摘要
目的:探讨虚拟现实技术联合重复经颅磁刺激对帕金森病患者轻度认知障碍的临床疗效。方法:将帕金森病患者64例随机分成对照组和观察组各32例,对照组予以常规认知训练和重复经颅磁刺激治疗,观察组予以虚拟现实技术联合重复经颅磁刺激治疗,并在治疗前、治疗8周后,采用蒙特利尔认知测试(MoCA)、简易精神状态检查(MMSE)、统一帕金森病评分量表第三分量表(UPDRSⅢ)、改良Barthel指数评定量表(MBI)对患者的认知功能和日常生活活动能力进行评定,并采用帕金森病生存质量问卷(PDQ-39)总评分评价临床疗效。结果:治疗8周后,2组MMSE评分较治疗前均有明显提高(P<0.01),组间MMSE评分的比较仅记忆力在治疗后观察组优于对照组(P<0.05),余亚项及总分的比较均无统计学意义;观察组视空间与执行功能、记忆评分及MoCA总评分较治疗前均明显提高(P<0.01),注意评分较治疗前提高(P<0.05),且治疗后观察组视空间与执行功能、记忆评分及MoCA总评分明显优于对照组(P<0.01),注意评分在治疗后优于对照组(P<0.05)。2组MBI评分较治疗前均有明显提高(P<0.01),且观察组MBI评分明显高于对照组(P<0.01)。观察组总有效率(93.75%)高于对照组(78.13%),差异有统计学意义(P<0.05)。结论:虚拟现实技术联合重复经颅磁刺激能提高帕金森患者认知与运动功能及日常生活活动能力,提高其生活质量。
Objective:To investigate the clinical efficacy of virtual reality technology combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of mild cognitive impairment in patients with Parkinson’s disease.Methods:A total of 64 patients with Parkinson’s disease were randomly divided into the control group and the observation group,32 patients in each group.The control group was treated with conventional cognitive training and repetitive transcranial magnetic stimulation.The observation group was treated with virtual reality technology combined with rTMS.Before and 8 weeks after treatment,Montreal Cognitive Assessment(MoCA),Mini Mental State Examination(MMSE),the third subscale of the Unified Parkinson’s Disease Rating Scale(UPDRSⅢ)and the modified Barthel Index(MBI)were used to evaluate the cognitive function and activities of daily living of patients,and the total score of Parkinson’s Disease Quality of Life Questionnaire(PDQ-39)was used to evaluate the clinical efficacy.Results:After 8 weeks of treatment,the MMSE scores in the two groups were significantly improved as compared with those before treatment(P<0.01).Only the memory in the observation group was better than that in the control group after treatment(P<0.05),and there was no statistically significant difference in the comparison of the remaining sub-items and the total scores.The scores of visual space and executive function,memory and MoCA in the observation group were significantly higher than those before treatment(P<0.01),and the scores of attention were higher than those before treatment(P<0.05).The scores of visual space and executive function,memory and MoCA in the observation group after treatment were significantly higher than those in the control group(P<0.01),and the scores of attention were better than those in the control group after treatment(P<0.05).MBI scores in both groups were significantly higher than those before treatment(P<0.01),and MBI scores in the observation group were significantly higher than those in the control group(P<0.01).The total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusion:Virtual reality technology combined with rTMS improve the cognitive and motor functions and activities of daily living of Parkinson’s patients,and improve their quality of life.
作者
张黎明
高磊
薛翠萍
赵亚茹
赵茹莲
刘爱贤
Zhang Liming;Gao Lei;Xue Cuiping(Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)
出处
《中国康复》
2023年第3期148-152,共5页
Chinese Journal of Rehabilitation
基金
首都医科大学附属北京康复医院科研攻关课题(NO.2020-068)。
关键词
虚拟现实技术
重复经颅磁刺激
帕金森病
轻度认知障碍
virtual reality technology
repetitive transcranial magnetic stimulation
Parkinson’s disease
mild cognitive impairment
