摘要：

目的 探讨运动想象疗法对脑卒中患者认知功能的康复作用。 方法 共99 例伴轻中度认知功能障碍的脑卒中患者随机接受常规康复训练（对照组，33 例）以及在此基础上联合认知功能训练（33 例）和运动想象疗法（33 例），于训练前和训练8 周时采用简易智能状态检查量表（MMSE）和蒙特利尔认知评价量表（MoCA）评价认知功能，事件相关电位检测P300 潜伏期和波幅。 结果 与训练前相比，训练8 周时3 组患者MMSE（P = 0.000）和MoCA（P = 0.000）评分增加、P300 潜伏期缩短（P = 0.000）和波幅升高（P = 0.000）；3 组患者训练前后MMSE（P = 0.030）和MoCA（P = 0.013）评分、P300 潜伏期（P = 0.004）和波幅（P = 0.009）差异有统计学意义，其中，认知功能训练组和运动想象疗法组MMSE（P = 0.019，0.021）和MoCA（P = 0.003，0.031）评分高于、P300 潜伏期短于（P =0.020，0.003）和波幅高于（P = 0.003，0.002）对照组。 结论 基于运动想象疗法的康复训练在提高脑卒中患者运动功能的同时亦改善认知功能。

关键词: 卒中, 认知障碍, 运动想象（非MeSH 词）, 康复

Abstract:

Objective To explore the rehabilitation effect of motor imagery therapy on cognitive function of stroke patients.  Methods  A total of 99 stroke patients with mild to moderate cognitive dysfunction were randomly divided into 3 groups: control group (N = 33), cognitive training group (N = 33) and motor imagery training group (N = 33). All patients received conventional rehabilitation training. Before and after 8-week training, all subjects were assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). At the same time, event-related potential (ERP) was examined to detect P300 latency and amplitude.   Results  ompared with before training, MMSE (P = 0.000) and MoCA (P = 0.000) scores were significantly increased, P300 latency was shortened (P = 0.000) and P300 amplitude was increased (P = 0.000) in 3 groups after 8 - week training. There were significant differences among 3 groups on MMSE (P = 0.030) and MoCA (P = 0.013) scores, P300 latency (P = 0.004) and P300 amplitude (P = 0.009) before and after training. Among them, cognitive training group and motor imagery training group had significantly higher MMSE (P = 0.019, 0.021) and MoCA (P = 0.003, 0.031) scores, shorter P300 latency (P = 0.020, 0.003) and higher P300 amplitude (P = 0.003, 0.002) than control group.  Conclusions  Motor imagery training can not only improve motor function of stroke patients, but also improve their cognitive function.

Key words: Stroke, Cognition disorders, Motor imagery (not in MeSH), Rehabilitation