工作记忆和运动想象疗法在脑卒中后患者康复中应用的临床研究  

The clinical study on application of working memory and mental practice in post-stroke patient

作　　者：张艳明[1] 戴洁[1] 钱龙[1] 宋为群[1] 

机构地区：[1]首都医科大学宣武医院康复医学科,北京100053

出　　处：《中华物理医学与康复杂志》2010年第2期128-131,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：国家自然科学基金（30540058,30770714）、北京市自然科学基金（7052030）、北京市委组织部优秀人才基金、北京市科技计划项目（Z0005187040191-1）资助

摘　　要：目的通过联合应用运动想象疗法和运动训练，研究脑卒中患者的工作记忆与其运动功能改善之间的关系。方法将40例脑卒中患者分为正常工作记忆组21例和受损工作记忆组19例，2组进行为期4周的运动想象疗法和运动训练，训练前进行运动想象问卷调查表评定和工作记忆评定及训练前、后进行下肢Fugl—Meyer评定、偏瘫侧下肢负重能力评定。结果正常工作记忆组患者偏瘫侧下肢Fugl-Meyer评分及下肢的负重能力的改善明显优于受损工作记忆组（P〈0．01），工作记忆评分与运动功能改善有明显的关系（P〈0．01）。结论运动想象疗法和运动训练相结合可明显改善脑卒中后患者下肢功能，并且下肢功能的改善程度与工作记忆对信息的保持和操作的能力程度相关。Objective To study the relationship between the improvement of working memory and motor function obtained from application of mental practice and exercise training in post-stroke patient rehabilitation. Methods A total of 40 post-stroke patients were divided indo a normal working memory group（21 cases） and an impaired working memory group（ 19 cases） , and all the patients were trained with mental practice and the general rehabilitation for 4 weeks. Kinesthetic and visual imagery questionnaire （KVIQ） and working memory were measured before treatment. Fugl-Meyer scole of lower limb and loading of the affected lower limb were measured in two groups before and after treatment. Results After 4 weeks of training, loading of the affected lower limb and Fugl-Meyer score of lower limb in normal working memory group had evident improvement compared with those in the impaired working memory group （ P 〈 0.01 ） , indicating that there was significant relationship between the working memory and motor function （P 〈 0.01 ）. Conclusions There is evident effect of mental practice and exercise training on the lower limb function of post-stroke patients, and the effect depends on the abilities of maintaining and operating information in working memory.

关 键 词：工作记忆 运动想象疗法 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]