]. J Neurol Neurosurg Psychiatry, 2004, 75(4): 560-566.
[11] 高呈飞,朱其秀,刘云霞,等. 视动刺激治疗视空问偏侧忽略的临床研究[J]. 中国康复医学杂志, 2014, 29(4): 324-328.
[12] Vossel S, Weiss PH, Eschenbeck P, et al. Anosognosia, neglect, extinction and lesion site predict impairment of daily living after right-hemispheric stroke [J]. Cortex, 2013, 49(7): 1782-1789.
[13] Nijboer T, van de Port I, Schepers V, et al. Predicting functional outcome after stroke: the influence of neglect on basic activities in daily living [J]. Front Hum Neurosci, 2013, 7: 182.
[14] Bowen A, Hazelton C, Pollock A, et al. Cognitive rehabilitation for spatial neglect following stroke [J]. Cochrane Database Syst Rev, 2013(7): CD003586.
[15] 中华医学会第四届全国脑血管病学术会议. 各项脑血管病诊断要点[J]. 中华神经内科杂志, 1996, 29(6): 379-380.
[16] 葛晴霞,郭根平,章慧霞. 运动想象疗法在脑卒中偏侧忽略训练中的应用[J]. 中国康复理论与实践, 2013, 19(2): 161-163.
[17] Bailey MJ, Riddoch MJ, Crome P. Treatment of visual neglect in elderly patients with stroke: a single-subject series using either a scanning and cueing strategy or a left-limb activation strategy [J]. Phys Ther, 2002, 82(8): 782-797.
[18] Cumming TB, Churilov L, Linden T, et al. Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke [J]. Acta Neurol Scand, 2013, 128(2): 122-129.
[19] 王伟,季相通,叶芊,等. 基于镜像神经元理论的偏侧忽略症康复新方法初探[J]. 中华物理医学与康复杂志, 2014, 36(12): 930-932.
[20] Luaute J, Halligan P, Rode G, et al. Visuo-spatial neglect: a systematic review of current interventions and their effectiveness [J]. Neurosci Biobehav Rev, 2006, 30(7): 961-982.
[21] Wiart L, C?me AB, Debelleix X, et al. Unilateral neglect syndrome rehabilitation by trunk rotation and scanning training [J]. Arch Phys Med Rehabil, 1997, 78(4): 424-429.
[22] Niemeier JP. The lighthouse strategy: use of a visual imagery technique to treat visual inattention in stroke patients [J]. Brain Inj, 1998, 12(5): 399-406.
[23] Mort DJ, Malhotra P, Mannan SK, et al. The anatomy of visual neglect [J]. Brain, 2003, 126(Pt 9): 1986-1997.
[24] Karnath HO, Ferber S, Himmelbach M. Spatial awareness is a function of the temporal not the posterior parietal lobe [J]. Nature, 2001, 411(6840): 950-953.
[25] Vallar G. Extrapersonal visual unilateral spatial neglect and its neuroanatomy [J]. Neuroimage, 2001, 14(1 Pt 2): S52-S58.
[26] He BJ, Snyder AZ, Vincent JL, et al. Breakdown of functional connectivity in frontoparietal networks underlies behavioral deficits in spatial neglect [J]. Neuron, 2007, 53(6): 905-918.
[27] 岳月红,宋为群,霍速,等. 非自我为中心的偏侧忽略的发生及其解剖[J]. 中国康复医学杂志, 2011, 26(8): 704-710.
[28] 辛艳平,张爱娟,王绍博,等. MoCA与MMSE对首发脑梗死患者认知功能的评估应用[J]. 中国实用神经疾病杂志, 2012, 15(6): 16-18.
[29] 崔利华,张慧丽,张小年. 脑卒中恢复期患者简易智能状态检查和蒙特利尔认知评估的对比研究[J]. 中国康复理论与实践, 2014, 20(8): 749-751.
[30] Beis JM, Andre JM, Baumgarten A, et al. Eye patching in unilateral spatial neglect: efficacy of two methods [J]. Arch Phys Med Rehabil, 1999, 80(1): 71-76.
[31] Cazzoli D, Müri RM, Schumacher R, et al. Theta burst stimulation reduces disability during the activities of daily living in spatial neglect [J]. Brain, 2012, 135(Pt 11): 3426-3439.
[32] Prakash RS, Snook EM, Erickson KI, et al. Cardiorespiratory fitness：A predictor of cortical plasticity in multiple sclerosis [J]. Neuroimage, 2007, 34(3): 1238-1244.
[33] 刘瑾彦,娄淑杰,陈佩杰. 跑台运动对不同月龄大鼠空间学习和记忆能的影响[J]. 中国体育科技, 2009, 45(6): 87-90.
[34] O'Callaghan RM, Ohle R, Kelly AM. The effects of forced exercise on hippocampal plasticity in the rat: a comparison of LTP, spatial- and non-spatial learning [J]. Behav Brain Res, 2007, 176(2): 362-366.
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