认知-运动双任务训练对脑卒中后注意力及记忆力的影响

目的：研究认知-运动双任务训练对脑卒中后认知障碍患者的注意力、记忆力及日常生活能力的影响。方法：采用计算机小程序将40例脑卒中患者分为DT组与ST组，每组各20例。观察组给予认知-运动双任务训练，对照组给予常规单任务康复训练。于入组时、治疗1周及2周时进行认知评估，包括MMSE、MoCA、DS、SDMT、TMT-A等量表以评估注意力与记忆力，BI评估日常生活能力。结果：治疗前2组患者的MMSE、MoCA、DS、SDMT、TMT-A及BI评分组间无统计学差异。治疗1周时，DT组所有量表的评分均优于治疗前（P＜0.05），且在MMSE、MoCA、DS及其各项分数中优于ST组（P＜0.05），而ST组仅在MMSE、MoCA、TMT-A及BI量表评分中优于治疗前（P＜0.05）；治疗2周时，2组患者所有量表的评分均优于治疗前（P＜0.05），且DT组在MMSE、MoCA、DS、SDMT、TMT-A中均优于ST组（P＜0.05）。2组患者的BI评分虽然在各时点均较治疗前增加且组内差异有统计学意义（P＜0.05），但组间差异无统计学意义。结论：认知-运动双任务训练较常规单任务康复训练能更好地改善脑卒中后认知障碍患者的注意力及记忆力，对日常生活能力的改善效果较常规单任务康复训练未显示出明显优势。

Effects of cognitive-motor dual-task training on attention and memory after stroke

Objective: To study the effects of cognitive-motor dual-task (DT) training on attention, memory and activities of daily living in patients with cognitive impairment after stroke. Methods: Totally, 40 stroke patients were divided into experimental group (DT) and control group (single task, ST) (n=20 in each group). DT group was given cognitive-motor dual-task training, and ST group was given routine single-task rehabilitation training. Cognitive assessment including MMSE, MoCA, DS, SDMT and TMT-A was performed at the time of enrollment, 1st week and 2nd week after treatment to assess attention and memory, and Barthel Index was used to assess the ability of daily living. Results: There was no significant difference in MMSE, MoCA, DS, SDMT, TMT-A and BI between the two groups before treatments. After one week of treatments, the scores of all scales in DT group were better than those before treatments (P<0.05), and MMSE, MoCA, DS scores and other scores in SD group were better than in ST group (P<0.05). The scores of MMSE, MoCA, TMT-A and BI scales in ST group were better than those before treatment (P<0.05). After two weeks of treatments, the scores of all scales in the two groups were better than those before treatments (P<0.05), and those of MMSE, MoCA, DS, SDMT and TMT-A in DT group were better than in ST group (P<0.05). Although the BI scores patients in the two groups increased at each time point after treatment as compared with those before treatments and there was a significant difference within the group (P<0.05), there was no significant difference between the groups. Conclusion: Cognitive-motor dual-task training can improve the attention and memory of patients with cognitive impairment after stroke better than conventional single-task rehabilitation training, but there was no obvious difference between the two groups in improving the ability of daily living.