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孙良文1,2, 王博1,2, 韦春霞1,2, 段强1,2, 卢敏1,2, 刘欢1,2, 黄肖群1,2
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1.三峡大学第一临床医学院·2.宜昌市中心人民医院
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| 摘要: |
| 目的 观察基于虚拟现实(VR)技术的远程康复对社区居住脑卒中后非痴呆型认知障碍(PSCIND)患者认知功能、日常生活活动能力、生活质量及康复依从性的影响。方法 采用随机数字表法将62例社区居住脑卒中后非痴呆型认知障碍(PSCIND)患者随机分为干预组(n=30)和对照组(n=32)。对照组出院前接受居家认知康复宣教并定期门诊随访接受认知康复指导,干预组采用基于虚拟现实的远程认知康复训练,两组干预周期均为12周。干预前、干预12周后采用蒙特利尔认知评估量表(MoCA)评估整体认知功能,数字广度测验(DST)、符号数字模态测验(SDMT)评估注意力/工作记忆及信息处理能力,干预后通过功能性活动问卷(FAQ)及脑卒中专用生活质量量表(SS-QOL)评估工具性日常生活活动能力及生活质量,并记录实际完成训练次数与计划训练次数的百分比以评估其康复依从性。结果 干预12周后,干预组MoCA总分、DST(顺背与倒背)、SDMT评分改善均显著优于对照组(P<0.05)。干预组IADL与SS-QOL评分的亦显著高于对照组(P<0.05)。干预组训练依从率显著高于对照组(P<0.05)。结论 基于VR的远程康复有利于改善PSCIND患者的整体认知功能、注意力/工作记忆及信息处理速度,并能进一步提升其日常生活活动能力与生活质量,且具有较高的康复依从性,是一种行之有效且可及性强的康复新模式。 |
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1.The First College of Clinical Medical Science, China Three Gorges University;2.Yichang Central People’s Hospital
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| Abstract: |
| Objective To observe the effects of virtual reality-based telerehabilitation technology on cognitive function, activities of daily living, quality of life and rehabilitation compliance in patients with non-dementia cognitive impairment after stroke living in the community. Methods Sixty-two community-dewelling stroke patients with non-dementia cognitive impairment were randomly divided into experimental group (n=30) and control group (n=32) by using the random number table. The control group received home cognitive rehabilitation education before discharge and regularly outpatient cognitive rehabilitation guidance, while the experimental group used virtual reality-based telerehabilitation cognitive rehabilitation training, and the intervention period of both groups was 12 weeks. Before and after 12 weeks of intervention, cognitive function was assessed by the Montreal Cognitive Assessment Scale (MoCA), Digital Span Test (DST) and Symbol - Digit Modalities Test (SDMT) were used to evaluate attention, work memory and information processing ability. After intervention the instrumental ability of daily living and quality of life were assessed by the Functional Activities Questionnaire (FAQ) and the Stroke-specific Quality of Life Scale (SS-QOL). The percentage of actual training completed and planned training times was recorded to evaluate their rehabilitation compliance. Results After 12 weeks of intervention, the total score of MoCA, DST (forward and backward back), and SDMT score in the experimental group were significantly better than those in the control group (P<0.05). The FAQ、SS-QOL scores in the experimental group were also significantly higher than those in the control group (P<0.05). The training adherence rate of the experimental group was significantly higher than that of the control group (P<0.05). Conclusion VR-based telerehabilitation is beneficial to improve the overall cognitive function, attention/working memory and information processing speed of PSCIND patients, and can further improve their daily living activities and quality of life, and has high rehabilitation compliance, which is an effective and accessible new rehabilitation model. |
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