上肢运动游戏对轻度认知障碍脑卒中患者功能恢复的效果  

Effects of upper limb exergames on functional recovery in stroke patients with mild cognitive impairment

作　　者：李秀丽 李珊 冯梦晨 黄富表[1,2] LI Xiuli;LI Shan;FENG Mengchen;HUANG Fubiao(Department of Occupational Therapy,Beijing Bo'ai Hospital,China Rehabilitation Research Center,Beijing 100068,China;Capital Medical University School of Rehabilitation Medicine,Beijing 100068,China)

机构地区：[1]中国康复研究中心北京博爱医院作业疗法科,北京市100068 [2]首都医科大学康复医学院,北京市100068

出　　处：《中国康复理论与实践》2023年第1期98-103,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：中国康复研究中心课题(No.2021ZX-Q4)。

摘　　要：目的观察上肢运动游戏对轻度认知障碍脑卒中患者认知功能、上肢运动功能和日常生活活动能力的影响。方法选取2020年8月至2021年11月在北京博爱医院住院的脑卒中后轻度认知障碍患者50例,随机分为对照组和试验组各25例,两组均接受常规作业疗法训练,对照组增加功能性作业治疗,试验组增加上肢运动游戏训练,共4周。治疗前后分别采用蒙特利尔认知评估量表(MoCA)、Fugl-Meyer评定量表上肢部分(FMA-UE)和改良Barthel指数(MBI)评估治疗效果。结果治疗后,两组MoCA总分、FMA-UE评分和MBI评分均较治疗前明显改善(|t|>3.354,|Z|>4.379,P<0.01)。对照组MoCA 5个认知维度(除命名和抽象思维外)较治疗前提高(|Z|>2.000,P<0.05);试验组MoCA 6个认知维度(除命名外)较治疗前明显提高(|Z|>2.646,P<0.01)。试验组治疗后MoCA总分及5个维度评分(除命名和抽象思维外)以及FMA-UE评分较对照组改善(|Z|>1.982,t=3.565,P<0.05)。结论上肢运动游戏可促进轻度认知障碍脑卒中患者认知功能、上肢运动功能和日常生活活动能力的恢复。Objective To explore the effects of upper limb exergames on cognitive function,upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.Methods From August,2020 to November,2021,50 troke patients with mild cognitive impairment in Beijing Bo’ai Hospital were randomly allocated to control group(n=25)and experimental group(n=25).Both groups received traditional occupational therapy.Additional functional occupational therapy was provided to the control group,and upper limb exergames were provided to the experimental group,for four weeks.They were assessed with Montreal Cognitive Assessment(MoCA),Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Barthel Index(MBI)before and after the treatment.Results After treatment,the scores of MoCA,FMA-UE and MBI improved in both groups(|t|>3.354,|Z|>4.379,P<0.01),and the scores increased in five MoCA cognitive domains in the control group(except map naming and abstract thinking)(|Z|>2.000,P<0.05)and in six MoCA cognitive domains in the experimental group(except map naming)(|Z|>2.646,P<0.01).After treatment,the scores of MoCA,MoCA five cognitive domains(except map naming and abstract thinking)and FMA-UE were better in the experiment group than in the control group(|Z|>1.982,t=3.565,P<0.05).Conclusion Upper limb exergames can facilitate the recovery of cognitive function,upper limb motor function and activities of daily living in stroke patients with mild cognitive impairment.

关 键 词：脑卒中 上肢运动游戏 认知功能 上肢运动功能 日常生活活动能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]