计算机辅助认知训练对智力发育障碍儿童视知觉功能的影响  

Effect of Computer-Assisted Cognitive Training on Visual Perception in Children with Intellectual Development Disorders

作　　者：李昭蓥 邓海茵 黄振明 何友泽 涂劲楠 曹蕾 黄佳[1,2] 吴劲松 LI Zhaoying;DENG Haiyin;HUANG Zhenming;HE Youze;TU Jingnan;CAO Lei;HUANG Jia;WU Jingsong(College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Fujian Collaborative Innovation Center for Rehabilitation Technology,Fuzhou,Fujian 350122,China)

机构地区：[1]福建中医药大学康复医学院,福建福州350122 [2]福建省康复技术协同创新中心,福建福州350122

出　　处：《康复学报》2023年第5期397-403,共7页Rehabilitation Medicine

基　　金：国家自然科学基金项目(8180152223);福建省科技厅引导项目(2022Y0038);福建省自然科学基金项目(2019J05101)。

摘　　要：目的:观察计算机辅助认知训练对智力发育障碍儿童视知觉功能的临床康复疗效。方法:纳入2019年8月—2020年12月在福州市各特殊教育学校、儿童康复中心招募的60例4~6.5岁学龄前的智力发育障碍(IDD)儿童为研究对象,按照随机数字表法分为对照组和试验组,每组30例,2组在研究过程中分别脱落4例。对照组进行人工认知训练,试验组采用计算机辅助认知训练,每周5次,持续训练5周。连续治疗5周后分别比较2组治疗前后以及3个月随访时的视觉-运动整合发展测试第6版(VMI-6)中的视知觉感知分测验(VPT)评分、图片词汇测验(PPVT)评分及Conners父母症状问卷(PSQ)评分;统计分析采用意向性分析集,并应用混合线性模型分析探讨干预与时间的组效应、时间效应及交互效应,以受试对象的实足年龄、身体质量指数作为协变量。结果:基线期各指标评分组间比较差异无统计学意义(P>0.05)。混合线性模型分析结果显示,计算机辅助认知训练在VPT、PPVT方面具有显著的组×时间交互效应(P<0.05)。治疗前后组间比较结果显示,试验组VPT评分[d=0.56,95%CI(0.05,1.08)]、PPVT评分[d=0.20,95%CI(-0.30,0.71)]的改善效果均优于对照组(P<0.01)。与基线期相比,随访期的组间比较结果显示,试验组VPT评分[d=0.80,95%CI(0.27,1.32)]、PPVT评分[d=0.79,95%CI(0.27,1.32)]、PSQ学习问题[d=-0.11,95%CI(-0.62,0.40)]的改善效果均显著优于对照组(P<0.01)。结论:为期5周的计算机辅助认知训练可有效改善智力发育障碍儿童的视知觉功能,同时也促进了词汇、学习问题、注意力行为的改善。Objective:To explore the clinical rehabilitation effect of a computer-assisted cognitive training on visual perception function of children with intellectual development disorders(IDD).Methods:A total of sixty IDD participants,aged 4-6.5 years old,recruited from special education schools and children's rehabilitation centers in Fuzhou city between August 2019 to December 2020,were included in the study,and they were randomly divided into control group and experimental group,with 30 cases in each group,4 cases dropped out during the process of the study in each of the two groups.The control group was trained with manual cognitive training,and the experimental group was trained with the computer-assisted cognitive training,five times per week for five weeks.The outcomes measures included the scores of visual perception test(VPT)in Beery-Buktenica developmental test of visualmotor integration sixth edition(VMI-6),Peabody picture vocabulary test(PPVT),and parent symptom questionnaire(PSQ).Scores were compared at baseline,post-intervention and 3-month follow-up.The intention-to-treat principle was applied in the statistical analysis.Then,the mixed linear model analysis was used to explore the group effect,time effect and interaction effect of intervention with the chronological age and body mass index of the subjects as covariates.Results:There was no statistically significant difference found in the scores of each index at baseline between the two groups(P>0.05).The results of mixed linear model analysis showed a significant group×time interaction effect of computer-assisted cognitive training on VPT and PPVT(P<0.05).The results of the between-group comparison showed that the experimental group was better than the control group in terms of improvement in VPT[d=0.56,95%CI(0.05,1.08)]and PPVT[d=0.20,95%CI(-0.30,0.71)](P<0.01)before and after treatment.Compared with the baseline,the results of the between-group comparison in the follow-up period showed that the improvement effects of VPT[d=0.80,95%CI(0.27,1.32)],PPVT[d

关 键 词：智力发育障碍 计算机辅助 认知训练 视知觉 学龄前儿童 注意力功能 

分 类 号：R748[医药卫生—神经病学与精神病学]