摘要目的 观察感知提醒疗法治疗脑卒中后单侧空间忽略的疗效.方法 采用单组小样本治疗前、后对照预试验设计,共选取5例稳定期脑卒中后单侧忽略患者,在常规康复训练基础上辅以感知提醒干预(每天累计提醒时间为3h,每周治疗5d),持续治疗2周.分别于治疗开始前2周、治疗开始前1天、治疗结束后1天、治疗结束后2周及治疗结束后4周采用香港版单侧忽略行为测试常规子量表(BIT-C)对入选患者单侧空间忽略程度进行评定.结果 治疗前2周与治疗前1天时入选患者BIT-C评分[分别为(51.2±11.0)分、(61.4±12.1)分]差异无统计学意义(P＞0.05);治疗结束后1天、治疗结束后2周及治疗结束后4周时入选患者BIT-C评分[分别为(101.4±20.8)分、(106.6±20.4)分和(92.4±20.6)分]均较治疗开始前1天时BIT-C评分显著提高,其间差异均具有统计学意义(P＜0.05),并且以删除类任务评分的改善幅度较显著,病情越严重的患者在本治疗中获益越显著.结论 感知提醒疗法可改善脑卒中后单侧忽略患者对忽略侧空间的注意力,可望成为一种简便易行、尤其适用于急性期单侧空间忽略患者的辅助治疗方法,但还需大样本随机对照研究进一步验证其疗效.

abstractsObjective To investigate the effects of sensory cueing (SC) on unilateral spatial neglect after stroke.Methods Five stroke survivors with unilateral spatial neglect underwent a tailored sensory cueing treatment (wearing a sensory cueing device 3 hours a day, 5 days a week for 2 weeks) in addition to their conventional rehabilitation.Two weeks before and one day before the treatment, and then one day, two weeks and 4 weeks after the treatment, all five patients were assessed using the Hong Kong edition of the behavioral inattention test (BIT-C).Results No significant changes were identified in the average BIT-C ratings at the two time point before the intervention.However, the average score had increased significantly only one day after the start of the intervention, with further significant improvement at each of the succeeding 2 week intervals.The greatest improvement was in finishing cancellation tasks, and the most severely affected patient showed the greatest improvement.Conclusion Sensory cueing treatment may be useful and feasible in reducing unilateral spatial neglect for stroke survivors.However, randomized and controlled trials with larger samples are needed to further verify its effects.