Pyun Sung-Bom, Yang Heeseung, Lee Sangil, Yook Jinsook, Kwon Jaesung, Byun Eun-Mi
Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, South Korea.
Brain Inj. 2009 Jul;23(7):686-92. doi: 10.1080/02699050902997862.
To evaluate the effectiveness of a 12-week individualized home programme of rehabilitation for patients with cognitive impairment.
Six patients with cognitive dysfunction, after haemorrhagic stroke, participated in this study. A programme was carried out in the home environment that consisted of four mixed training programmes: cognitive remediation therapy, story retelling, cognitive enhancing games and aerobic exercise. The patients performed the home programme for 2 hours a day, 7 days a week, for 12 weeks. The main outcomes were measured using the MMSE, Neurobehavioural Cognitive Status Examination (NCSE), domain-specific computerized neuropsychological test for attention, memory and executive function, the Lowenstein Occupational Therapist Cognitive Assessment (LOTCA), the Modified Barthel Index (MBI) and the Seoul-Instrumental Activity of Daily Living (S-IADL).
After completion of a 12-week home programme, the patients' S-IADL scores improved significantly (p < 0.05). The patients' MMSE and NCSE scores improved marginally, with mean score changes of 4.2 (p = 0.058), 4.7 (p = 0.078) and 6.8 (p = 0.068) points, respectively. However, the patients' domain-specific cognitive test and LOTCA scores did not significantly change.
The results of this study showed that an individualized home programme improved IADL performance in patients with cognitive dysfunction and may have a beneficial effect on cognition, as assessed by general cognitive measures.
评估一项针对认知障碍患者的为期12周的个性化家庭康复计划的有效性。
6名出血性中风后出现认知功能障碍的患者参与了本研究。在家庭环境中开展了一项计划，该计划包括四个混合训练项目：认知康复治疗、故事复述、认知增强游戏和有氧运动。患者每周7天，每天进行2小时的家庭计划，为期12周。主要结局指标采用简易精神状态检查表（MMSE）、神经行为认知状态检查（NCSE）、针对注意力、记忆力和执行功能的特定领域计算机化神经心理测试、洛温斯坦作业疗法认知评定量表（LOTCA）、改良巴氏指数（MBI）和首尔日常生活活动能力量表（S-IADL）进行测量。
完成12周的家庭计划后，患者的S-IADL评分显著提高（p<0.05）。患者的MMSE和NCSE评分略有提高，平均得分变化分别为4.2分（p=0.058）、4.7分（p=0.078）和6.8分（p=0.068）。然而，患者的特定领域认知测试和LOTCA评分没有显著变化。
本研究结果表明，一项个性化家庭计划改善了认知功能障碍患者的IADL表现，并可能对认知产生有益影响，这是通过一般认知测量评估得出的。
