Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
Chinese Journal of Alzheimer's Disease and Related Disorders >
Progress in rehabilitation treatment of mild cognitive impairment
Received date: 2020-02-29
Revised date: 2020-03-08
Online published: 2020-06-25
Mild cognitive impairment (MCI) is a relatively high incidence of senile disease at present, its significant symptom is memory impairment. MCI is closely related to the occurrence of Alzheimer's disease (AD), early identification of MCI is beneficial to early prevention of AD. Therefore, accurate and convenient screening methods and effective methods of rehabilitation treatment have become the focus of research in the field of geriatric cognition at home and abroad. Based on the characteristics of cognitive impairment in the elderly, the diagnosis and methods of rehabilitation intervention at home and abroad in recent years are respectively elaborated in the paper, in order to improve the accuracy and practicability of MCI diagnosis and treatment, it is expected to find effective methods to prevent and alleviate the further development of the disease to AD, so as to provide reference for clinical rehabilitation treatment and further rehabilitation research.
ZHAO Jinxuan , SHA Rui , MI Tianhao , WANG Hong . Progress in rehabilitation treatment of mild cognitive impairment[J]. Chinese Journal of Alzheimer's Disease and Related Disorders, 2020 , 3(2) : 147 -153 . DOI: 10.3969/j.issn.2096-5516.2020.02.011
表1 认知功能训练的常用方法及效果 |
认知训练法 Cognitive training | 研究 Researchers | 患者年龄段(岁) Age of patient (year) | 样本量(名) The number of patient (number) | 认知训练方式 Ways to train cognition | 训练方向 Aspects of training | 治疗频率 Frequency of treatment | 干预效果 Effect of intervention |
---|---|---|---|---|---|---|---|
认知康复训练 Cognitive rehabilitation training | 任杰俞[27] Ren J Y[27] | 实验组:44~68.5 对照组:45~70 Experimental group: 44~68.5 Control group: 45~70 | 88 | 指导患者对图片、短文、数字、词语等的记忆、重复等 Instruct the patient to memorize and repeat pictures, passages, Numbers, words, etc. | 记忆力 Memory | 2次/天,30 min/次,共4周 2 times per day, 30 min per time, 4 weeks in all | 经治疗后, 患者的MMSE评分均较治疗前明显改善 After treatment, the MMSE scores of the patients were significantly improved than before treatment |
与日常生活密切相关的简单的数学题 Simple math problems that are closely related to daily life | 计算力 Capacity of calculation | ||||||
设计一定的活动和游戏 Design some activities and games | 注意力 Attention | ||||||
感知时间、空间和人物 Perceive time, space and characters | 定向力 Orientation | ||||||
模拟购物训练 Shopping simulation training | 刘莹[28] Liu Y[28] | 实验组: 61.44±7.33 对照组: 62.72±6.99 Experimental group: 61.44±7.33 Control group:62.72±6.99 | 64 | 利用卡片及简单的代币工具进行模拟购物、售货练习 Use cards and simple token tools for mock shopping and sales exercises | 执行能力、命名、记忆、注意力、语言、计算能力方面的综合练习 A comprehensive exercise in executive function, naming, memory, attention, language, and capacity of calculation | 1~2次/月,30 min/次,共3个月 1 to 2 times per month, 30 min per time, 3 months in all | 提高患者处理复杂生活活动的能力,改善患者生活质量 Improve patients' ability to handle complex life activities and improve patient quality of life |
视听综合训练 Audiovisual comprehensive training | Lee L P[29], 等 Lee L P[29], etc. | >60 | 20 | 根据Play Station 4选择的歌曲演奏太子鼓(日本打击乐器) Play a Taiko drum (Japanese percussion instrument) according to the songs chosen through the Play Station 4 | 注意力、反应力 Attention, reaction | 3次/周,2 h/次,共14天 3 times per week, 2 hours per time, 14 days in all | 试听一体化(AV)训练对老年MCI患者的认知功能和运动功能均有增强作用 Audiovisual integrative(AV) training can enhance the cognitive and motor functions of elderly MCI patients |
RehaCom软件 RehaCom software | Messinis L[30], 等 Messinis L[30], etc. | >60 | 36 | RehaCom电脑辅助认知互动系统 RehaCom computer-aided cognitive interaction system | 语言表达能力、视空间以及注意力 Language expression skills, visual space and attention | 3次/周,45 min/次,共8周 3 times per week, 45 min per time, 8 weeks in all | 语言学习、视觉空间记忆和信息处理速度方面均有明显改善 Significant improvement in language learning, visual spatial memory and information processing speed |
计算机认知训练 Computer cognitive training | Harvey P D[31], 等 Harvey P D[31], etc. | 18~50 | 49 | Posit Science Brain HQ系统 Posit Science Brain HQ system | 注意力、记忆力、执行力 Attention, memory, executive ability | 3次/周,30 min/次,共17天 3 times per week, 30 min per time, 17 days in all | 认知能力显著提高 Significant improvement in cognitive ability |
表2 针灸对MCI患者的影响 |
针刺法 | 研究 | 患者年龄段(岁) | 样本量(名) | 穴位 | 治疗频率 | 研究结果 |
---|---|---|---|---|---|---|
毫针与毫针透刺疗法 | Jia B[43], 等. | 实验组:74.1±7.8 对照组:73.7±7.3 | 23 | 太溪 | 留针60 s,频率2 HZ | 针刺太溪穴可改善包括额中回、颞下回和后扣带回区域的神经元活动 |
Tony Willcox[44], 等 | 67.3~78.5 | 12 | 百会、神庭、人中、大椎、四神聪、关元、神门、心俞、肾俞、太溪、涌泉 | 45 min/次,2次/周,共8周 | 针刺治疗提高了AD引起的MCI患者的认知能力,有效改变焦虑、抑郁等情绪,对患者机体功能有改善作用 | |
电针法 | 徐建国[45], 等 | 45~74 | 60 | 四神聪、百会、神庭、风池 (双) | 频率4~15 Hz,强度2~4 mA,1次/天,3天/周,共 8周 | 有效率在50%左右,同时炎症因子下降,整体认知水平显著提高 |
Leung A W[46], 等 | ≥65 | 150 | 四神聪、百会、本神、风池、悬钟 | 频率2 Hz,强度5~10 mA, 1次/天,3天/周,共8周 | 电针干预能降低MCI患者认知能力下降速度 | |
体针疗法 | 王超[47] | 76.71±8.65 | 20 | 百会、风池、神庭、神门、大钟 | 40 min/次,3次/周(隔天1次),共6个月 | 6个月后MMSE评分有效率为60.78%,患者的定向力、记忆力、回忆能力、语言能力显著性提高 |
史哲[48] | 69.65±9.20 | 36 | 主穴取内关(双)、水沟、三阴交(患侧)、百会、四神聪、太冲(双)、丰隆(患侧);辅穴:极泉、风池、尺泽、完骨、委中、天柱 | 1次/天,共28天 | 有效改善认知、记忆、语言、运用和视空间技能 |
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