The Observation Of Early Cognitive Training On Improving The Effect Of Rehabilitation Training After Cerebral Infarction

With the change of modern people’s life rhythm and diet structure,stroke incidence increasing rapidly.stroke is a highly disabling disease.The dysfunctions after stroke which make people have to pay attention.Improving the patient’s dysfunctions have become the nerve rehabilitation worker’s daily work.However,the recovery of cognitive impairment after stroke has been a key and difficult work in the process of rehabilitation training,and the long duration and the severe symptoms that make it become a bottleneck affecting the patient rehabilitation.The workers who commitment to nerve rehabilitation have been trying to find feasible measures to boost the improvement of cognitive impairment.Cognitive training on the improvement of limbs dysfunctions after stroke have become the focus in recent years.The research on the factors that influence the cognitive function after stroke has reached the level of cellular and molecular biology.It is worth mentioning that the level of homocysteine in the blood has been shown to be an independent risk factor for cognitive impairment and affects the recovery of cognitive function.Objective:To explore the efficacy of early cognitive training in patients with cognitive impairment after cerebral infarction.Methods:Sixty cases of patients with cerebral apoplexy combined cognitive impairment for the first time were divided into treatment group(including 30cases)and control group(including 30 cases)according to random number table method.The treatment group received cognitive training for 30 to 45 minutes per time,1 time per day,5 days per week.Besides routine drug treatment and rehabilitation training and the control group received the samedrug and regular training with treatment group except cognitive training.The Loewenstein occupational therapy cognitive asessment(LOTCA),Fugl-Meyer motor assessment(FMA),modified Barthel index(MBI)and Berg balance scale(BBS)served to assess the function of limbs and the ability of daily living.At the same time the homocysteine levels in plasma were tested for the two groups of patients before and at the point of the 4th week ending of training.And compared before and after treatment.Results:In terms of the LOTCA,before the intervention,the distribution of cognitive domains impairment of LOCTA in the treatment group and the control group was approximately the same as the non-parametric test.After 4weeks of treatment,the total scores of the treatment group is 69.23±17.92 which increased from 43.57±17.38 primitively and the total scores of the control group is 65.83±19.51 which increased from 44.83±16.69 primitively.In terms of the FMA,before the intervention,the score of the treatment group is 33.67±25.43.4 weeks later the score increase to 51.63±27.11.By contrast,the score of the control group is 38.13±24.80 which increased from27.30±23.29 initially.In terms of the MBI,before the intervention,the score of the treatment group is 37.60±21.33.4 weeks later,the score increase to 65.37±21.06.By contrast,the score of the control group is 53.07±23.95 which increased from34.53±24.39 initially.In terms of the BBS,before the intervention,the score of the treatment group is 11.57±11.54.4 weeks later,the score increase to 30.00±14.95,By contrast,the score of the control group is 20.50±14.05 which increased from8.80 ±8.79 initiallyIn terms of the Hcy in plasma,after 4 weeks of treatment,the levels of homocysteine in the treatment group is 10.38 ±2.67 umol/L which decreased from 18.40 ±6.34 umol/L primitively and the levels of homocysteine in the control group is 14.62±5.73 umol/L which decreased from 18.85 ±7.43 umol/L primitively.Before treatment,there was no significant distinction between the two groups according to all the assessments which serve the reserch(P>0.05).After 4 weeks of training,the LOCTA scores,FMA limbs function scores,MBI scores,BBS balance ability scores and the declineing of Hcy levels of both groups had obviously improved(P<0.05).The treatment group ameliorated significantly compared with control group in terms of the LOCTA scores,FMA limbs function scores,MBI scores,BBS balance ability scores and the declining of Hcy levels(P<0.05).In plasma Hcy levels drop degree and the LOCTA assess cognitive improvement degree has no obvious linear relationship.Conclusion:1 In this study,the improvement was significantly better in the treatment group than the control group in terms of the LOCTA score,FMA limb function score,MBI score,BBS score.Accordingly,the cognitive therapy amalgamated with conventional rehabilitation therapeutic methods can not only advance the recovery of cognitive impairment but also improve the limbs function and the activities of daily living of the patients’ dysfunction after cerebral infarction.2 In this study,Hcy levels in plasma declined obviously in treatment group than the control group after 4 weeks treatment.Therefore,the improvement of the cognition maight associated with plasma homocysteine levels.3 In this study,cognitive training therapy was conducted 30 to 45 minutes at a time,1 time per day,and 5 days per week.The result of this study testifies the valid of the measures we adopted in the process of research.4 In this study,we have not found obvious linear relationship between the cognitive improvement degree and the plasma homocysteine levels decline degree of the patients after stroke.In terms of the results,there are many factors that influence the decline of homocysteine in the blood,the experiment had a poor control for diets,genetic factors and other merger diseases.It remains to be standard experiments into a set of conditions then conduct multivariate linear analysis and finally get the results.It is essential to takeother effective and practical measures.