Relationship between the cognitive impairment in senile stroke patients and the restoration of activities of daily living

doi:10.3321/j.issn:1673-8225.2004.34.003

Abstract：BACKGROUND: One of the main problems of rehabilitative treatment of stroke is that the cognitive impairment disturbs the restoration of activities of daily life (ADL).OBJECTIVE: To explore the disturbance of cognitive impairment to the improvement of ADL in stroke patients.DESIGN: A non-randomized and controlled trial based on diagnosis.SETTING: The neurological department of Shaoxing People' s Hospital.PARTICIPANTS: A total of 40 hospitalized stroke patients in the neurological department of Shaoxing People' s Hospital were evaluated with concise mental state examination table within 3 days after stroke attack and were divided into two groups(normal and abnormal group), based on the evaluation results. In abnormal group were 20 patients(male 11, female 9)with cognitive impairment. In normal group were 20 patients(male 13, female 7) without cognitive impairment.METHODS: The patients in the two groups were frist evaluated and then treated respectively according to the treatment plans, which includes posture setting, daily punctual from passive gradually to active movement acoompanied with acupuncture, hyperbaric oxygen treatment and low-frequency circulation treatment. Evaluation was conducted regularly and the treatment plans were adjusted correspondingly to the evaluation results. The change and effect of ADL at the second week, third month and 6th month were recorded and compared. The comparison was conducted according to the clinical neurological deficit scale for stroke.MAIN OUTCOME MEASURES:①) The improvement of ADL in the two groups before and after the treatment. ② The result of therapeutic effect.RESULTS: The improvement of ADL between the two groups was also different ( P ＜ 0. 05). The total effective rate in the two groups was different,too(80% vs 15%, P ＜0.001).CONCLUSION: The cognitive impairment seriously affects senile stroke patient' s improvement in ADL. It is of great importance to evaluate the cognitive impairment and prescribe timely cognitive rehabilitation intervention for improving the social adjustment ability and the living quality of the patients as well as their prognosis.