應用團體電腦認知復健治療認知損傷病患之前導性研究

A Pilot Study of Group-Based Computer-Assisted Cognitive Rehabilitation for Patients with Cognitive Impairment

徐宛伶(Wan-Ling Hsu) ； 廖梓葳(Tzu-Wei Liao) ； 盧奕均(Yi-Chun Lu) ； 騫心曼(Hsin-Man Chien) ； 曾奕翔(I-Shiang Tzeng)

《台灣復健醫學雜誌》 48卷1期 (2020/06) Pp. 25-33

https://doi.org/10.6315/TJPMR.202006_48(1).0003

摘要

本研究嘗試探討團體電腦輔助認知復健對認知損傷病患之介入成效。研究共收取11位後天性腦傷個案，進行為期兩個月，一週兩次，每次一小時的團體電腦輔助認知復健，並於介入前後使用簡短智能測驗（Mini Mental State Exam, MMSE）、中文版蒙特利爾智能測驗（Montreal Cognitive Assessment, MoCA）、知能篩檢測驗（Cognitive Abilities Screening Instrument, CASI C-2.0）、魏氏智力測驗第四版（中文版）－記憶廣度分測驗（Digit Span subtest, DS）、路徑描繪測驗（Trail Making Test part A, TMT-A）、顏色路徑描繪測驗（Color Trail Making Test, CTT）、功能獨立量表（Functional Independence Measure, FIM）與工具性日常生活活動能力量表（Instrumental Activities of Daily Living scale, IADLs）等來量測個案的基本認知功能與日常生活功能改變。結果發現綜合認知評量，包含MMSE、MoCA與CASI C-2.0參與者後測表現較前測佳，具統計顯著差異（p＜0.05）。其他評量結果雖未達統計顯著差異，但多數分數在後測皆有進步，尤其是TMT-A與IADLs兩者趨近統計顯著差異（p=0.07）。顯示利用團體電腦輔助認知復健來介入認知損傷個案有一定的效果存在，尤其是注意力表現；另外基本認知功能的提升或許可間接改善部分IADL功能。而為正確了解團體電腦輔助認知復健對認知損傷者的實際效益，需未來研究進一步了解。

關鍵字

團體電腦輔助認知復健（group-based computer-assisted cognitive rehabilitation） ； 認知損傷（cognitive impairment） ； 注意力（attention） ； 工具性日常生活活動（instrumental activities of daily living）

並列摘要

Objective: This study attempted to investigate effects of group-based computer-assisted cognitive rehabilitation for patients with cognitive impairment. Methods: A total of 11 patients with cognitive impairment were included in the study. Cognitive impairment and activities of daily living were assessed using Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Cognitive Abilities. Screening Instrument (CASI C-2.0), Digit Span subtest (DS), Trail Making Test part A (TMT-A), Color Trail Making Test (CTT), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living scale (IADLs) at the beginning of the study, soon after receiving the intervention. Treatment was scheduled for 2 hours per week for 2 months. Results: Positive intervention effects were found in global cognitive functional tests, including MMSE, MoCA and CASI C-2.0, which had statistically significant difference (p＜0.05). Near-significant improvements were noted in the TMT-A and IADLs(p=0.07). Conclusion: Group-based computer-assisted cognitive rehabilitation for patients with cognitive impairment was effective in improving their global cognitive function, especially in attention ability; enhancement of basic cognitive functions may indirectly improve IADL function. Further studies are needed to clarify the actual effect of group-based computer-assisted cognitive rehabilitation in patients with cognitive impairment.

並列關鍵字

group-based computer-assisted cognitive rehabilitation ； cognitive impairment ； attention ； instrumental activities of daily living

參考文獻

1. De Luca R, Leonardi S, Spadaro L , et al. Improving Cognitive Function in Patients with Stroke: Can Computerized Training Be the Future? J Stroke Cerebrovasc Dis 2017;27:1055-60.

2. Zucchella C, Capone A, Codella V, et al. Assessing and restoring cognitive functions early after stroke. Funct Neurol 2014;29:255-62.

3. Tsaousides T and Gordon WA. Cognitive rehabilitation following traumatic brain injury: assessment to treatment. Mt Sinai J Med 2009;76:173-81.

4. De Luca R, Calabrò RS, Gervasi G, et al. Is computer-assisted training effective in improving rehabilitative outcomes after brain injury? A case-control hospital-based study. Disabil Health J 2014;7:356-60.

5. Hokkanen L, Poutiainen E, Valanne L, et al. Cognitive impairment after acute encephalitis: comparison of herpes simplex and other aetiologies. J Neurol Neurosurg Psychiatry 1996;61:478-84.