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中风后的运动和认知障碍。

Motor and cognitive impairment after stroke.

作者信息

Cengić Ljiljana, Vuletić Vladimira, Karlić Mladen, Dikanović Marinko, Demarin Vida

机构信息

Department of Neurology, Vinkovci General Hospital, Vinkovci, Croatia.

出版信息

Acta Clin Croat. 2011 Dec;50(4):463-7.

Abstract

Cognitive abilities have great impact on rehabilitation program in stroke patients. Therefore, fast and practical psychometric assessment as an indicator of individual rehabilitation program is of great importance. The aim of this study was to analyze and compare motor and cognitive impairment in stroke patients in acute, subacute and chronic phase of the disease, taking age, sex, education, stroke risk factors, lateralization and type of stroke in consideration. The study included 50 stroke patients, 33 male and 17 female. Ischemic stroke was diagnosed in 78% and hemorrhagic stroke in 22% of patients. Hypertension was the leading stroke risk factor in 82% of patients. Cognitive impairment in acute, subacute and chronic phase of the disease was noticed in 12% of stroke patients with ischemia in the left brain hemisphere, mMMSE average score 31 and SKT score 19, IQ under 90. Better motor recovery in acute and subacute phase of stroke was followed by better cognitive status. All cognitively impaired stroke patients had low level of education, some had accomplished elementary education and others had not, all much below the dementia risk age of 75 years. Exclusion of patients with severe stroke from the study led to overestimation of the results. Finally, a coherent algorithm for somatic and cognitive stroke assessment in stroke patients poses itself as an imperative as a guideline for plastic, individualized and appropriate rehabilitation.

摘要

认知能力对中风患者的康复计划有很大影响。因此,快速实用的心理测量评估作为个体康复计划的指标非常重要。本研究的目的是分析和比较中风患者在疾病急性期、亚急性期和慢性期的运动和认知障碍,同时考虑年龄、性别、教育程度、中风危险因素、中风的侧别和类型。该研究纳入了50名中风患者,其中男性33名,女性17名。78%的患者被诊断为缺血性中风,22%的患者为出血性中风。82%的患者中风的主要危险因素是高血压。在疾病的急性期、亚急性期和慢性期,12%的左侧脑半球缺血性中风患者存在认知障碍,简易精神状态检查表(mMMSE)平均得分为31分,斯堪的纳维亚失语症测试(SKT)得分为19分,智商低于90。中风急性期和亚急性期更好的运动恢复伴随着更好的认知状态。所有认知受损的中风患者教育水平都较低,一些人完成了小学教育,另一些人则没有,均远低于75岁的痴呆风险年龄。将严重中风患者排除在研究之外导致结果被高估。最后,作为整形、个性化和适当康复的指导方针,一种连贯的中风患者躯体和认知评估算法成为当务之急。

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