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增强中风后的神经可塑性:认知行为训练的作用。

Enhancing Neuroplasticity Post Stroke: The Role of Cognitive-Behavioral Training.

作者信息

Moursy Mohamed Rasmy, Atteya Abdulalim A, Zakaria Hoda M, Ibrahim Zizi M, Ali Olfat Ibrahim, Alkhamees Nouf H, Basheer Mye A, Elkafrawy Noura A

机构信息

Department of Physical Therapy, Akhmim Hospital, Sohag 82749, Egypt.

Department of Physical Therapy for Neurology, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt.

出版信息

Brain Sci. 2025 Mar 22;15(4):330. doi: 10.3390/brainsci15040330.

Abstract

: Stroke is a primary cause of adult disability and often causes cognitive impairment. Rehabilitation interventions aim to enhance patients' cognitive abilities, thereby addressing care needs, improving quality of life, and optimizing performance in compromised functions. : To evaluate the impact of incorporating cognitive-behavioral training (CBT) into a selected exercise program on cortical reorganization and cognitive recovery in post-stroke patients. : Thirty post-stroke patients of both sexes (27 male and 3 female) aged from 40 to 65 years were randomly divided into two groups: the study group (n = 15) received CBT combined with a selected exercise program including weight-bearing, balance, and aerobic exercises, while the control group (n = 15) underwent the selected exercise program only. All participants engaged in an 8-week intervention with three sessions per week. Cortical reorganization was measured using quantitative electroencephalography (QEEG) at electrode sites F3, F4, T5, and T6, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and RehaCom, focusing on memory, attention, concentration, logical reasoning, and reaction behavior. Assessments were carried out for all patients before and after the 8-week treatment program. : Improvements were assessed through three key measures: QEEG, the MoCA, and RehaCom. Post-intervention, the study group demonstrated a significantly higher (alpha + beta)/(delta + theta) ratio at F3, F4, T5, and T6 ( < 0.01), indicative of enhanced cortical reorganization. MoCA scores increased by 16.98% in the study group compared to 7.40% in the control group ( < 0.01). Additionally, RehaCom assessments revealed marked improvements in memory, attention, logical reasoning, and reaction behavior in the study group ( < 0.01). : Integrating cognitive-behavioral training with a selected exercise program significantly enhances cortical reorganization and cognitive recovery in post-stroke patients. These findings suggest that adding CBT to rehabilitation protocols can effectively address deficits in memory and attention, ultimately improving functional outcomes.

摘要

中风是成人残疾的主要原因,常导致认知障碍。康复干预旨在提高患者的认知能力,从而满足护理需求、改善生活质量并优化受损功能的表现。

为了评估将认知行为训练(CBT)纳入选定的运动计划对中风后患者皮质重组和认知恢复的影响。

30名年龄在40至65岁之间的中风后患者(27名男性和3名女性)被随机分为两组:研究组(n = 15)接受CBT结合选定的运动计划,包括负重、平衡和有氧运动,而对照组(n = 15)仅进行选定的运动计划。所有参与者进行为期8周的干预,每周三次。使用定量脑电图(QEEG)在电极部位F3、F4、T5和T6测量皮质重组,并使用蒙特利尔认知评估(MoCA)和RehaCom评估认知功能,重点关注记忆、注意力、专注力、逻辑推理和反应行为。在为期8周的治疗计划前后对所有患者进行评估。

通过三项关键指标进行改善评估

QEEG、MoCA和RehaCom。干预后,研究组在F3、F4、T5和T6处的(α + β)/(δ + θ)比值显著更高(<0.01),表明皮质重组增强。研究组的MoCA评分提高了16.98%,而对照组提高了7.40%(<0.01)。此外,RehaCom评估显示研究组在记忆、注意力、逻辑推理和反应行为方面有显著改善(<0.01)。

将认知行为训练与选定的运动计划相结合可显著增强中风后患者的皮质重组和认知恢复。这些发现表明,在康复方案中加入CBT可以有效解决记忆和注意力方面的缺陷,最终改善功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e0d/12025195/0469e1c50fc0/brainsci-15-00330-g001.jpg

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