不同偏瘫侧别脑卒中患者视空间注意能力与静态平衡功能的相关性

关键词：脑卒中  视空间注意能力  平衡功能  自我为中心参考系  非自我为中心参考系

Keywords:stroke  balance function  visual spatial attention  egocentric reference frame  allocentric reference frame

摘要：

      摘要 目的：基于不同参考系，探究不同偏瘫侧脑卒中患者的视空间注意能力与静态平衡功能的相关性。 方法：将38例脑卒中患者按照偏瘫侧分为左侧偏瘫和右侧偏瘫两组。所有患者完成认知、平衡和视空间注意能力的评估。视空间注意能力通过自我为中心和非自我为中心参考系的两种视觉空间注意反应准确率、反应时间以及效率得分（反应时间除以准确率）来反映。对比两组受试者认知功能、平衡功能和视空间注意能力的差异，并对认知功能结果、视空间功能结果与平衡功能测试结果进行相关性分析。 结果：两组脑卒中患者在性别、年龄、病程、Brunnstrom分期、脑卒中类型、病灶部位、MoCA和数字广度评分无显著性差异（P>0.05），但在连线测试A评分有差异（P<0.05），具有显著性意义。两组脑卒中患者在闭眼状态下的前后平均运动速度和运动长度有显著性差异（P<0.05）。两组脑卒中患者在自我为中心参考范式的反应准确率、非自我为中心参考范式的反应时间和效率得分上有显著性差异（P<0.05）。右侧偏瘫患者在自我为中心与非自我为中心参考范式的反应时间和效率得分都与静态平衡参数呈正相关关系（P<0.05），但左侧偏瘫患者的认知功能和视空间注意能力与静态平衡功能相关性无显著差异（P>0.05）。 结论：右侧偏瘫患者的平衡功能和视空间注意能力较左侧偏瘫患者好，而且右侧偏瘫患者的静态平衡功能与自我为中心视空间注意能力更相关，为脑卒中患者的平衡康复提供了重要的理论依据。

Abstract:

      Abstract Objective：To explore the correlation between visual spatial attention ability and static balance function in stroke patients with different hemiplegic sides based on different reference frames. Method：Thirty-eight patients with stroke were divided into left hemiplegia group and right hemiplegia group according to hemiplegic side. All patients completed the assessments in cognition， balance and visual spatial attention function. Visual spatial attention ability was assessed through response accuracy and reaction time in egocentric and allocentric reference frame， and the efficiency score is accuracy rate divided by reaction time. The differences of cognitive function， balance function and visual spatial attention ability between the two groups were analyzed. The correction between the results of cognitive function， visual spatial attention function and balance function were analyzed. Result：There was no significant difference between the two groups in terms of sex， age， course of disease， Brunnstrom stage， stroke type， location of the lesion，MoCA and digit span task score （P>0.05）， but there were significant differences in the score of A section of trial making test （P<0.05）. Significant differences were found between the two groups in the average movement speed and length during closed-eye conditions（P<0.05）.There were significant differences in the accuracy rate in egocentric test， the reaction time and efficiency score in allocentirc test between the two groups（P<0.05）. The reaction time and the efficiency scores in egocentric and allocentric tests were positively related to the static balance parameters in right hemiplegic stroke patients （P<0.05）. However， there was no significant correlation between cognitive function， visual spatial attention ability and static balance function in patients with left hemiplegia（P>0.05）. Conclusion：The balance function and visual spatial attention ability of patients with right hemiplegia patients were better than those with left hemiplegia. There is a positive correlation between static balance function and egocentric visual spatial attention ability in patients with right hemiplegia. All these findings provide an important theoretical basis for stroke patients in balance rehabilitation.