本文關(guān)鍵詞：認(rèn)知雙任務(wù)訓(xùn)練對(duì)腦卒中后平衡能力的影響　出處：《上海體育學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：研究目的:通過在常規(guī)腦卒中后康復(fù)訓(xùn)練的基礎(chǔ)上對(duì)患者進(jìn)行認(rèn)知雙重任務(wù)的訓(xùn)練,目的在于分析認(rèn)知雙重任務(wù)對(duì)腦卒中平衡障礙患者平衡能力的影響,并嘗試為腦卒中后平衡功能障礙患者提供安全有效的訓(xùn)練方法。研究方法:選取2016-2017年進(jìn)入上海市華東醫(yī)院康復(fù)科的腦卒中病人,選取診斷為具有平衡功能功能障礙的患者20名。隨機(jī)分為兩組,具體操作按照Excel軟件隨機(jī)函數(shù)生成的隨機(jī)數(shù)列將患者分為實(shí)驗(yàn)組和對(duì)照組,每組均為10人。對(duì)照組采用常規(guī)的平衡訓(xùn)練,訓(xùn)練時(shí)間為每次30分鐘,實(shí)驗(yàn)組在常規(guī)的平衡訓(xùn)練基礎(chǔ)上加用認(rèn)知雙任務(wù)訓(xùn)練,訓(xùn)練時(shí)間每次30分鐘。一周進(jìn)行5次,兩組均進(jìn)行4周訓(xùn)練。訓(xùn)練前后測(cè)定實(shí)驗(yàn)對(duì)象基本生命體征;運(yùn)用Berg量表評(píng)估跌倒風(fēng)險(xiǎn);運(yùn)用動(dòng)靜態(tài)平衡儀評(píng)測(cè)動(dòng)靜態(tài)平衡能力;運(yùn)動(dòng)認(rèn)知連線測(cè)試評(píng)定認(rèn)知反應(yīng)功能。采用統(tǒng)計(jì)軟件Spss19.0對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,采用T檢驗(yàn)對(duì)符合正態(tài)分布的計(jì)量資料進(jìn)行檢驗(yàn)。研究結(jié)果:1.訓(xùn)練前后實(shí)驗(yàn)組和對(duì)照組的患者基本生命體征指標(biāo)脈搏、體溫、呼吸、血壓均在正常范圍內(nèi),且前后比較均無顯著性差異。2.在Berg量表得分訓(xùn)練前后比較中,對(duì)照組和實(shí)驗(yàn)組的Berg量表得分與訓(xùn)練前相比均有提高,其中實(shí)驗(yàn)組的訓(xùn)練前后差異具有高度顯著性。3.在靜態(tài)平衡綜合指標(biāo)中,實(shí)驗(yàn)組訓(xùn)練前后相比有提高,且差異具有高度顯著性,對(duì)照組訓(xùn)練前后相比有提高,差異具有顯著性。4.在重心極限測(cè)試中,實(shí)驗(yàn)組與對(duì)照組在訓(xùn)練后平均反應(yīng)時(shí)間均縮短,提示患者的反應(yīng)能力有所提高,其中實(shí)驗(yàn)組的差異具有高度顯著性,對(duì)照組的差異具有顯著性。在重心移動(dòng)速度指標(biāo)中,實(shí)驗(yàn)組經(jīng)訓(xùn)練后,重心移動(dòng)平均速度有所提高,且差異具有高度顯著性,而對(duì)照組重心移動(dòng)平均速度的提高沒有顯著性差異。在端點(diǎn)行程距離測(cè)試和最大偏移測(cè)試中,實(shí)驗(yàn)組與對(duì)照組的端點(diǎn)行程距離平均值均有所提高,其中實(shí)驗(yàn)組的差異具有高度顯著性,對(duì)照組的差異具有顯著性。實(shí)驗(yàn)組的最大偏移距離平均值有所提高,且差異具有顯著性,對(duì)照組訓(xùn)練前后無明顯改變。經(jīng)過訓(xùn)練后腦卒中患者實(shí)驗(yàn)組方向控制能力有所提高,且差異具有顯著性,腦卒中患者對(duì)照組訓(xùn)練后方向控制能力無明顯改善。5.感覺統(tǒng)合測(cè)試的結(jié)果顯示,實(shí)驗(yàn)組和對(duì)照組訓(xùn)練后感覺統(tǒng)合測(cè)試得分均有提高,實(shí)驗(yàn)組差異有高度顯著性,對(duì)照組差異具有顯著性。6.在認(rèn)知注意力連線測(cè)試中,實(shí)驗(yàn)組訓(xùn)練后所用時(shí)間縮短,且差異具有高度顯著性,且錯(cuò)誤數(shù)有減少,差異具有高度顯著性。對(duì)照組訓(xùn)練后與訓(xùn)練前相比所用時(shí)間與錯(cuò)誤數(shù)的改變均無統(tǒng)計(jì)學(xué)差異。實(shí)驗(yàn)組與對(duì)照組相比,兩者訓(xùn)練前錯(cuò)誤數(shù)不具有統(tǒng)計(jì)學(xué)差異,訓(xùn)練后差異具有顯著性。研究結(jié)論:1.認(rèn)知雙任務(wù)訓(xùn)練可以提高腦卒中后平衡功能障礙患者的平衡能力。2.認(rèn)知雙任務(wù)訓(xùn)練是訓(xùn)練腦卒中后平衡功能障礙的一種安全的方法。3.認(rèn)知雙任務(wù)訓(xùn)練可提高腦卒中病人認(rèn)知執(zhí)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.

【學(xué)位授予單位】：上海體育學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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