Effects Of Early Cognitive Rehabilitation Intervention For Patients With Cognitive Impairment After Traumatic Brain Injury

Objective:This study aimed to explore the the effectiveness of early cognitive rehabilitation intervention centered on patients,nurses and patients' families and rehabilitation therapists to participate on cognitive function,activities of daily living and functional independence for patients with cognitive impairment after traumatic brain injury(TBI).This study provides the theoretical basis for the implementation of intervention strategies.Methods:From 2015.12 to 2016.11,65 TBI patients from neurosurgery department of the second affiliated hospital of Knming Midical Uiversity were divided into two groups in accordance with the different ward area,such as the intervention group(n=32)and the control group(n=33).Both groups received usual neurosurgery department and rehabilitation department treatment,care,health education guidance and early routine training for the physical functions.Patients in the intervention group received an early cognitive rehabilitation intervention including the training of attention,memory,thinking,orientation and name.Which is carried by nurses,centered on patients,and patients' families and rehabilitation therapists to participate over a period of 12 weeks.Patients were investigated with the Montreal Cognitive Assessment(MoCA),Modified Barthel Index(MBI)and Functional independence measurement(FIM)at the begining of the sdudy,then at week 6 and week 12 for cognition function,activities of daily living and functional independence.Results:The analysis within group:(1)For the intervention group:the cognitive function,activities of daily living and functional independence at week 6 and 12 have improvement compared with pre-intervention.For the cognitive function,the activities of daily living and functional independence,there was statistically significant difference between pre and post-intervention(P<0.05).(2)For the control group:the cognitive function,activities of daily living and functional independence at week 6 and 12 have improvement compared with pre-intervention,there was statistically significant difference between pre and post-intervention by week 12(P<0.05),but there was no statistically significant difference between pre and post-intervention by week 6,post-intervention by week 6 and 12(P>0.05).The analysis between groups:(1)The study found no significant difference in the demography,relevant clinical manifestation and the scores of neuropsychological assessment scales(P>0.05).(2)On cognitive function:Post-intervention by week 6,the total scores and others are siginficatly improvement of intervention group were better than control group,and there was statistically significant diffirence between two groups(P<0.05),except the visual space and executive function,name,language and ion.Post-intervention by week 12,compared with control group,there were statistically significant diffirence on the total scores and others except the name(P<0.05).On activities of daily living:Post-intervention by week 6,the total scores and others are siginficatly improvement of intervention group were better than control group.There were statistically significant diffirence on the total scores,feed,personal hygiene,dress,walk or wheelchair(P<0.05),but there was no statistically significant diffirence on other aspects(P>0.05).Post-intervention by week 12,compared with control group,there were statistically significant diffirence on the total scores and others except the anus control and bladder control(P<0.05).On functional independence:Both post-intervention by week 6 and 12,the FIM total scores,somatic function and cognitive function scores of intervention group were better than control group,and there was statistically significant differences between two groups(P<0.05).Conclusion:The early cognitive rehabilitation intervention designed according to the patients'existing cognitive function,carried by nurses,centered on patients,patients' families and rehabilitation therapists to participate,including the training of attention,memory,thinking,orientation and name,is effective and easy to implement.Which is not only improves the patients' cognitive function,but also is beneficial to enhance their activities of daily living,functional independence and quality of life,which will help them be comprehensive rehabilitation and return to the family and society as soon as possible.At the same time,it is helpful to relieve the economic and mental burden from the patients' family and the society.