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认知康复的作用和益处的简要概述与评估。

Brief overview and assessment of the role and benefits of cognitive rehabilitation.

作者信息

Basford Jeffrey R, Malec James F

机构信息

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.

Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN; Rehabilitation Hospital of Indiana, Indianapolis, IN.

出版信息

Arch Phys Med Rehabil. 2015 Jun;96(6):977-80. doi: 10.1016/j.apmr.2015.02.025. Epub 2015 Mar 7.

Abstract

Cognition is one of our most important attributes. Arresting its decline, whether in association with normal aging or a diagnosis of mild cognitive impairment, acquired brain injury, or dementia, concerns everyone, regardless of whether their role is that of spouse, child, or clinician. This article provides a brief, and by necessity, somewhat superficial appraisal of the status of our knowledge of the benefits of cognitive rehabilitation in these conditions and the authors' assessment of its strengths and weaknesses. In summary, there is support for the belief that participation in exercise as well as socially and cognitively stimulating activities (whether or not rehabilitative in nature) is beneficial for all but perhaps those with the most severe dementia. Focused efforts at cognitive training/rehabilitation also appear potentially helpful but are best established for those with acquired brain injury. There are, however, caveats to this assessment. For example, cognitive retraining is resource and time intensive while, even for those most likely to benefit, its impact on their daily activities and quality of life remains unclear. In addition, responses to training may vary from person to person and are likely to be influenced by factors such as an individual's acceptance of the need for assistance. Future research may benefit from continued efforts to treat the patient holistically, fit the treatment to those most likely to benefit, and encouraging the translation of training effects to functioning in the real world.

摘要

认知是我们最重要的属性之一。阻止其衰退,无论这与正常衰老相关,还是与轻度认知障碍、后天性脑损伤或痴呆症的诊断相关,都关乎每一个人,无论其角色是配偶、子女还是临床医生。本文简要且必然有些表面地评估了我们对认知康复在这些情况下的益处的了解现状,以及作者对其优缺点的评估。总之,有证据支持这样一种观点,即参与锻炼以及社会和认知刺激活动(无论本质上是否具有康复性)对所有人都有益,但可能对患有最严重痴呆症的人除外。针对认知训练/康复的集中努力似乎也有潜在帮助,但对后天性脑损伤患者最为有效。然而,这一评估也有一些需要注意的地方。例如,认知再训练需要大量资源和时间,而且即使对那些最可能受益的人来说,其对他们日常活动和生活质量的影响仍不明确。此外,对训练的反应可能因人而异,并且可能受到诸如个人对接受帮助的需求的接受程度等因素的影响。未来的研究可能会受益于持续全面治疗患者、使治疗适合最可能受益的人群以及鼓励将训练效果转化为现实世界中的功能的努力。

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