Pachalska M, Talar J, Baranowski P, Macqueen B D
Oddział Rehabilitacji Medycznej, Krakowskie Centrum Rehabilitacji, Kraków.
Ortop Traumatol Rehabil. 2000 Sep 30;2(3):77-87.
One of the most difficult problems in the rehabilitation of patients with closed-head injuries is posed by executive function disturbances, that is, difficulty in making the transition from thinking to acting. This article presents the working hypotheses and a description of a rehabilitation program developed by the authors, oriented directly towards training executive functions, in contract to the existing standard program, based on physical therapy with the addition of neuropsychological exercises directed towards training particular cognitive functions. The program consists of exercises supporting the development of not only cognitive and emotional-motivational elements, but also mediating metaprocesses and behavioral processes. In their own research involving 24 patients the authors confirmed the existence of objective disturbances of executive functioning in all subjects. The patients were divided into two groups: a control group of 12 patients treated with the standard program, and an experimental group of 12 patients who received the new rehabilitation program. The results obtained clearly indicate the superior effectiveness of the new program, not only in terms of executive functions per se, but also in transfer to other neurosychological parameters not treated separately. The authors discuss the etiology of executive function disturbances and the significance of the results obtained for rehabilitation. The authors' Clinical Test of Executive Functions is also presented.
闭合性颅脑损伤患者康复过程中最困难的问题之一是执行功能障碍，即从思考到行动的转变困难。本文提出了作者制定的康复计划的工作假设和描述，该计划直接针对执行功能训练，与现有标准计划不同，现有标准计划基于物理治疗，并增加了针对特定认知功能训练的神经心理学练习。该计划包括不仅支持认知和情绪 - 动机元素发展，还支持中介元过程和行为过程发展的练习。在作者自己涉及24名患者的研究中，证实了所有受试者都存在执行功能的客观障碍。患者被分为两组：12名接受标准计划治疗的患者组成的对照组，以及12名接受新康复计划的患者组成的实验组。所获得的结果清楚地表明了新计划的卓越有效性，不仅在执行功能本身方面，而且在转移到未单独治疗的其他神经心理学参数方面。作者讨论了执行功能障碍的病因以及所获结果对康复的意义。还介绍了作者的执行功能临床测试。
