目的 探讨轮椅辅助上肢运动联合多维认知训练对脑卒中偏瘫伴认知障碍患者上肢运动、静态平衡和认知功能的影响，为加速患者的康复进程提供新的治疗方法。方法 2022年10月至2023年9月，采用便利抽样选取在某医院住院的某医院康复科住院的脑卒中偏瘫伴认知障碍患者119例为研究对象，按随机数字表法将其分为A组（n=40）、B组（n=39）和C组（n=40），三组患者均接受常规治疗，B组增加轮椅辅助上肢训练，C组在B组基础上增加多维认知训练，共4周。分别于干预前、后采用Fugl-Meyer评定量表、蒙特利尔认知评估量表对3组患者的运动、平衡和认知功能进行评定。结果 干预4周后,B组、C组上肢运动功能、平衡功能和认知功能评分均高于A组，且C组高于B组，差异均有统计学意义（均P＜0.05）；主效益及交互效应均有统计学意义（均P＜0.05）。结论 轮椅辅助上肢运动联合多维认知训练，能有效提升脑卒中偏瘫伴认知障碍患者的上肢运动、静态平衡和认知功能。

Objective To explore the effects of wheelchair-assisted upper limb movement combined with multi-dimensional cognitive training on upper limb movement,static balance,and cognitive function in hemiplegia stroke patients with cognitive impairment,and to provide new methods to accelerate the rehabilitation process.Methods From October 2022 to September 2023,119 hemiplegia stroke patients with cognitive impairment hospitalized in the Rehabilitation Department of a hospital were selected by the convenience sampling method as study objects,and were divided into group A(n=40),group B(n=39) and group C(n=40) according to random number table method.All patients in the 3 groups received conventional treatment.Group B added wheelchair-assisted upper limb training,while group C added multidimensional cognitive training on the basis of group B,in 4 weeks.Fugl-Meyer Assessment (FMA) and Montreal Cognitive Assessment (MoCA) were used to evaluate their motor,balance and cognitive functions before and after the interventions.Results After 4 weeks of intervention,the scores of upper limb motor function,balance function and cognitive function in groups B and C were higher than those in group A,and group C was higher than group B,the differences were statistically significant (all P＜0.05).The main benefit and interaction effect were statistically significant (all P＜0.05).Conclusion Wheelchair-assisted upper limb movement combined with multi-dimensional cognitive training can effectively improve the upper limb movement,static balance and cognitive function of stroke patients with hemiplegia and cognitive impairment.

R473.74

河北省重点研发计划项目（21377748D）；河北省医学科研课题（20231580）；河北省重点实验室项目（SZX202327）