Miller Laurie A, Radford Kylie
a Neuropsychology Unit , Royal Prince Alfred Hospital , Sydney , Australia.
Neuropsychol Rehabil. 2014;24(5):721-37. doi: 10.1080/09602011.2014.894479. Epub 2014 Mar 14.
Memory complaints are common after stroke, yet there have been very few studies of the outcome of memory rehabilitation in these patients. The present study evaluated the effectiveness of a new manualised, group-based memory training programme. Forty outpatients with a single-stroke history and ongoing memory complaints were enrolled. The six-week course involved education and strategy training and was evaluated using a wait-list crossover design, with three assessments conducted 12 weeks apart. Outcome measures included: tests of anterograde memory (Rey Auditory Verbal Learning Test: RAVLT; Complex Figure Test) and prospective memory (Royal Prince Alfred Prospective Memory Test); the Comprehensive Assessment of Prospective Memory (CAPM) questionnaire and self-report of number of strategies used. Significant training-related gains were found on RAVLT learning and delayed recall and on CAPM informant report. Lower baseline scores predicted greater gains for several outcome measures. Patients with higher IQ or level of education showed more gains in number of strategies used. Shorter time since onset was related to gains in prospective memory, but no other stroke-related variables influenced outcome. Our study provides evidence that a relatively brief, group-based training intervention can improve memory functioning in chronic stroke patients and clarified some of the baseline factors that influence outcome.
中风后记忆问题很常见,但针对这些患者记忆康复效果的研究却非常少。本研究评估了一种新的基于小组的记忆训练方案手册的有效性。招募了40名单发中风病史且仍有记忆问题的门诊患者。为期六周的课程包括教育和策略训练,并采用等待列表交叉设计进行评估,每隔12周进行三次评估。结果指标包括:顺行性记忆测试(雷氏听觉词语学习测验:RAVLT;复杂图形测试)和前瞻性记忆测试(皇家阿尔弗雷德王子前瞻性记忆测试);前瞻性记忆综合评估(CAPM)问卷以及所使用策略数量的自我报告。在RAVLT学习、延迟回忆以及CAPM信息提供者报告方面发现了与训练相关的显著进步。较低的基线分数预示着多项结果指标会有更大的进步。智商较高或教育水平较高的患者在使用策略数量上的进步更大。发病后时间较短与前瞻性记忆的进步有关,但没有其他与中风相关的变量影响结果。我们的研究提供了证据,表明相对简短的基于小组的训练干预可以改善慢性中风患者的记忆功能,并阐明了一些影响结果的基线因素。