亨廷顿舞蹈症患者接受为期一年的多学科强化康复计划后的认知表现：一项观察性研究
Cognitive Performance After a One-Year Multidisciplinary Intensive Rehabilitation Program for Huntington's Disease: An Observational Study.
作者信息
van Walsem Marleen R, Piira Anu, Mikalsen Geir, Fossmo Hanne Ludt, Howe Emilie I, Knutsen SynnØve F, Frich Jan C
机构信息
Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway.
Research Centre for Habilitation and Rehabilitation Models & Services, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
出版信息
J Huntingtons Dis. 2018;7(4):379-389. doi: 10.3233/JHD-180294.
BACKGROUND
Studies of physical therapy and multidisciplinary rehabilitation programs for Huntington's disease (HD) have shown improvements in gait function, balance, and physical quality of life. There is a gap in the literature on effects of cognitive interventions and the potential to improve cognitive performance.
OBJECTIVE
To assess changes in cognitive performance among patients with early to middle stage HD as secondary analyses from a one-year multidisciplinary rehabilitation program. The program included cognitive stimulation as a non-specific cognitive intervention in addition to physical interventions.
METHODS
A one-year rehabilitation program that included comprehensive neuropsychological assessments was completed by 31 out 37 participants with early to middle stages of HD. Socio-demographic and clinical information was recorded. A battery of neuropsychological tests was used to measure cognitive functions before and after the intervention. Descriptive statistics was used for sample characteristics. Paired sample t-tests and nonparametric Wilcoxon Signed ranked tests were used to compare cognitive measures at both time points.
RESULTS
Scores on the Symbol Digit Modalities Test (SDMT) were significantly lower post intervention. There were no significant differences in all other measures. Scores on the Stroop color naming and California Verbal Learning Test-II (CVLT-II) long-term delayed recall tasks showed tendencies towards lower scores post intervention.
CONCLUSIONS
An intensive multidisciplinary rehabilitation program for patients with HD was generally well tolerated and feasible, with no indication of negative effects on cognition. Neuropsychological measures overall remained stable following an intensive multidisciplinary rehabilitation program, however continued progression of cognitive impairment was evident on the SDMT, suggesting that disease progression is not halted. Randomized controlled trials are needed to verify these findings.
背景
针对亨廷顿舞蹈症（HD）的物理治疗和多学科康复项目研究表明，步态功能、平衡能力和身体生活质量有所改善。关于认知干预的效果及改善认知表现的潜力，文献中存在空白。
目的
作为一项为期一年的多学科康复项目的二次分析，评估早期至中期HD患者认知表现的变化。该项目除了物理干预外，还包括作为非特异性认知干预的认知刺激。
方法
37名早期至中期HD参与者中有31人完成了一项为期一年的康复项目，该项目包括全面的神经心理学评估。记录了社会人口统计学和临床信息。在干预前后使用一系列神经心理学测试来测量认知功能。描述性统计用于样本特征分析。配对样本t检验和非参数威尔科克森符号秩检验用于比较两个时间点的认知测量结果。
结果
干预后符号数字模态测试（SDMT）的分数显著降低。其他所有测量结果均无显著差异。在斯特鲁普颜色命名和加利福尼亚言语学习测试-II（CVLT-II）长期延迟回忆任务中的分数显示出干预后有降低的趋势。
结论
针对HD患者的强化多学科康复项目总体耐受性良好且可行，没有对认知产生负面影响的迹象。经过强化多学科康复项目后，神经心理学测量结果总体保持稳定，然而在SDMT上认知障碍的持续进展很明显，这表明疾病进展并未停止。需要进行随机对照试验来验证这些发现。
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