Neuropsychological Rehabilitation
Neuropsychological Rehabilitation
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DOI：
10.1007/978-0-387-70715-0_19
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Barrett, Anna M.
中科院分区：
文献类型：
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作者：
Eskes, Gail A.;Barrett, Anna M.
中风后的认知障碍很常见，可以显着影响功能的恢复以及功能活动和角色的恢复。 “血管性认知障碍”一词涵盖了大脑认知中血管的连续变化，范围从轻度损伤（对功能能力没有影响）到明显的血管性痴呆（见第 7 章）。对注意力、意动（知识和情感转化为行为）和认知障碍的个体的管理各不相同，具体取决于缺陷的严重程度及其功能后果。本章的重点是对中风后认知缺陷患者（无痴呆）康复的证据进行回顾。在本章中，我们将认知功能广泛地定义为包含和/或作用于特定领域知识表示（例如语言、空间函数、计算）的多个模块化心理系统。什么是认知康复？大多数定义都集中在这样一个观点上：认知康复是一个系统的治疗过程，旨在补救、减轻或管理认知缺陷，以改善日常功能（Cicerone 等，2000；Sohlberg & Mateer 2001a，Wilson 2002）。经常受中风影响的认知和其他心理过程包括注意力和记忆、视觉感知能力和执行功能。在本章中，我们将概述针对中风后这些认知障碍康复的程序的有效性证据。虽然每个认知领域都在单独的章节中讨论，但我们认识到认知功能经常相互作用，中风幸存者通常存在多种缺陷；潜在的行为和对干预的反应可能会相互作用。此外，情感障碍的存在（如第 16 章所述）也会改变对治疗的反应，应将其作为护理计划的一部分，但本章不会讨论。
Cognitive impairment after stroke is common and can significantly impact on recovery of function and return to functional activities and roles. The term ‘‘vascular cognitive impairment’’encompasses the continuum of vascular changes in brain cognition, ranging from mild impairment (no impact on functional abilities) to frank vascular dementia (see Chapter 7). Management of individuals with attentional, conative (the translation of knowledge and emotion to behavior), and cognitive impairment varies, depending upon the severity of the deficits and their functional consequences. Review of the evidence for rehabilitation of individuals with cognitive deficits post-stroke (without dementia) will be the focus of this chapter. In this chapter, we define cognitive function broadly as multiple modular mental systems either containing and/or acting on domainspecific knowledge representations (eg language, spatial function, calculations). What is cognitive rehabilitation? Most definitions converge on the idea that cognitive rehabilitation is a systematic, therapeutic process designed to remediate, alleviate, or manage cognitive deficits in order to improve daily functioning (Cicerone et al., 2000; Sohlberg & Mateer 2001a, Wilson 2002). Cognitive and other mental processes frequently affected by stroke include attention and memory, visuo-perceptual abilities, and executive function. In this chapter we will provide an overview of the evidence for the efficacy of procedures targeted toward rehabilitation of these cognitive disorders after stroke. While each cognitive domain is discussed in separate sections, we recognize that cognitive functions frequently interact, and stroke survivors commonly have multiple deficits; the potential behavior and response to intervention may interact. In addition, the presence of affective disorders (as dealt with in Chapter 16) also modifies response to treatment and should be included as part of a care plan, but will not be discussed in this chapter.