Cerebral infarction can cause ischemia and hypoxia of local brain tissue, leading to limb dysfunction, and is often accompanied by cognitive dysfunction, which seriously affects patients' activities of daily living. The effects of conventional drug therapy and rehabilitation treatment are relatively single.
To explore the effect of hyperbaric oxygen chamber occupational therapy on activities of daily living in patients with cognitive dysfunction after cerebral infarction.
1. General Information
A total of 60 patients with cognitive dysfunction after cerebral infarction admitted from May 2020 to April 2024 were selected and divided into a control group and a study group by random number table method, with 30 cases in each group. There were no statistically significant differences in general information (age, gender, course of disease, etc.) between the two groups (P>0.05), indicating comparability.
2. Inclusion and Exclusion Criteria
Inclusion Criteria: First onset of disease, complete clinical data, consistent with the diagnostic criteria in "Analysis of Characteristics of Cognitive Dysfunction After Acute Cerebral Infarction", confirmed by imaging examination, Montreal Cognitive Assessment (MoCA) score ≤26 points, and signed informed consent.
Exclusion Criteria: A history of neurological/mental diseases, cognitive impairment caused by other diseases, severe organic diseases, and contraindications to hyperbaric oxygen chamber therapy.
3. Treatment Methods
Control Group: Conventional occupational therapy was adopted, including active/passive joint activities, jigsaw puzzles, painting, hand function training, tactile stimulation, etc., combined with basic drug therapy.
Study Group: On the basis of the control group, hyperbaric oxygen chamber occupational therapy was added. The pressure of the hyperbaric oxygen chamber was set at 0.2 MPa, and each treatment lasted for 110 minutes (20 minutes for compression, 60 minutes for stable pressure oxygen inhalation, 20 minutes for decompression, with 10 minutes of air inhalation in the middle), once a day. Both groups received treatment for 10 courses (10 times as one course).
4. Observation Indicators
Cognitive Function: Assessed by the Montreal Cognitive Assessment (MoCA), which includes 7 items such as orientation and language fluency, with a full score of 30 points. A score <26 points indicates cognitive impairment.
Activities of Daily Living: Assessed by the Modified Barthel Index (MBI), which includes 11 items such as eating and bathing, with a full score of 100 points. A higher score indicates stronger ability.
Degree of Neurological Deficit: Assessed by the National Institutes of Health Stroke Scale (NIHSS), with a total score of 42 points. A higher score indicates more severe deficit.
Clinical Efficacy: Divided into ineffective, effective, and markedly effective. Total effective rate = (effective cases + markedly effective cases)/total cases ×100%.
5. Statistical Methods
SPSS 22.0 software was used for analysis. Measurement data were tested by t-test, and count data were tested by χ² test. P<0.05 was considered statistically significant.
III. Research Results
Cognitive Function (MoCA Score): There was no difference between the two groups before treatment (P>0.05); after treatment, the scores of both groups increased, and the study group was significantly higher than the control group (P<0.05).
Activities of Daily Living (Barthel Index): There was no difference between the two groups before treatment (P>0.05); after treatment, the scores of both groups increased, and the study group was significantly higher than the control group (P<0.05).
Neurological Deficit (NIHSS Score): There was no difference between the two groups before treatment (P>0.05); after treatment, the scores of both groups decreased, and the study group was significantly lower than the control group (P<0.05).
Clinical Efficacy: The total effective rate of the study group (93.33%) was significantly higher than that of the control group (63.33%) (P<0.05).
IV. Discussion and Conclusion
Mechanism of Action
Hyperbaric oxygen can increase blood oxygen content and diffusivity, improve cerebral tissue hypoxia, promote the establishment of collateral circulation, and alleviate oxidative stress response; in-chamber occupational therapy consolidates the effect of cognitive training and improves patients' self-care ability by simulating daily scenarios.
Conclusion
Hyperbaric oxygen chamber occupational therapy can effectively improve cognitive function and the degree of neurological deficit in patients with cognitive dysfunction after cerebral infarction, and significantly enhance their activities of daily living.