| Objective: Post-stroke cognitive impairment(post-stroke cognitive impairment,PSCI)is a common complication after stroke.Patients often present with impairments of orientation,memory,computing power,executive ability,and language ability,which affect the daily communication ability and daily The ability to live reduces the quality of life of the patient and places a heavy burden on the patient and his family.In this study,exercise re-learning,mirror image therapy,and exercise re-learning combined with mirror image therapy were used to intervene in patients with PSCI.The improvement of motor function and cognitive function of PCSI patients was evaluated through a related scale.Correlation analysis,analysis and comparison of the advantages of sports re-learning and mirror image therapy,and provides data support for the use of sports re-learning combined with mirror image therapy for cognitive function rehabilitation of PSCI patients.Methods: Selected from July 2018 to February 2019 in 45 patients with PSCI in the Department of Occupational Therapy,Shaanxi Provincial Rehabilitation Hospital,randomly divided into three groups: exercise re-learning group(R),mirror therapy group(M),exercise re-learning combined with mirror therapy Group(R + M).On the basis of traditional rehabilitation,exercise re-learning intervention in group R,mirror treatment intervention in group M,exercise re-learning combined with mirror treatment intervention in group R + M,1 hour / time,5 times / week,a total of 8weeks.Before the intervention,4 weeks and 8 weeks,the MMSE scale,the modified Barthel index evaluation scale,the FIM scale and the Ueda sensitive scale were used to evaluate patients' cognitive function,daily life ability,functional independence and upper limb and hand motor function.Changes.Each scale test is operated by fixed personnel,and the test data results are statistically analyzed using SPSS 25.0.The descriptive statistics were used for counting data,the paired sample t test was used for group comparison before and after intervention,and repeated measurement analysis of variance was used for group comparison after intervention.The correlation between motor function and cognitive function after intervention was analyzed using Person correlation.P <0.05 indicates that the results are statistically significant.Results:(1)MMSE score Compared with before intervention,after 4 weeks of intervention,M group's language ability(P <0.05)and MMSE total score improved(P <0.05);R + M group all itemsexcept computing ability,scores were improved(P <0.01,P <0.05).Compared with before intervention,after 8 weeks of intervention,the scores of memory results in groups R and M decreased,and the scores of MMSE in group M increased(P <0.05);the scores of memory,language ability,and total MMSE scores in group R + M increased(P <0.01,P <0.05).After 4 weeks of intervention,the cognitive function of the three groups of patients all improved,but there was no significant difference.After 8 weeks of intervention,the memory and MMSE total scores of group M increased(P <0.05),and the memory and MMSE total scores of R + M group increased(P <0.05);compared with group M,R +The memory and MMSE total scores of group M were improved(P <0.05).(2)ADL scores Compared with before intervention,after 4 weeks of intervention,the scores of item bed-chair transfer and up and down stairs in group R increased(P <0.05);the total score of ADL in group M increased(P <0.05);the total score of ADL in group R + M increased(P <0.05).Compared with before intervention,after 8 weeks of intervention,the scores of bed-chair transfer,walking,up and down stairs and ADL total scores of group R items increased(P <0.05);M walking scores increased(P <0.05);items of group R + M Dressing,bed-chair transfer,and ADL total score improved(P <0.05).After 4 weeks of intervention,there was no significant difference in the scores of the items among the three groups(P> 0.05).After 8 weeks of intervention,compared with the M group,the total scores of dressing,toileting,and ADL in the R group were all improved(P <0.05),and the R + M group were improved in dressing,toileting,and walking(P <0.05).;Compared with the R + M group,the total score of bed-chair transfer,walking and ADL in the R group was improved(P <0.05).(3)FIM score Compared with before intervention,after 4 weeks of intervention,the scores of the FIM exercise and FIM total scores in the R group improved(P <0.01,P <0.05);the scores of the FIM items in the R + M group increased(P <0.05).After 8 weeks of intervention,the total score of FIM in group R and M tended to be stable;the scores of FIM items in group R + M increased(P <0.05).After 4 weeks of intervention,compared with the M group,the FIM exercise score of the R group increased(P <0.05);compared with the R + M group;the FIM exercise score of the R group increased(P <0.05).After 8 weeks of intervention,compared with the M group,the FIM exercise score of the R group was improved(P <0.05),and the FIM cognitive score and the total FIM score of the R + M group weresignificantly improved(P <0.05);The FIM exercise score of the + M group increased(P <0.05);compared with the R + M group,the exercise score of the R group increased(P <0.05).(4)Minami Ueda's upper limb and hand function scores Compared with before intervention,the upper limb and hand scores of Ueda Min in the R group increased after 4 weeks of intervention(P <0.05);the upper limb scores of the R + M group increased significantly(P <0.05).Compared with before intervention,after 8 weeks of intervention,the upper limb function of group R and group M was repeated,and the score of Ueda Toshiba in group R + M increased(P<0.05).Compared with 4 weeks after the intervention,the upper limb score of Ueda Min increased in the M group after 8 weeks of intervention(P <0.05).After 4 weeks of intervention,there was no statistically significant change in the scores of the Ueda Minka sports items in the three groups.After 8 weeks of intervention,the upper limb and hand function scores of Ueda Min in R group were improved compared with group M(P <0.05);the upper limb and hand function scores were increased in R + M group compared with M group(P <0.05).(5)Correlation analysis of motor function and cognitive function in group R and M After 4 weeks of intervention,only one ADL score in the R group was moderately correlated with the MMSE score(P <0.0,r = 0.678);there were 2 significant correlations between the motor function score and the cognitive function score in the M group,namely the ADL score It was highly correlated with MMSE score(P <0.01,r = 0.820),and FIM exercise score was moderately correlated with MMSE score(P<0.05,r = 0.655).This indicates that mirror therapy is more effective in improving cognitive function in patients with PSCI than in exercise and relearning.Conclusions:(1)Exercise re-learning combined with mirror image therapy can improve the cognitive function of PSCI patients in recovery period,and it is superior to exercise re-learning therapy or mirror image therapy in terms of orientation,memory,language ability,and retelling.(2)Exercise re-learning and mirror image therapy are effective in improving motor function,daily life ability and cognitive function of PSCI patients,respectively.(3)The 4-week intervention significantly improved cognitive function,and the effect tended to be stable after 8 weeks;however,the 4-week intervention PSCI patients' motor function improvement was not as obvious as the 8-week improvement,suggesting that the longer the motor relearning intervention period in the recovery period of stroke effective.(4)After the intervention of exercisere-learning and mirror image therapy for a period of time,the function of PSCI patients will appear to have decreased stress.The combined treatment of the two may balance the function of the cerebral cortex to a certain extent. |
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