基于PASS理论的认知训练对卒中后认知障碍的效果

doi:10.3969/j.issn.1006-9771.2020.01.013

Abstract

Abstract:

Objective To observe the effect of cognitive training based on PASS theory on cognition in patients with post-stroke cognitive impairment (PSCI).
Methods From August, 2018 to June, 2019, 42 patients with PSCI were randomly divided into control group (n = 21) and intervention group (n = 21). The intervention group accepted computer-assisted cognitive training based on the PASS theory, and the control group accepted routine computer-assisted cognitive training, for four weeks. They were assessed with Mini-Mental State Examination (MMSE) and Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) before and after training.
Results There were 18 patients in each group finishing the trail. After training, the scores of MMSE and LOTCA increased in both groups (t > 8.831, P < 0.001), and increased more in the intervention group than in the control group ( t > 2.198, P < 0.05). For the LOTCA factors scores, it increased in orientation, visual perception, spatial perception, motion praxis, visuomotor organization and thinking operations in both groups ( t > 2.122, P < 0.05) after training, and increased more in the intervention group than in the control group in visual perception, spatial perception and thinking operations ( t > 2.356, P < 0.05), and the differences of visuomotor organization was more in the intervention group than in the control group ( t = 2.354, P < 0.05).
Conclusion Cognitive training based on PASS theory can improve cognition for patients with PSCI, especially for visual perception, spatial perception, thinking operations and visuomotor organization.

Key words: stroke, post-stroke cognitive impairment, PASS theory, computer-assisted cognitive rehabilitation

CLC Number:

R743.3

LEI Xing-xing,SONG Lu-ping. Effect of Cognitive Training Based on PASS Theory on Post-stroke Cognitive Impairment[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(1): 70-76.

Figures/Tables 10

References 35

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项目	对照组(n = 18)	干预组(n = 18)	χ²/t值	P值
性别(男/女, n)	16/2	15/3		1.000
年龄(岁)	48.33±9.38	48.11±12. 93	-0.059	0.953
受教育程度(年)	14.72±2.45	14.39±3.52	-0.330	0.743
病程(月)	2.54±1.25	2.82±1.30	0.641	0.526
卒中类型(出血/梗死, n)	9/9	10/8	0.111	0.738
病灶侧别(左/右, n)	13/5	13/5	-	1.000
MMSE	16.61±5.33	18.61±3.99	1.275	0.211
LOTCA	76.89±18.30	83.72±15.48	1.210	0.235
简式Fugl-Meyer评定量表	31.61±31.81	43.50±30.00	1.154	0.257
Fugl-Meyer评定量表平衡部分	7.17±3.78	8.94±3.21	1.522	0.137
NIHSS	8.83±3.99	6.94±3.54	-1.503	0.142
改良Barthel指数	48.06±24.92	55.56±24.25	0.915	0.367

项目	对照组(n = 18)	干预组(n = 18)	χ²/Z值	P值
病灶部位(n)			5.800	0.326
额叶	1	1
颞叶	0	1
额颞叶	0	2
额顶叶	2	2
额颞顶叶	3	3
颞顶叶	3	2
基底节区	8	5
放射冠区	0	1
丘脑	0	1
侧脑室旁	1	0
基础慢性病史(n)			2.533	0.639
无	2	6
高血压	7	2
心脏病	3	2
2型糖尿病	1	1
高血压、高血脂	1	1
高血压、2型糖尿病	3	3
其他	1	3
病因(n)			4.667	0.587
高血压性	8	4
动脉粥样硬化性	7	7
脑血管畸形	0	5
动脉瘤破裂	1	1
心源性	2	0
其他	0	1
手功能分级(n)			-0.652	0.589
废用手	13	10
辅助手C	2	1
辅助手B	0	1
辅助手A	0	3
实用手B	0	2
实用手A	3	1
功能步行分级(n)			-0.417	0.677
0级	8	4
Ⅰ级	3	4
Ⅱ级	1	2
Ⅲ级	2	2
Ⅳ级	2	5
Ⅴ级	2	1

组别	n	训练前	训练后	差值	t值^a	P值^a
对照组	18	16.61±5.33	21.50±5.80	4.89±2.35	23.61	< 0.001
干预组	18	18.61±3.99	25.22±4.24	6.61±2.33	12.039	< 0.001
t值		1.275	2.198	2.209
P值		0.211	0.035	0.034

组别	n	训练前	训练后	差值	t值^a	P值^a
对照组	18	76.89±18.30	86.89±18.61	10.00±4.37	9.718	< 0.001
干预组	18	83.72±15.48	100.17±13.48	16.44±2.96	8.831	< 0.001
t值		1.210	2.451	5.186
P值		0.235	0.02	< 0.001

组别	n	训练前	训练后	差值	t值^a	P值^a
对照组	18	10.78±3.62	12.83±2.40	2.06±1.98	4.395	< 0.001
干预组	18	11.44±3.00	14.28±2.45	2.83±1.89	6.372	< 0.001
t值		0.602	1.521	0.296
P值		0.551	0.138	0.77

Effect of Cognitive Training Based on PASS Theory on Post-stroke Cognitive Impairment

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组别	n	训练前	训练后	差值	t值^a	P值^a
对照组	18	12.00±2.79	13.50±2.41	1.50±1.20	5.301	< 0.001
干预组	18	13.17±2.36	15.11±1.18	1.94±1.70	4.862	< 0.001
t值		1.356	2.549	0.497
P值		0.184	0.015	0.619

组别	n	训练前	训练后	差值	t'值^a	P值^a
对照组	18	8.94±2.24	10.33±2.20	1.39±1.34	4.415	< 0.001
干预组	18	10.33±2.45	11.67±0.97	1.33±1.97	2.871	0.011
t'值		1.777	2.356	1.497
P值		0.085	0.027	0.150

组别	n	训练前	训练后	差值	t'值^a	P值^a
对照组	18	10.50±2.62	10.89±2.48	0.39±0.78	2.122	0.049
干预组	18	11.39±1.65	11.78±0.94	0.39±2.17	2.122	0.049
t'值		1.219	1.426	1.427
P值		0.233	0.168	0.169

组别	n	训练前	训练后	差值	t值^a	P值^a
对照组	18	19.28±6.05	21.78±6.16	2.50±2.20	4.815	< 0.001
干预组	18	21.06±6.11	24.72±4.61	3.67±2.17	7.171	< 0.001
t值		0.877	1.623	2.354
P值		0.386	0.114	0.029

组别	n	训练前	训练后	差值	t值^a	P值^a
对照组	18	15.39±5.14	17.67±6.11	2.28±2.27	4.257	0.001
干预组	18	16.33±5.63	22.67±6.04	6.33±2.93	9.169	< 0.001
t值		0.526	2.470	0.451
P值		0.602	0.019	0.359

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