认知功能障碍对偏瘫康复的影响

目的探讨认知功能障碍对脑卒中偏瘫康复的影响。方法对 66例脑卒中偏瘫患者于康复治疗前后采用洛文斯顿作业疗法用认知评定成套测验进行认知功能筛查 ,并进行简式Fugl Meyer运动功能评定 (FMA)和功能独立性评定 (FIM )。 结果存在认知功能障碍患者的运动功能和功能独立性康复明显滞后于认知功能正常患者 ,认知功能障碍与脑卒中偏瘫康复有密切关系。结论认知功能障碍直接影响脑卒中偏瘫康复 ,应采用针对性和综合性治疗方法 ,改善患者的认知功能 ,以减少对康复的影响     

认知康复对精神分裂症认知功能影响的研究

目的:探讨认知康复对精神分裂症认知功能的影响。方法:对象取自无锡市精神卫生中心住院精神分裂症患者100例。随机分配到个别认知康复组(个别康复)33例、集体认知康复组(集体康复)33例和单独服用抗精神病药物组(对照组)34例。认知康复的主要内容是认知重建技术和社会技能训练。每周治疗3次,每次60min,6个月为1疗程。应用韦氏成人智力量表(WAIS)和威斯康星卡片分类测验(WCST)评定治疗前后的认知功能。结果:100例患者均完成治疗,三组患者康复训练前后的WAIS、WCST均无显著差异。但康复训练后个别康复、集体康复的WAIS总分、作业增分的差值显著高于对照组(P=0.034、P=0.039),集体康复的言语分差值显著高于对照组(P=0.040)。WCST操作显示接受认知康复的患者其执行功能的改善优于对照组(P<0.05—0.01)。但个别康复和集体康复之间差异无显著性。结论:接受认知康复的精神分裂症患者在认知功能改善方面优于仅服用抗精神病药物的患者。     

首届语言认知与失语症新进展学习班通知

国际上失语症治疗与研究已经发生了日新月异的变化,为了提高广大临床医师和康复治疗师对语言加工机制的认识和失语症的评价、治疗及科研水平,中国医师协会康复医师分会、中国康复医学会康复治疗专业委员会(言语治疗学组)、首都医科大学宣武医院将于2012年9月8—10日在北京举办"首届语言认知与失语症新进展学习班"。本学习班将重点介绍国际先进的语言认知加工理论、失语症评价与治疗新理念、新技术、新进展。届时将邀请北京师范大学认知神经科学与学习国家重点实     

第十届全国认知障碍诊断与康复治疗技术学习班报名通知

<正>中国残疾人康复协会康复技术专业委员会与中国康复研究中心康复评定科将于2016年8月1~5日在北京联合举办第10届全国认知障碍诊断与康复治疗技术学习班。教学内容:认知损伤及康复相关理论;脑卒中、脑外伤、脑瘫以及老年性痴呆认知障碍的临床表现特点;注意、记忆、计算、执行功能以及知觉障碍相关的实用、可操作的评定技术、诊断以及康复治疗技术。学习班期间还将介绍当前认知康复领域新进展,特别是远程认知康复方面的研究成果和临床应用。学习班将举办多个     

认知神经心理康复——脑机能康复的新方向（待续）

近年来，在脑机能康复研究中出现了一个新的方向——认知神经心理康复．同作业治疗和言语治疗中的许多康复手段相比，神经心理康复的历史是比较短的，但它却因理论上的突出而引起人们的普遍关注。然而其临床价值和康复效益却只有当认知手段被采用到临床井与个案的方法紧密结合之后才得以充分表现出来。传统神经心理康复与认知神经心理康复之间的主要区别在于后更侧重于患的认知缺陷的详细分析。     

康复治疗专业技术人才准入标准

一、概述康复治疗师是在康复医疗机构工作、为患者进行康复治疗的专业技术人员一康复治疗师的主要职责是在综合的康复治疗中，为患者进行物理治疗和作业治疗，促进其康复。主要任务为使用身体运动和各种物理因子(电、光、热、冷、水、磁、力等)作为治疗手段，进行神经肌肉和骨关节运动功能的评估与治疗训练以及减轻疼痛；又用日常生活活动训练、手工艺治疗、认知训练等作业治疗手段对患者进行手细致功能、认知功能、家居及社会生活能力等的评估和治疗训练，促进身心康复，重返社会，改善生活质量。     

早期护理干预对腔隙性脑梗死患者认知功能康复认知及依从性的影响

目的 探讨早期护理干预对腔隙性脑梗死患者认知功能障碍康复认知及依从性的影响.方法 选择61例初次发病的腔隙性脑梗死住院患者,使用中文版蒙特利尔认知评估(MoCA)量表进行认知功能障碍评分,将评分＜26分的患者随机分为实验组和对照组,对照组(31例)给予常规的认知康复护理,实验组(30例)在常规的康复护理基础上实施早期护理干预3个月,即根据患者情况制定个体化认知功能康复训练以及手指操训练,在干预前、后两组进行认知康复治疗的认知情况比较,在干预1,2,3个月后对两组进行认知功能康复治疗的依从性进行调查.结果 护理干预前,两组的认知功能康复认知状况分别得分(4.8±0.68)和(4.8±0.54),差异无统计学意义(P＞0.05),干预后2周实验组和对照组的认知功能康复认知状况得分分别为(15.7±2.65),(11.5 ±1.87)分,差异有统计学意义(t=7.088,P＜0.01);经护理干预3个月后,实验组的认知功能康复治疗的依从性在1,2,3个月均显著高于对照组,差异均有统计学意义(P＜0.05).结论 对腔隙性脑梗死认知功能障碍的患者进行早期护理干预可以显著提高认知功能康复治疗的依从性.     

中国康复医学会2004年学会继续教育活动计划预告

活动名称主要内容肌电图与电诊断技术研讨班全国语言与认知功能障碍康复研讨班康复治疗新技术讲习班康复医学进展高级研讨班实用康复医学培训班肌电图与电诊断技术在康复评定中的作用及国内外进展语言与认知功能障碍的评定与康复治疗新技术进展国内外康复治疗新技术进展康复医学基础理论研究、现代康复评定与康复治疗技术新进展康复医学基础理论、康复功能评定方法和实用康复治疗技术tbyan@hotmail.comkanghe@263.netnchm@sohu.comjarm@public1.ptt.js.cn时间规模(人)地点联系人电话E-mail2月5月5月8月9月广州北京黄山哈尔滨南京燕铁斌祝朝…     

电脑辅助及远程认知康复的发展与应用

颅脑损伤患者通常存在自我照顾及社区生活技能方面的行为障碍问题 ,这些问题主要是由患者的认知及情感障碍等所造成 ,需要对其进行长期的认知康复治疗。在香港 ,认知康复治疗目前还是一个崭新的领域[1] ,其应用前景十分广阔 ,但同时也面临着许多新的问题及挑战。本文拟就国外及香港地区关于电脑辅助认知康复及远程认知康复的基本情况略作一介绍 ,为国内有志于此方面研究的同道们抛砖引玉。认知康复的理论与实践认知康复的理论主要来源于神经心理学、认知心理学、教育心理学及康复医学等学科。过去人们一直认为患者发生颅脑损伤后其行为障碍…     

认知康复的新领域--认知神经心理康复

认知功能属于大脑皮质高级活动范畴，它包括感觉、知觉、注意、记忆、理解和智能等。认知康复(cognitive rehabilitation,CR)是“发展脑损伤病人的认知能力，以克服知觉、记忆和语言障碍的一种康复治疗方法”(Giarutsos 1986)。随着临床神经心理学的发展，认知康复主要运用了神经心理学的研究成果，对认知障碍患者进行评测与训练，故而也称为神经心理康复(neuropsychology rehabilitation)。     

Memory training and multiple sclerosis: A case study

Multiple sclerosis (MS) is a progressive neurological disorder often accompanied by significant cognitive deficits. Some research suggests that recent memory is the most commonly affected cognitive ability in MS. However, there is only one empirical investigation examining the efficacy of cognitive rehabilitation in individuals with MS. We report the application of a memory training program to remediate memory deficits in a patient with MS. The program focused on teaching mnemonic strategies to increase list learning ability and ability to recall names of faces. Results suggested that memory training improved visual and verbal memory abilities. The most marked improvement was present on tests assessing verbal memory abilities. These results contribute to a growing body of literature indicating that teaching mnemonic strategies is one method of improving memory functioning in individuals with mild to moderate memory impairment.     

Marked improvement of neuropsychological impairment in a patient with chronic obstructive pulmonary disease after lung volume reduction surgery

This paper reports a case of a 71-year-old pulmonary emphysema patient with neuropsychological impairments that were markedly improved 6 months after he underwent lung volume reduction surgery (LVRS). He also underwent pulmonary rehabilitation before and after surgery. He was suspected of having memory impairment and attention disorder when he was referred for rehabilitation. The neuropsychologic test showed a general cognitive impairment, attention disorder, and verbal memory impairment. Magnetic resonance imaging showed moderate atrophy of the left hippocampal area, cortex, and lacunae infarction in the periventricular area. Interestingly, scores of the neuropsychologic test, as well as severity of dyspnea and lung function, remarkably improved 6 months after LVRS. These results suggested that the neuropsychological impairments in pulmonary emphysema patients can be improved after lung reduction surgery.     

记忆障碍康复训练的疗效研究

目的 研究记忆障碍康复训练的疗效,比较不同训练模式的疗效及优缺点,对可能影响疗效的因素进行分析.方法 将全国12家综合医院和专业康复机构144例记忆障碍患者分为仪器训练组、人工训练组和对照组.仪器和人工训练组患者进行以记忆为主的认知康复训练,1次/d,30min次,分别治疗6周和12周;对照组不参加训练.对训练前后的瞬时、短时和长时记忆进 行评定;比较仪器训练组、人工训练组及对照组训练前后组内及组间成绩;并对性别、年龄、受教育年限、病程、损伤部位及昏迷时间对疗效的影响进行分析.结果 仪器训练组及人工训练组6周、12周成绩均较初评显著提高(P＜0.001),并均明显高于对照组(P＜0.01);仪器训练组成绩明显高于人工训练组(P＜0.01);年龄与疗效呈负相关.结论 记忆障碍康复的疗效显著;12周的康复训练可使患者的记忆功能显著提高;采用认知康复专业仪器进行认知训练模式的疗效明显优于人工训练模式,应予以普及推广.     

帕金森病的认知障碍及康复治疗

帕金森病是一个运动系统的疾病 ,但也有认知功能的障碍 ,研究发现帕金森病患者的认知障碍主要表现为 :言语流畅性障碍、视空间障碍、额叶功能记忆障碍、智能障碍等。其中最引起人们关注和最引起病人丧失生活能力的是智能障碍 ,即痴呆。病人的认知功能障碍尤其是痴呆对其生活造成了极大的影响 ,因此有必要对帕金森病患者的认知障碍进行康复治疗。本文在总结了国内外的文献的基础上 ,对帕金森病的认知障碍及其康复治疗做一简单综述     

Integrative group-based cognitive rehabilitation efficacy in multiple sclerosis: a randomized clinical trial

Purpose: This study aimed to determine the efficacy of the integrative group-based cognitive rehabilitation programme, REHACOP, on improving cognitive functions in multiple sclerosis (MS).

Methods: Fourty-two MS patients were randomized to the treatment programme REHACOP (n?=?21) or waiting list control condition (n?=?21). The REHACOP group received cognitive rehabilitation in group format for three months focused on attention, processing speed, learning and memory, language, executive functioning, and social cognition. Patients completed a neuropsychological assessment at baseline and follow-up, which included tests of attention, processing speed, working memory, verbal memory, verbal fluency, and executive functioning. Repeated measures multivariate analysis of covariance (MANCOVA) was used to determine the efficacy of the cognitive rehabilitation programme.

Results: Group?×?Time interactions revealed significant improvements in the REHACOP group as compared with the control group for processing speed (p?=?0.011, n_p²?=?0.16), working memory (p?=?0.014, n_p²?=?0.15), verbal memory (p?=?0.025, n_p²?=?0.13), and executive functioning (p?=?0.024, n_p²?=?0.13), showing medium–large effect sizes.

Conclusions: Patients receiving REHACOP showed improvements in several cognitive domains. This preliminary study thus provides evidence supporting the efficacy of this integrative group-based cognitive rehabilitation intervention in MS. Future research should confirm these findings, examine the impact of the treatment on everyday life functioning and explore the presence of brain changes associated with cognitive rehabilitation.

• Implications for rehabilitation

• This study provides initial evidence for integrative group-based cognitive rehabilitation efficacy in MS patients through the implementation of the REHACOP cognitive rehabilitation programme.

• Patients received cognitive rehabilitation for three months (3 one-hour-sessions per week) focused on training attention, learning and memory, language, executive functioning, and social cognition.

• Patients attending REHACOP sessions showed medium to large and statistically significant improvements in processing speed, working memory, verbal memory, and executive functioning.

     

The effects of cognitive rehabilitation on Alzheimer’s dementia patients’ cognitive assessment reference diagnosis system performance based on level of cognitive functioning

[Purpose] The purpose of this study is to apply cognitive rehabilitation according to Alzheimer’s disease (AD) patients’ level of cognitive functioning to compare changes in Cognitive Assessment Reference Diagnosis System performance and present standards for effective intervention. [Subjects] Subjects were 30 inpatients diagnosed with AD. Subjects were grouped by Clinical Dementia Rating (CDR) class (CDR-0.5, CDR-1, or CDR-2, n = 10 per group), which is based on level of cognitive functioning, and cognitive rehabilitation was applied for 50 minutes per day, five days per week, for four weeks. [Methods] After cognitive rehabilitation intervention, CARDS tests were conducted to evaluate memory. [Results] Bonferroni tests comparing the three groups revealed that the CDR-0.5 and CDR-1 groups showed significant increases in Delayed 10 word-list, Delayed 10 object-list, Recognition 10 object, and Recent memory performance compared to the CDR-2 group. In addition, the CDR-0.5 group showed significant decreases in Recognition 10 word performance compared to the CDR-1 group. [Conclusion] Cognitive rehabilitation, CDR-0.5 or CDR-1 subjects showed significantly greater memory improvements than CDR-2 subjects. Moreover, was not effective for CDR-2 subjects.Key words: Alzheimer’s, Cognitive rehabilitation, Clinical dementia rating     

Neurocognitive enhancement therapy with work therapy: Productivity outcomes at 6- and 12-month follow-ups

Neurocognitive enhancement therapy (NET), which involves computerized cognitive training and other methods, has been shown to improve working memory and executive function in schizophrenia. In the present study, 145 outpatients with diagnoses of schizophrenia or schizoaffective disorder recruited from a Department of Veterans Affairs mental hygiene clinic and from a community mental health center were ran domized to 6 months of paid work therapy (WT) or to NET+WT. Mixed random effects analyses revealed significant increase in hours worked and money earned over time for both conditions (p < 0.0001). NET+WT worked more hours than WT (p < 0.03), with differences emerging after rehabilitation. Responders to NET+WT worked the most during follow-up and tended to have more competitive-wage employment. Results indicate that work outcomes were enhanced by NET training. Effects were greatest for NET responders. Findings support the efficacy of cognitive training when it is integrated into broader rehabilitation programs.     

记忆障碍的康复

记忆障碍是脑外伤、脑卒中、老年性痴呆等患者最普遍的认知功能损害。目前国内外学者采用不同方法针对脑损伤患者的记忆障碍进行康复训练,取得了一定的进展。本文对近年有关记忆障碍康复的方法及疗效做一综述,初步探讨最佳的康复治疗方案。     

Helping brain-injured people to contend with hidden cognitive deficits

In brain injury, cognitive processes are often impaired. These impairments may be hidden, complicating rehabilitation. We discuss clinical issues in cognitive rehabilitation with particular emphasis on its implications for daily living. For illustration we present two cases of persons with severe, but isolated disorders of memory and visual perception, respectively.     

Identification and Management of Cognitive and Perceptual Deficits in the Rehabilitation Patient

The rehabilitation nurse frequently encounters patients who display cognitive/perceptual impairments as a result of a head injury or cerebrovascular accident. Deficits in attention, perception, memory, sequencing, and initiation may prevent the patient from reaching goals set by nurses or other rehabilitation professionals. When nurses recognize cognitive or perceptual impairments and have techniques available that will compensate for such deficits, they can more readily help patients meet rehabilitation goals.