体感互动游戏在卒中后认知障碍患者认知康复中的应用
文献类型：学位论文
| 作者 | 王昳晨 |
| 答辩日期 | 2023-12 |
| 文献子类 | 继续教育硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 陈天勇 |
| 关键词 | 体感互动游戏 卒中后认知障碍 认知功能 主观幸福感 生活质量 |
| 学位名称 | 理学硕士 |
| 学位专业 | 发展与教育心理学 |
| 其他题名 | Application of somatosensory interactive games in the cognitive rehabilitation of patients with post-stroke cognitive impairment |
| 中文摘要 | Objective: The incidence rate of stroke in China is increasing year by year, which causes heavy burden for individuals, families and society. In clinical practice, post stroke cognitive impairment (PSCI) is a common complication of stroke. Despite the increasing development of medical technology and the progress of post stroke rehabilitation treatment for stroke patients, the attention paid to limb rehabilitation training in the past was significantly higher than that of cognitive rehabilitation. With the transformation of medical models, intervention treatment for PSCI is gradually being paid attention to by clinical physicians, patients, and their families. Somatosensory interactive games break through the traditional operation mode of simply inputting buttons through the controller, and are a new type of electronic game that operates through changes in body movements. Previous studies have shown that somatosensory interactive games can promote the rehabilitation treatment of various functions such as limb strength, balance function, and cognition in stroke patients. However, somatosensory interactive games are still in its early stages in the field of cognitive function in PSCI patients. Therefore, this study aims to investigate the impact of somatosensory interactive games on cognitive function recovery in patients with PSCI. Methods: In this study, a randomized controlled trial ( RCT ) was used to select 126 patients with PSCI admitted to the rehabilitation department of a hospital in Beijing from June 2021 to June 2022 as the study subjects. According to the grouping time, they were divided into the somatosensory interactive game group and the conventional treatment group, 63 cases each. Both groups received routine medical treatment and rehabilitation intervention, on the basis of which the conventional treatment group adopted routine cognitive rehabilitation training, and the somatosensory interactive games group adopted somatosensory interactive games on the basis of the conventional treatment group and both were intervened for 4 weeks. The two groups were observed and compared before and after the intervention, Cognitive function was evaluated by Mini-Mental State Examination ( MMSE ) and Montreal Cognitive Assessment ( MoCA ). Neurological function was evaluated by the National Institutes of Health Stroke Scale ( NIHSS ). Barthel index scale ( BI ) was used to evaluate and compare the ability of daily living. The subjective well-being was evaluated by the Memorial University of Newfoundland Happiness Scale ( MUNSH ). The quality of life was evaluated by stroke impact scale ( SIS ). at the same time, after the intervention, the self-made treatment attitude questionnaire was used to evaluate and compare the attitude scores of the two groups of patients after the intervention. Results: After 4 weeks of intervention, compared with the conventional treatment group: (1)Somatosensory interactive games can improve the cognitive function of PSCI patients. The MMSE score and MoCA score of PSCI patients in the somatosensory interactive game group increased more significantly (p <0.05)； (2)Somatosensory interactive games can improve the neurological function of PSCI patients. The NIHSS score of PSCI patients in the somatosensory interactive game group decreased more significantly (p <0.05)； (3)Somatosensory interactive games can improve the daily living ability of PSCI patients. The BI score of PSCI patients in the somatosensory interactive game group increased more significantly (p <0.05)； (4)Somatosensory interactive games can improve the subjective well-being of PSCI patients. The MUNSH score of PSCI patients in the somatosensory interactive game group increased more significantly (p <0.05)； (5)Somatosensory interactive can improve the quality of life of PSCI patients. The SIS score of PSCI patients in the somatosensory interactive game group increased more significantly (p <0.05)； (6)Somatosensory interactive games can improve the attitude of PSCI patients to treatment. The somatosensory interactive game group scored higher on the attitude of treatment during rehabilitation training (p <0.05). Conclusion: Stroke is one of the diseases that seriously harm human health. The incidence of cognitive impairment after stroke is high, which has a serious impact on patients and their families. At present, cognitive rehabilitation treatment is limited, and the improvement of treatment outcomes is of great significance in clinical treatment. Post-stroke neurological impairment mainly includes limb dysfunction, cognitive dysfunction, speech dysfunction, etc., which will hinder the play of patients' daily functional activities and social roles, and reduce the quality of life and subjective well-being. Somatosensory interactive games can improve the neural function of PSCI patients, and then have an obvious recovery effect on cognitive function. At the same time, it can improve the daily life ability, subjective well-being and quality of life of PSCI patients, and the improvement of all aspects further enhance the subjective well-being. Furthermore, somatosensory interactive games improved the attitudes of PSCI patients towards treatment, which in turn increased compliance during treatment.It provides new ideas for the treatment of cognitive impairment after stroke. |
| 英文摘要 | 目的：我国脑卒中发病率逐年上涨，造成患者个人、家庭、社会较重负担。卒中后认知障碍（post-stroke cognitive impairment，PSCI）为脑卒中常见并发症。 虽然医疗技术日益发展，脑卒中患者后期康复治疗技术日趋进步，但以往肢体康复训练关注度明显高于认知康复，随着现在医学模式转变，对于 PSCI 干预治疗逐渐走入大众视野，被临床医师、患者及家属关注。体感互动游戏，突破了以往电子游戏设备设定，单纯依靠手柄操纵或按键输入操作方式，是一种通过捕捉肢体动作变化，将其转换为信号进行（操作）的新型电子游戏。已有研究表明，体感互动游戏可促进脑卒中患者肢体力量、平衡功能、认知等多种功能康复治疗， 但体感互动游戏对于 PSCI 患者认知功能领域尚处于起步阶段。因此，本研究旨在考察体感互动游戏如何影响 PSCI 患者认知功能恢复。 方法：本研究采用随机对照实验（randomized controlled trial, RCT），选取 2021年6月～2022年6月北京某医院康复科收治的126例PSCI患者为研究对象， 按照入组时间，分为体感互动游戏组、常规治疗组，各 63 例。2 组均予以常规内科治疗与康复干预，此基础上常规治疗组采取常规认知康复训练，体感游戏组在常规治疗组基础上采取体感互动游戏，均干预 4 周。2 组干预前后认知功能应 用简易智力状态检查量表（mini mental status examination, MMSE）、蒙特利尔认知评估量表（Montreal Cognitive Assessment Scale, MoCA）评价比较；神经功能应用美国国立卫生研究院卒中量表（ National Institutes of Health Stroke Scale ,NIHSS）评价比较；日常生活能力应用 Barthel 指数量表（Barthel index ,BI）评价比较；主观幸福感应用纽芬兰纪念大学幸福度量表（Memorial University of Newfoundland Scale of Happiness ,MUNSH）评价比较；生活质量应用脑卒中影响量表（Stroke Impact Scale ,SIS）评价比较；同时，干预后应用自制治疗态度问卷评价比较两组患者干预后对治疗的态度评分。 结果：体感互动游戏干预治疗 4 周，与常规组相比： （1）体感互动游戏可改善 PSCI 患者认知功能，其 MMSE 评分、MoCA 评分提高更显著（P＜0.05）； （2）体感互动游戏可改善 PSCI 患者神经功能，其 NIHSS 评分降低更明显 （P＜0.05）； （3）体感互动游戏可改善 PSCI 患者日常生活能力，其 BI 评分提高更显著 （P＜0.05）； （4）体感互动游戏可改善 PSCI 患者主观幸福感，其 MUNSH 评分提高更显著（P＜0.05）； （5）体感互动游戏可改善 PSCI 患者生活质量，其 SIS 评分提高更显著（P ＜0.05）； （6）体感互动游戏可改善 PSCI 患者对治疗的态度，在康复训练过程中其治 疗的度评分更高（P＜0.05）。 结论：脑卒中是严重危害人类健康的疾病之一，卒中后认知障碍发病率高，对于患者及家属具有严重的影响，目前认知康复治疗手段有限，治疗结局的改善在临床治疗中具有重要意义。卒中后神经功能损伤主要包括肢体功能障碍、认知功能障碍、言语功能障碍等，而这些方面将会阻碍患者日常功能活动和社会角色的扮演，降低生活质量及主观幸福感。体感互动游戏的应用可以改善 PSCI 患者的神经功能，进而对于认知功能的恢复效果明显，同时，提升了 PSCI 患者日常生活能力及生活质量，各方面的改善也进一步的提升了主观幸福感。此外，体感互动游戏改善了 PSCI 患者对于治疗的态度，进而提高了治疗过程中的依从性。为卒中后认知障碍的治疗提供了新的思路。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/48209]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 王昳晨. 体感互动游戏在卒中后认知障碍患者认知康复中的应用[D]. 中国科学院心理研究所. 中国科学院大学. 2023. |
入库方式： OAI收割
来源：心理研究所
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