基于蒙特梭利法的多模式干预对脑卒中后认知障碍的影响
摘要
目的以认知能力和生活能力为评价指标,观察基于蒙特梭利法的多模式干预对脑卒中后认知功能障碍(PSCI)患者的影响。方法选择PSCI患者50例对其进行日常生活能力训练和蒙特梭利认知训练。分别在治疗前、治疗4 w后、治疗8 w后进行认知能力[简易智能状态检查表(MMSE)评分、蒙特利尔认知评估(MoCA)评分]和日常生活能力[Barthel指数(BI)]评定。结果治疗4 w和治疗8 w后MMSE评分、BI评分与治疗前相比差异有统计学意义(P<0.05,P<0.01)。治疗8 w后MoCA评分与治疗前相比差异有统计学意义(P<0.05)。年龄越小、文化程度越高、照护越好,对脑卒中后认知功能的改善越有意义(P<0.05)。年龄越小、照护越精心对脑卒中后日常生活能力提高越有意义(P<0.05)。结论以人为中心的蒙特梭利法,训练方法简便实用,既能改善PSCI患者的认知能力,又能提高社会适应能力,更有利于患者回归社会、回归家庭。
引文
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8 李奎成,唐丹,刘晓艳,等.国内Barthel指数和改良Barthel指数应用的回顾性研究[J].中国康复医学杂志,2009;24(8):737-40.
9 冯俏,金奕,周官恩,等.护士主导的强化认知干预对脑卒中患者非痴呆认知障碍的影响[J].中国老年学杂志,2014;34(21):6043-5.
10 王鑫,孙彩花,施伟,等.音乐疗法对卒中后认知障碍的临床疗效[J].实用临床医药杂志,2014;18(19):10-6.
11 Erickson KI,Voss MW,Prakash RS,et al.Exercise training increases size of hippocampus and improves memory[J].Proc Natl Acad Sci USA,2011;108(7):3017-22.
12 Kirk-Sanchez NJ,McGough EL.Physical exercise and cognitive performance in the elderly:current perspectives[J].Clin Interv Aging,2014;9:51-62.
13 Wilks SE,Boyd PA,Bates SM,et al.Montessori-based activities among persons with late-stage dementia:evaluation of mental and behavioral health outcomes[J].Dementia(London),2017:1471301217703242.
14 Karp A,Paillard-Borg S,Wang HX,et al.Mental,physical and social components in leisure activities equally contribute to decrease dementia risk[J].Dement Geriatr Cogn Disord,2006;21(2):65-73.
2 董强,郭起浩,罗本燕,等.卒中后认知障碍管理专家共识[J].中国卒中杂志,2017;12(6):519-31.
3 Mudar RA,Chapman SB,Rackley A,et al.Enhancing latent cognitive capacity in mild coanitive impairment with gist reasoning training:a pilot study[J].Int J Geriatr Psychiatry,2017;32(5):548-55.
4 张继华,王强,谢家兴,等.强化认知训练对脑卒中后认知障碍患者日常生活活动能力的影响 [J].中国康复理论与实践,2012;18(8):778-80.
5 Sheppard CL,McArthur C,Hitzig SL.A systematic review of montessori-based activities for persons with dementia[J].J Am Med Dir Assoc,2016;17(2):117-22.
6 Scazufca M,Almeida OP,Vallada HP,et al.Limitations of the mini-mental state examination for screening dementia in a community with low socioeconomic status:results from the sao paulo ageing & health study[J].Eur Arch Psychiatry Clin Neurosci,2009;259 (1):8-15.
7 Nasreddine ZS,Phillips NA,Bedirian V,et al.The montreal cognitive assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005;53(4):695-9.
8 李奎成,唐丹,刘晓艳,等.国内Barthel指数和改良Barthel指数应用的回顾性研究[J].中国康复医学杂志,2009;24(8):737-40.
9 冯俏,金奕,周官恩,等.护士主导的强化认知干预对脑卒中患者非痴呆认知障碍的影响[J].中国老年学杂志,2014;34(21):6043-5.
10 王鑫,孙彩花,施伟,等.音乐疗法对卒中后认知障碍的临床疗效[J].实用临床医药杂志,2014;18(19):10-6.
11 Erickson KI,Voss MW,Prakash RS,et al.Exercise training increases size of hippocampus and improves memory[J].Proc Natl Acad Sci USA,2011;108(7):3017-22.
12 Kirk-Sanchez NJ,McGough EL.Physical exercise and cognitive performance in the elderly:current perspectives[J].Clin Interv Aging,2014;9:51-62.
13 Wilks SE,Boyd PA,Bates SM,et al.Montessori-based activities among persons with late-stage dementia:evaluation of mental and behavioral health outcomes[J].Dementia(London),2017:1471301217703242.
14 Karp A,Paillard-Borg S,Wang HX,et al.Mental,physical and social components in leisure activities equally contribute to decrease dementia risk[J].Dement Geriatr Cogn Disord,2006;21(2):65-73.