临床研究

团体认知行为的作业训练对脑卒中后认知障碍的效果

  • 张丽 ,
  • 刘晓丹 ,
  • 薛炘 ,
  • 金雪明 ,
  • 朱锦杰 ,
  • 陶然 ,
  • 胡军
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  • 1.上海中医药大学康复医学院,上海市 201203
    2.上海新起点康复医院康复治疗部,上海市 201100
    3.上海中医药大学附属岳阳中西医结合医院康复医学科,上海市 200437
张丽(1995-),女,汉族,安徽滁州市人,硕士研究生,主要研究方向:神经及老年疾病的康复。

收稿日期: 2019-04-30

  修回日期: 2019-05-27

  网络出版日期: 2019-09-25

基金资助

1.上海中医药大学预算内项目(No. A1-GY01100101; No. 18TS081);2.上海中医药大学“歧康”青年创新人才计划项目(No. A4-Q1501805)

Effect of Group Occupational Training Based on Cognitive Behavioral Therapy on Post-stroke Cognitive Impairment

  • ZHANG Li ,
  • LIU Xiao-dan ,
  • XUE Xin ,
  • JIN Xue-ming ,
  • ZHU Jin-jie ,
  • TAO Ran ,
  • HU Jun
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  • 1.School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
    2.Department of Rehabilitation, Shanghai New Beginning Rehabilitation Hospital, Shanghai 201100, China
    3.Department of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China

Received date: 2019-04-30

  Revised date: 2019-05-27

  Online published: 2019-09-25

Supported by

Supported by Shanghai University of Traditional Chinese Medicine Budgeted Scientific Research Project (No. A1-GY01100101; No. 18TS081) and Shanghai University of Traditional Chinese Medicine Qikang Youth Innovation Program (No. A4-Q1501805)

摘要

目的 探讨基于认知行为的团体作业训练对脑卒中后认知障碍患者的临床疗效。 方法 2018年5月至2019年3月,脑卒中后认知障碍患者56例随机分为对照组(n = 29)和试验组(n = 27)。两组均接受常规康复治疗,试验组接受团体认知作业训练,每周3次,共12次。干预前后采用蒙特利尔认知评定量表(MoCA)、改良Barthel指数(MBI)和简明健康状况调查量表(SF-36)进行评定。 结果 干预后两组MoCA总分、MBI评分和SF-36平均分均提高(t > 2.275, P < 0.05),试验组各项评分干预前后差值均明显高于对照组(t > 2.835, P < 0.01)。 结论 团体作业训练可改善脑卒中后认知障碍患者的认知功能,提高日常生活活动能力和生活质量。

本文引用格式

张丽 , 刘晓丹 , 薛炘 , 金雪明 , 朱锦杰 , 陶然 , 胡军 . 团体认知行为的作业训练对脑卒中后认知障碍的效果[J]. 中国康复理论与实践, 2019 , 25(9) : 1070 -1074 . DOI: 10.3969/j.issn.1006-9771.2019.09.015

Abstract

Objective To explore the clinical effect of group occupational training based on cognitive behavior on patients with post-stroke cognitive impairment. Methods From May, 2018 to March, 2019, 56 patients with post-stroke cognitive impairment were randomly divided into control group (n = 29) and experimental group (n = 27). Both groups received routine rehabilitation, and the experimental group received group occupational therapy, three times a week, for twelve times. They were assessed with Montreal Cognition Assessment (MoCA), modified Barthel Index (MBI) and the Short Form of Health Survey (SF-36) before and after intervention. Results The scores of MoCA, MBI and SF-36 increased in both groups after intervention (t > 2.275, P < 0.05), and their difference before and after intervention was more in the experimental group than in the control group (t > 2.835, P < 0.01). Conclusion Group occupational training can improve the cognitive function of patients with post-stroke cognitive impairment and improve their activities of daily living and quality of life.

参考文献

1 胡盛寿,高润霖,刘力生,等. 《中国心血管病报告2018》概要[J]. 中国循环杂志, 2019, 34(3): 209-220.
2 WangY L, DaiY, ZhengJ, et al. Sex difference in the incidence of stroke and its corresponding influence factors: results from a follow-up 8.4 years of rural China hypertensive prospective cohort study [J]. Lipids Health Dis, 2019, 18(1): 72.
3 YangS, HuangJ, TaoJ, et al. The synergistic effect of acupuncture and computer-based cognition training on post-stroke cognitive dysfunction: a study protocol for a randomized controlled trail of 2×2 factorial design [J]. BMC Complement Altern Med, 2014, 14(1): 290.
4 王静,李淑杏,陈长春,等. 中老年缺血性脑卒中患者执行功能障碍的影响因素[J]. 中国老年学杂志, 2013, 33(12): 2886-2888.
5 CellaM, ReederC, WykesT. Group cognitive remediation for schizophrenia: exploring the role of therapist support and metacognition [J]. Psychol Psychother, 2016, 89(1): 1-14.
6 KunikataH, YoshinagaN, NakajimaK. Effect of cognitive behavioral group therapy for recovery of self-esteem on community-living individuals with mental illness: non-randomized controlled trial [J]. Psychiatry Clin Neurosci, 2016, 70(10): 457-468.
7 SatoD, YoshinagaN, NagaiE, et al. Effectiveness of internet-delivered computerized cognitive behavioral therapy for patients with insomnia who remain symptomatic following pharmacotherapy: randomized controlled exploratory trial [J]. J Med Internet Res, 2019, 21(4): e12686
8 JoostenW B L W, RoelofsS C, VernooijD M J, et al. Long-term effects of group therapy for patients with mild cognitive impairment and their significant others: a 6- to 8-month follow-up study [J]. Dementia (London), 2013, 12(1): 81-91.
9 范晓禹,张桂玉. 认知行为多层次干预护理对卒中后抑郁的效果[J]. 中国康复理论与实践, 2015, 21(12): 1471-1474.
10 SusanK W, AlynaT, JohnA H, et al. Group cognitive behavioural therapy for stroke survivors with depression and their carers [J]. Top Stroke Rehabil, 2016, 23(5): 358-365.
11 中华神经科学会,中华神经外科学会. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380.
12 ChitiG, PantoniL. Use of Montreal Cognitive Assessment in patients with stroke [J]. Stroke, 2014, 45(10): 3135-3140.
13 SulterG, SteenC, de KeyserJ. Use of the Barthel index and modified Rankin Scale in acute stroke trials [J]. Stroke, 1999, 30(8): 1538-1541.
14 胡春伟,张慧萍,王聪,等. 奥拉西坦治疗脑卒中后认知功能障碍疗效与不良反应观察[J]. 国际精神病学杂志, 2017, 44(3): 487-489.
15 迟晓玲,邱海丽,黄鹏展,等. 补肾活血益智汤对缺血性脑卒中患者轻度认知障碍的影响[J]. 中国中医药科技, 2017, 24(1): 109-110.
16 刘芳,姚立群,陈金辉. 针刺百会、神庭穴治疗脑卒中后认知功能障碍效果的系统评价[J]. 上海针灸杂志, 2018, 37(1): 104-111.
17 周瑞,皮敏. 调任通督针刺法治疗脑梗死后轻度认知障碍疗效观察[J]. 中医药临床杂志, 2016, 28(4): 511-515.
18 张超丽,钟雪华,柯秋琴. 认知功能训练配合康复护理对脑卒中后认知障碍患者康复的疗效观察[J]. 广州中医药大学学报, 2018, 46(3): 112-114, 121.
19 何雯,林桦,唐忆云,等. 个体化作业疗法对老年脑卒中后认知障碍的影响[J]. 中国康复理论与实践, 2012, 18(9): 843-845.
20 KellyM E, LoughreyD, LawlorB A, et al. The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: a systematic review and meta-analysis [J]. Ageing Res Rev, 2014, 15(1): 28-43.
21 BanduraA. 社会学习理论[M]. 陈欣银,李伯黍,译. 北京:中国人民大学出版社, 2015: 13-27.
22 DamushT M, MyersL, AndersonJ A, et al. The effect of locally adapted, secondary stroke risk factor self-management program on medication adherence among veterans with stroke/TIA [J]. Transl Behav Med, 2016, 6(3): 1-12.
23 LiuT W, NgG Y F, NgS S M. Effectiveness of a combination of cognitive behavioral therapy and task-oriented balance training in reducing the fear of falling in patients with chronic stroke: study protocol for a randomized controlled trial [J]. Trials, 2018, 19(1): 168.
24 王明. 计算机辅助认知康复结合小组认知训练对脑卒中患者认知功能的疗效[J]. 微循环学杂志, 2019, 29(1): 43-47.
25 MehdizadehM, HassanI MehrabanA, ZahediyannasabR. The effect of group-based occupational therapy on performance and satisfaction of stroke survivors: pilot trail, neuro-occupational view [J]. Basic Clin Neurosci, 2017, 8(1): 69-76.
26 Cohen-MansfieldJ, HaiT, ComishenM. Group engagement in persons with dementia: the concept and its measurement [J]. Psychiatry Res, 2017, 251: 237-243.
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