| Background and ObjectiveRehabilitation medicine entered China in the early 1980 s and started late in our country,but with the continuous improvement of our economic system and the rapid development of social economy,as well as the continuous exploration and unremitting efforts of domestic experts,The development of rehabilitation medicine is advancing by leaps and bounds and maturing day by day.The methods of rehabilitation are gradually diversified.The state has made great efforts to promote the development of rehabilitation medicine in our country,our country has also made certain achievements in the aspects of talent training and the construction of talents ranks,our country has strengthened the popularization of social security and the popularization of the health literacy of the whole people.We will strengthen the construction of a rehabilitation service system.Brain injury is the main cause of disability all over the world and can cause permanent neurological dysfunction.Focal craniocerebral injury generally leads to swallowing disorders,motor disorders,cognitive disorders and language disorders,and so on.The prevalence rate is high in both developed and developing countries.With the rapid development of China’s economy,Accidents such as traffic accidents and high-altitude falls increase the incidence of craniocerebral injury.Nearly 43% of these patients have cognitive impairment in varying degrees,which seriously affects the quality of life of the patients and their families and prevent patients from reintegrating into society.Repetitive transcranial magnetic stimulation(repetitive transcranial magnetic stimulation,rTMS)is a new non-invasive neuroregulatory technique and can change the excitability of cortical and subcortical neurons and restore the cortical function of the stimulating region,thus improving cognitive impairment.Repetitive transcranial magnetic stimulation(rTMS)has been widely used in clinical trials as a post-stroke rehabilitation for ischemic stroke and has been shown to alleviate functional deficits after stroke.However,there are few reports on the treatment of sequelae after craniocerebral trauma.Cognitive function training is to improve the cognitive function of patients by systematically training their cognitive abilities,such as memory,computing,speech,visual spatial power,perceptual perception,attention,execution and so on.Computer-aided cognitive function training is the combination of traditional cognitive rehabilitation training and advanced computer technology to form a man-machine interactive one-to-one rehabilitation training model.This experiment combined repeated transcranial magnetic stimulation with computer cognitive function training to improve the cognitive function of the patients after craniocerebral injury,and compared with the single computer cognitive function training for the treatment of post-traumatic cognitive impairment.To observe the effection of repetitive transcranial magnetic stimulation combined with computer-assisted cognitive function training on cognitive impairment after craniocerebral injury,and to provide scientific basis for the treatment and evaluation of cognitive impairment after craniocerebral injury.Material and methodsFrom September 2016 to March 2018,60 patients with cognitive impairment after craniocerebral injury were selected as subjects.They were randomly divided into two groups,experimental group and control group,with 30 cases in each group.On the basis of routine support therapy,both groups were given computer-assisted cognitive rehabilitation training for 30 minutes a day and 5 days a week.The experimental group was treated with repeated transcranial magnetic stimulation.The stimulation site was the contralateral dorsolateral prefrontal lobe(90% static threshold(rest motor threshold,RMT),the stimulation frequency was 10 Hz,the stimulation time was 20 minutes,and the treatment time was 5 days a week,the stimulation frequency was 10 Hz,the stimulation time was 20 minutes,and the stimulation intensity was 90% once a day;Before treatment,at the end of one month,at the end of three months,It is using the MMSE,the MoCAt,the auditory word learning test-HuaShan version,Wechsler adult intelligence scale digit span test,Trail Making Test,and modified Barthel index to evaluate the recovery of cognitive function in patients.The data were analyzed by SPSS22.0 software.Results1.After 1 month of treatment and 3 months of treatment,The score of the MMSE,MoCA scale and the modified Barthel Index scale in the experimental group was higher than that of the control group,the difference was obvious significant(P < 0.05)..2.After one month and three months treatment,The scores of immediate memory,short delayed memory and recognition ability in the experimental group were evidently higher than those in the control group,and there was significant difference between the experimental group and the control group(P < 0.01).After 1 month treatment,there was no significant difference in long delayed memory scores between the experimental group and the control group(P > 0.05).After 3 months of treatment,there was significant difference between the experimental group and the control group in long-delayed memory score(P < 0.01).3.After one month and three months treatment,Compared with the control group,the numerical breadth test-cis-dorsum score in the experimental group was observably higher than that in the control group,and the difference was statistically significant(P < 0.01).There was no significant difference between the experimental group and the control group after one month’s treatment(P > 0.05).After 3 months of treatment,the digital breadth test-inverted score in the experimental group was significantly higher than that in the control group,and there was no significant difference between the experimental group and the control group(P > 0.05).The difference was statistically significant(P < 0.01).4.One month after treatment,there was no significant difference in the scores of the TMT between the experimental group and the control group(P > 0.05).After 3 months of treatment,the scores of the TMT in the experimental group were remarkably higher than those in the control group(P < 0.01),and there was a significant difference between the two groups(P < 0.01).ConclusionsAfter repeated transcranial magnetic stimulation combined with computer-assisted cognitive rehabilitation training,the patients with craniocerebral injury can effectively improve the memory,attention,execution and cognitive function of the patients after craniocerebral injury.It can improve the activity of daily life of patients. |
PDF Full Text Request