| 姚望,赵薇薇,邓国刚,车培,吴明,杨金宇,王彤.脑卒中后认知障碍患者平衡与执行功能的相关性分析[J].中国康复,2025,40(10):611-617 |
| 脑卒中后认知障碍患者平衡与执行功能的相关性分析 |
| Correlation between balance and executive function in patients with post-stroke cognitive impairment |
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| DOI：10.3870/zgkf.2025.10.006 |
| 中文关键词: 脑卒中后认知障碍 平衡功能 执行功能 任务转换 |
| 英文关键词: post-stroke cognitive impairment balance function executive function task switching |
| 基金项目:江苏省中医药科技发展计划项目(MS2021046) |
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| 中文摘要: |
| 目的：探索脑卒中后认知障碍(PSCI)患者平衡能力与执行功能的相关性，为临床康复中解决平衡功能障碍提供新的思考角度。方法：采用横断面研究设计，纳入50例PSCI患者。使用Berg平衡量表(BBS)和三维骶骨定标法中睁眼和闭眼重心平均摆动路径(SP)评估平衡功能，通过数字连线测验(TMT-A)、2-back任务和Stroop色词任务评估执行功能。采用Spearman相关性分析和多元线性回归分析探讨两者关系。结果：相关性分析显示TMT-A与BBS评分呈负相关（P<0.01），与睁眼SP和闭眼SP均呈正相关(均P<0.01)。2-back任务正确率与睁眼SP呈负相关(P<0.05)。Stroop任务一致性准确率与睁眼SP和闭眼SP均呈负相关(均P<0.05)。一致性任务反应时与BBS评分呈负相关(P<0.05)，与闭眼SP呈正相关(P<0.05)。不一致性任务准确率仅与BBS评分呈正相关(P<0.05)。不一致性任务反应时与BBS评分呈负相关(P<0.01)，与睁眼SP和闭眼SP均呈正相关(P<0.05)。多元线性回归分析显示，TMT-A与BBS评分存在独立关联(P<0.05)，模型解释度为17.9%（R2＝0.279，调整R2=0.179）。结论：PSCI患者的平衡功能与执行功能显著相关，尤其是任务转换能力对平衡功能有显著影响。临床康复中应重视对患者执行功能的评估，整合平衡训练与执行功能干预，以改善平衡能力，降低跌倒风险。 |
| 英文摘要: |
| Objective: To investigate the correlation between balance function and executive functions in patients with post-stroke cognitive impairment (PSCI), providing new insights for addressing balance dysfunction in clinical rehabilitation. Methods: This cross-sectional study enrolled 50 PSCI patients. Balance function was assessed using the Berg Balance Scale (BBS) and center-of-pressure sway path (SP) under eyes-open and eyes-closed conditions via three-dimensional sacral marker methodology. Executive functions were evaluated using the Trail Making Test-A (TMT-A), 2-back task, and Stroop color-word test. Spearman correlation analysis and multiple linear regression were employed to examine their relationships. Results: Correlation analysis demonstrated that TMT-A showed significant negative correlation with BBS scores (P<0.01), while positive correlations with both eyes-open SP and eyes-closed SP (both P<0.01). The accuracy rate of the 2-back task was negatively correlated with eyes-open SP (P<0.05). Stroop congruent task accuracy showed negative correlations with both eyes-open and eyes-closed SP (both P<0.05). Congruent reaction time was negatively correlated with BBS scores (P<0.05) and positively correlated with eyes-closed SP (P<0.05). Incongruent task accuracy showed positive correlation only with BBS scores (P<0.05). Incongruent reaction time was negatively correlated with BBS scores (P<0.01) and positively correlated with both eyes-open and eyes-closed SP (P<0.05,P<0.01). Multiple linear regression analysis revealed that TMT-A was independently associated with BBS scores (P<0.05), with the model explaining 17.9% of the variance (R2＝0.279，adjusted R2=0.179). Conclusion: Balance function in PSCI patients is significantly associated with executive functions, particularly task-switching ability, which substantially influences balance performance. Clinical rehabilitation should emphasize the assessment of executive functions and incorporate integrated balance training with exe-cutive function interventions to improve balance ability and reduce fall risk. |
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