认知双任务训练对脑卒中后平衡能力的影响

发布时间：2018-01-06 11:30

本文关键词：认知双任务训练对脑卒中后平衡能力的影响　出处：《上海体育学院》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:通过在常规脑卒中后康复训练的基础上对患者进行认知双重任务的训练,目的在于分析认知双重任务对脑卒中平衡障碍患者平衡能力的影响,并尝试为脑卒中后平衡功能障碍患者提供安全有效的训练方法。研究方法:选取2016-2017年进入上海市华东医院康复科的脑卒中病人,选取诊断为具有平衡功能功能障碍的患者20名。随机分为两组,具体操作按照Excel软件随机函数生成的随机数列将患者分为实验组和对照组,每组均为10人。对照组采用常规的平衡训练,训练时间为每次30分钟,实验组在常规的平衡训练基础上加用认知双任务训练,训练时间每次30分钟。一周进行5次,两组均进行4周训练。训练前后测定实验对象基本生命体征;运用Berg量表评估跌倒风险;运用动静态平衡仪评测动静态平衡能力;运动认知连线测试评定认知反应功能。采用统计软件Spss19.0对数据进行统计分析,采用T检验对符合正态分布的计量资料进行检验。研究结果:1.训练前后实验组和对照组的患者基本生命体征指标脉搏、体温、呼吸、血压均在正常范围内,且前后比较均无显著性差异。2.在Berg量表得分训练前后比较中,对照组和实验组的Berg量表得分与训练前相比均有提高,其中实验组的训练前后差异具有高度显著性。3.在静态平衡综合指标中,实验组训练前后相比有提高,且差异具有高度显著性,对照组训练前后相比有提高,差异具有显著性。4.在重心极限测试中,实验组与对照组在训练后平均反应时间均缩短,提示患者的反应能力有所提高,其中实验组的差异具有高度显著性,对照组的差异具有显著性。在重心移动速度指标中,实验组经训练后,重心移动平均速度有所提高,且差异具有高度显著性,而对照组重心移动平均速度的提高没有显著性差异。在端点行程距离测试和最大偏移测试中,实验组与对照组的端点行程距离平均值均有所提高,其中实验组的差异具有高度显著性,对照组的差异具有显著性。实验组的最大偏移距离平均值有所提高,且差异具有显著性,对照组训练前后无明显改变。经过训练后脑卒中患者实验组方向控制能力有所提高,且差异具有显著性,脑卒中患者对照组训练后方向控制能力无明显改善。5.感觉统合测试的结果显示,实验组和对照组训练后感觉统合测试得分均有提高,实验组差异有高度显著性,对照组差异具有显著性。6.在认知注意力连线测试中,实验组训练后所用时间缩短,且差异具有高度显著性,且错误数有减少,差异具有高度显著性。对照组训练后与训练前相比所用时间与错误数的改变均无统计学差异。实验组与对照组相比,两者训练前错误数不具有统计学差异,训练后差异具有显著性。研究结论:1.认知双任务训练可以提高脑卒中后平衡功能障碍患者的平衡能力。2.认知双任务训练是训练脑卒中后平衡功能障碍的一种安全的方法。3.认知双任务训练可提高脑卒中病人认知执行的能力。
[Abstract]:Objective: through the basis of routine rehabilitation training in stroke patients on the cognitive tasks of training, in order to influence cognitive analysis of dual task of balance disorders in stroke patients with balance ability, and try to provide training for a safe and effective method for patients with balance dysfunction after stroke. Methods: Thirty stroke patients 2016-2017 in Shanghai city of East China Hospital, diagnosed with balance dysfunction selected 20 patients were randomly divided into two groups according to the random sequence specific operation Excel software random the patients were divided into experimental group and control group, each group had 10 people. The control group adopted routine balance training, training time for 30 minutes each time, in the experimental group on the basis of routine balance training combined with cognitive dual task training, the training time for 30 minutes each time. 5 times a week, two groups 4 weeks of training. The determination of the vital signs before and after the training; the use of Berg scale to assess the risk of falls; the use of static and dynamic balance testing instrument of static and dynamic balance ability; cognitive connection test to evaluate the cognitive reaction function. By using the statistical software Spss19.0 statistical analysis of data, using T test measurement data to conform to normal distribution of test. Results: basic vital signs of the patient's pulse, the experimental group and the control group 1. before and after training, body temperature, respiration, blood pressure were within the normal range, and the comparison showed no significant difference in.2. Berg scores before and after training, the control group and the experimental group Berg scores with before training is higher than the experimental group before and after the training, the difference is highly significant.3. in the comprehensive index of static balance in the experimental group before and after training compared with the increase, and the difference is highly Obviously, compared with the control group before and after training, the difference was significant.4. in the ultimate test, the experimental group and the control group were shortened after training the average reaction time, suggesting that the patient's ability to improve, the differences between the experimental group has significant difference, the control group was significant. In the center of gravity the moving speed index, the experimental group after training, center of gravity moving average speed increased, and the difference is highly significant, while the control group average speed of the center of gravity. No significant difference in endpoint distance test and maximum deviation test, endpoint distance of experimental group and control group mean values were the difference between the experimental group increased, with significant differences, the control group was significant. The maximum offset distance in the experimental group the average value has increased, and the difference is significant, control Before and after the training group had no obvious change. After training in stroke patients in experimental group, direction control ability has improved significantly, stroke patients in the control group after the training direction control ability significantly improved.5. sensory integration test results show that the experimental group and the control group after training in sensory integration test scores were improved significantly the difference of the experimental group, the control group with significant difference in cognitive.6. attention connection test, the experimental group after training in a shorter time, and the difference is highly significant, and reduce the number of errors, the difference is highly significant. Compared with the control group after the training before the training time and the number of errors change there was no significant difference compared with the control group. The experimental group, the number of errors before training was not statistically difference after training has significant difference. Conclusion: 1. cognitive dual task training Exercise can improve the balance ability of patients with post stroke balance dysfunction..2. cognitive dual task training is a safe way to train balance dysfunction after stroke..3. cognitive dual task training can improve the cognitive execution ability of stroke patients.

【学位授予单位】：上海体育学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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