洛文斯顿作业疗法用认知评定成套测验的应用研究

通过应用ＬＯＴＣＡ城套测验对健康人进行认知能力的评定,建立适用于我国ＬＯＴＣＡ评分标准。５４例健康成人,２５例脑血管病患者参加测验。评定分三个阶段进行。第一阶段健康人组受试者接受原版ＬＯＴＣＡ评定;第二阶段,对原版中某些检查内容做必要的修改后再进行测验;第三阶段,应用ＬＯＴＣＡ评定脑血管病患者。     

影响左侧偏瘫患者上肢功能预后的相关因素分析

目的探讨影响左侧偏瘫患者上肢功能和日常生活活动(ADL)能力等康复疗效的相关因子。方法对64例脑卒中左侧偏瘫患者进行常规康复训练1个月,治疗前采用简易智能状态检查表(MMSE)、洛文斯顿认知成套测验(LOTCA)、运动保持困难量表(MI)、Schenkenberg等分线段、Albert划线、字母删除试验等量表进行认知功能评测,并于治疗前和治疗后采用Brunnstrom运动功能分期、上田敏偏瘫手指功能评定表、偏瘫上肢能力评定表、改良Barthel指数(MBI)等量表,对患者进行肢体功能及ADL能力评分。应用多元逐步回归分析分析上述因素与上肢功能和ADL能力恢复程度之间的关系。结果患者上肢功能的恢复程度与训练前的LOTCA思维运作能力评分呈明显正相关(P<0.01);手指功能的恢复程度与训练前的MI呈明显负相关(P<0.01);手的实用性恢复程度与训练前的LOTCA的思维运作能力及ADL评分呈明显正相关(P<0.01);ADL的恢复程度与LOTCA的思维运作能力量表得分及病变部位呈明显正相关(P<0.01),与Schenkenberg等分线段量表得分呈明显负相关(P<0.01)。结论康复训练前的LOTCA思维运作能力、Schenkenberg等分线段量表、ADL、MI功能等评分,对卒中后左侧偏瘫患者上肢功能的预后有预测作用。     

并联无缝链接救护模式在优化救治颅脑外伤患者的价值分析

目的探讨并联无缝链接救护模式在优化救治颅脑外伤患者的价值。 方法选取哈尔滨医科大学附属第一医院神经外科自2016年1月至2017年12月接受治疗的94例颅脑外伤患者为研究对象，按随机数字表法将患者分为并联无缝链接救护模式组（观察组）和常规救护模式组（对照组），每组各47例。比较分析2组患者的救治时间、LOTCA评分、临床疗效等。 结果观察组的流程时间（就诊到影像学检查之间的时间、影像学检查到实施救治之间的时间、治疗时间）均显著短于对照组，差异具有统计学意义（P<0.05）。观察组的知觉与思维评分、治疗有效率明显高于对照组，差异均具有统计学意义（P<0.05）。 结论并联无缝链接救护模式救治时间短，工作效率高，值得推广。     

洛文斯顿作业疗法认知评定量表中文应用软件的研制

目的将洛文斯顿作业疗法认知评定量表（LOTCA）的操作和记分系统开发成计算机软件.方法将LOTCA人工操作和记分转换为计算机的工艺流程,通过整合Basic、C、C^＋＋语言与F1ash虚拟机等技术生成中文应用软件的初步版本,并应用于临床评定,收集反馈意见,对评定中发现的问题及信度与效度不满意的条目进行优化.结果生成了LOTCA中文应用软件,包括测试系统、记分分析系统、数据库管理系统、附属系统四个部分,含有普通话和粤语两种测试语言,可在Windows 2000及Windows XP两种系统下运行.结论洛文斯顿作业疗法认知评定中文应用软件客观、规范、便捷,适合在临床工作中使用.     

洛文斯顿认知评定量表评价糖尿病患者的早期认知功能损害

目的：探讨洛文斯顿认知评定量表（LOTCA）对于2型糖尿病老年患者早期认知功能损害评价的临床意义。方法：入选研究对象共80例,其简易精神状态检查（MMSE）总分≥24分,其中糖尿病患者为病例组,非糖尿病患者为对照组,每组40例,2组间的年龄、性别、受教育程度等人口学因素进行配对,采用LOTCA量表评价认知功能情况,对2组的MMSE总分、LOTCA总分及各项得分进行比较。结果：2组MMSE总分无差异。LOTCA总分、知觉及其子项目（不完整物体识别、空间知觉）、视运动组织及其各子项目、思维运作及其子项目（Riska有组织形状、图片排列A、B几何推理）及注意集中项目差异均有统计学意义。结论：糖尿病老年患者认知功能损害可能出现较早。与MMSE比较,LOTCA可更早识别其认知功能损害。     

Supporting the Loewenstein occupational therapy cognitive assessment using distributed user interfaces

Purpose: Improve the quantity and quality of information obtained from traditional Loewenstein Occupational Therapy Cognitive Assessment Battery systems to monitor the evolution of patients’ rehabilitation process as well as to compare different rehabilitation therapies. Methods: The system replaces traditional artefacts with virtual versions of them to take advantage of cutting edge interaction technology. The system is defined as a Distributed User Interface (DUI) supported by a display ecosystem, including mobile devices as well as multi-touch surfaces. Due to the heterogeneity of the devices involved in the system, the software technology is based on a client-server architecture using the Web as the software platform. Results: The system provides therapists with information that is not available (or it is very difficult to gather) using traditional technologies (i.e. response time measurements, object tracking, information storage and retrieval facilities, etc.). Conclusions: The use of DUIs allows therapists to gather information that is unavailable using traditional assessment methods as well as adapt the system to patients’ profile to increase the range of patients that are able to take this assessment.

• Implications for Rehabilitation

• Using a Distributed User Interface environment to carry out LOTCAs improves the quality of the information gathered during the rehabilitation assessment.

• This system captures physical data regarding patient’s interaction during the assessment to improve the rehabilitation process analysis.

• Allows professionals to adapt the assessment procedure to create different versions according to patients’ profile.

• Improves the availability of patients’ profile information to therapists to adapt the assessment procedure.

     

Effectiveness of an Occupational Therapy Home Programme in Spain for People Affected by Stroke

The main aim of this paper is to assess the effects of an occupational therapy home programme in Spain on 23 people who had had stroke (mean age 61.17 years). The programme was made up of a set of activities and techniques of physical, cognitive, social and functional nature aimed at preventing, maintaining and/or rehabilitating the abilities affected of people who had had stroke. A multiple‐baseline intrasubject design and replication with a treatment withdrawal period to check whether the effects of the programme remained was applied. The results show a significant statistical improvement, concerning not only the participants' cognitive skills through Loewenstein Occupational Therapy Cognitive Assessment Battery – Second Edition but also their functional independence as assessed by the Barthel Index. Despite the low number of participants, being one of the limitations of our study, the results support the need to carry out research about the effectiveness of rehabilitation treatments in the home with the goal to plan how public healthcare systems should tackle them and how to improve those already being used. Copyright © 2014 John Wiley & Sons, Ltd.     

针灸配合认知训练治疗颅脑外伤致认知障碍临床研究

目的观察针灸配合认知训练对颅脑外伤(TBI)致认知障碍的临床疗效。方法采用MINIMIZE分层软件将60例TBI患者随机分为对照组和治疗组。对照组予认知训练+常规治疗,治疗组予针灸+认知训练+常规治疗,疗程4周。采用简明精神状态量表(MMSE)、洛文斯顿认知功能评定测验(LOTCA)评定2组患者治疗前后的认知功能。结果有5例患者中途退出,最终对照组27例、治疗组28例完成治疗。治疗后,对照组和治疗组MMSE、LOTCA的总分及各子项目得分均较治疗前增加(P0.05),治疗组各项得分均高于对照组(P0.05)。结论针灸配合认知训练能提高MMSE和LOTCA得分,改善TBI所致的认知障碍,疗效优于单纯认知训练。     

洛文斯顿作业疗法认知评定中文量表信度和内在效度的初步研究

目的　测试洛文斯顿作业疗法认知评定 (LOTCA)量表 (第 2版 )中文译文的信度和内在效度。方法　将LOTCA(第 2版 )量表翻译成中文后 ,分别由 2名评定员根据其中文译文在 2周内对 3 4例脑外伤患者 (病例组 )和 64例无中枢神经系统疾病者 (对照组 )进行评定 ,对LOTCA量表中文译文的评定员一致性信度、重测信度、组内信度、内容效度和区分效度进行比较。结果　⑴绝大部分项目信度良好 (r >0 .8,P <0 .0 0 1)。⑵病例组的克朗巴哈α信度系数为 0 .977,对照组为 0 .873 ,病例组每个领域的克朗巴哈α信度系数均>0 .9。⑶病例组LOTCA量表内容效度较好 ,各项条目所在领域的相关性好 (r =0 .697～ 0 .975 ,P <0 .0 1)。⑷LOTCA量表具有较高的区分效度 (P <0 .0 0 1)。结论　对于我国脑外伤患者 ,LOTCA量表中大部分项目具有较高的信度和效度 ,适宜在国内临床工作中推广。     

综合康复治疗及认知护理干预对脑损伤后认知障碍的临床观察

目的 观察综合康复治疗及认知护理干预对脑损伤患者认知障碍的临床疗效.方法 将本科所收治的30例患者随机分为对照组、药物组和治疗组,各10例,分别采用相应方法最少治疗3个月,在治疗前后分别采用MMSE及LOTCA量表进行评分、统计学处理.结果 三组患者治疗后LOTCA及MMSE量表评分(P<0.01),治疗组LOTCA、MMSE量表患者均高于对照组及药物组(P<0.01或0.05).结论 综合康复治疗配合认知护理干预对脑损伤所致认知障碍有确切的疗效.