急性缺血性卒中患者运动想象训练中认知负荷与生理指标的相关性研究  

Correlation between Cognitive Load and Physiological Indicators in Motor Imagery Training in Patients with Acute Ischemic Stroke

作　　者：张欣悦 常红[1] 赵洁[1] 李佩佩 刘梦娆 李苏爱 ZHANG Xinyue;CHANG Hong;ZHAO Jie;LI Peipei;LIU Mengrao;LI Suai(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国卒中杂志》2025年第4期435-446,共12页Chinese Journal of Stroke

基　　金：国家重点研发计划(2023YFC3605200,2023YFC3605201);科技部国家医学研究中心后补助经费(303-01-001-0272-10)。

摘　　要：目的通过对急性缺血性卒中患者运动想象训练中生理指标的动态监测,探究认知负荷与不同生理指标间的关系。方法采用描述性相关研究设计,连续纳入2022年2—11月首都医科大学宣武医院神经内科符合纳入标准的急性缺血性卒中患者进行测评。患者在双手握球状态下模仿计算机屏幕中的抓握动作,先进行左手抓握想象训练(4 s)3次,休息3 s,再进行右手抓握想象训练(4 s)3次,休息3 s,共进行42轮、252次抓握想象训练,总时长约为20 min。在患者运动想象训练前、训练结束即刻,利用认知负荷量表测量认知负荷,训练全程监测患者生理指标,通过潜在剖面分析与相关性分析对患者认知负荷与生理指标的关系进行探究。结果共纳入102例急性缺血性卒中患者,平均年龄(58.94±13.07)岁,发病到就诊时间2(1~5)d,NIHSS评分3(2~5)分。潜在剖面分析与相关性分析结果显示,急性缺血性卒中患者运动想象训练前的认知负荷潜在分型分为3型,具体为“认知负荷全维度低谷型”“高努力程度与零体力要求型”“高脑力要求-自我表现型”。心率、脉率、呼吸频率、血氧饱和度、收缩压、舒张压、收缩压变异系数、舒张压变异系数、结束即刻心率、结束即刻脉率、结束即刻呼吸频率、结束即刻血氧饱和度与认知负荷总分、认知负荷各维度具有不同程度的相关性。运动想象训练过程中认知负荷的潜在分型分为4型,具体为“高时限要求-低受挫程度型”“高体力要求-时限要求-努力程度-受挫程度与低自我表现型”“高努力程度与低自我表现-受挫程度型”“高体力要求-努力程度-受挫程度与低自我表现型”。心率、脉率、呼吸频率、血氧饱和度、收缩压、舒张压、平均动脉压、收缩压变异系数、舒张压变异系数、结束即刻心率、结束即刻脉率、结束即刻呼吸频率、结束即刻血氧饱和度、结Objective To explore the relationship between cognitive load and different physiological indicators by dynamic monitoring the physiological indicators in the motor imagery training in patients with acute ischemic stroke.Methods A descriptive correlational research design was adopted,and patients with acute ischemic stroke who met the inclusion criteria were consecutively enrolled for assessments from February to November 2022 at the Department of Neurology of Xuanwu Hospital,Capital Medical University.Patients mimicked the grasping actions on the computer screen while holding a ball with both hands.They first performed left-hand grasping imagery training(4 seconds)three times,then rested for 3 seconds.After that,they performed right-hand grasping imagery training(4 seconds)three times,then rested for 3 seconds again.A total of 42 rounds and 252 grasping imagery training sessions were conducted,with a total duration of approximately 20 minutes.Before the start of motor imagery training and immediately after its completion,the cognitive load scale was used to measure the cognitive load,and the physiological indicators were monitored throughout the training.The relationship between cognitive load and physiological indicators was analyzed using latent profile and correlation analyses.Results A total of 102 patients with acute ischemic stroke were included,with an average age of(58.94±13.07)years,the time from onset to treatment of 2(1-5)days,and the NIHSS score of 3(2-5)points.Results from latent profile and correlation analyses revealed that the latent types of cognitive load in patients with acute ischemic stroke before motor imagery training were divided into three classes,specifically“low cognitive load in all dimensions type”“high effort and zero physical requirements type”and“high mental requirements-self-expression type”.Heart rate,pulse rate,respiratory rate,blood oxygen saturation,systolic blood pressure,diastolic blood pressure,coefficient of variability of systolic blood pressure,coefficient o

关 键 词：急性缺血性卒中 运动想象 认知负荷 生理指标 相关性分析 

分 类 号：R74[医药卫生—神经病学与精神病学]