fa تأثیر توان‌بخشی شناختی بر توجه پراکنده، توجه انتخابی و کارکردهای اجرایی افراد بزرگ‌سال دچار سکته مغزی تخصصي Special كاربردي Applicable <div style="text-align: justify;"><span style="font-family:arial;"><strong><span style="font-size:12.0pt;">مقدمه:</span></strong> <span style="font-size:12.0pt;">سکته</span> <span style="font-size:12.0pt;">مغزی</span> <span style="font-size:12.0pt;">یا</span> <span style="font-size:12.0pt;">حادثه</span> <span style="font-size:12.0pt;">عروقی</span> <span style="font-size:12.0pt;">مغزی</span> <span style="font-size:12.0pt;">عبارت</span> <span style="font-size:12.0pt;">است</span> <span style="font-size:12.0pt;">از</span> <span style="font-size:12.0pt;">آغاز</span> <span style="font-size:12.0pt;">ناگهانی</span> <span style="font-size:12.0pt;">نوعی</span> <span style="font-size:12.0pt;">اختلال</span> <span style="font-size:12.0pt;">نورولوژیک</span> <span style="font-size:12.0pt;">که</span> <span style="font-size:12.0pt;">به</span> <span style="font-size:12.0pt;">یک</span> <span style="font-size:12.0pt;">علت</span> <span style="font-size:12.0pt;">عروقی</span> <span style="font-size:12.0pt;">کانونی</span> <span style="font-size:12.0pt;">قابل</span> <span style="font-size:12.0pt;">انتساب</span> <span style="font-size:12.0pt;">است</span><span dir="LTR"><span style="font-size:12.0pt;">. </span></span><span style="font-size:12.0pt;">نقص</span> <span style="font-size:12.0pt;">در</span> <span style="font-size:12.0pt;">حافظه</span> <span style="font-size:12.0pt;">کاری</span> <span style="font-size:12.0pt;">از</span> <span style="font-size:12.0pt;">متداول</span> <span style="font-size:12.0pt;">ترین</span> <span style="font-size:12.0pt;">پدیده</span> <span style="font-size:12.0pt;">ها</span> <span style="font-size:12.0pt;">بعد</span> <span style="font-size:12.0pt;">از</span> <span style="font-size:12.0pt;">آسیب</span> <span style="font-size:12.0pt;">مغزی</span> <span style="font-size:12.0pt;">است</span><span dir="LTR"><span style="font-size:12.0pt;">. </span></span><br> <strong><span style="font-size:12.0pt;">هدف:</span></strong> <span style="font-size:12.0pt;">هدف</span> <span style="font-size:12.0pt;">این</span> <span style="font-size:12.0pt;">پژوهش</span> <span style="font-size:12.0pt;">بررسی</span> <span style="font-size:12.0pt;">تأثیر</span> <span style="font-size:12.0pt;">توان‌بخشی</span> <span style="font-size:12.0pt;">شناختی</span> <span style="font-size:12.0pt;">بر</span> <span style="font-size:12.0pt;">توجه</span> <span style="font-size:12.0pt;">پراکنده،</span> <span style="font-size:12.0pt;">توجه</span> <span style="font-size:12.0pt;">انتخابی</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">کارکردهای</span> <span style="font-size:12.0pt;">اجرایی</span> <span style="font-size:12.0pt;">افراد</span> <span style="font-size:12.0pt;">بزرگ‌سال</span> <span style="font-size:12.0pt;">دچار</span> <span style="font-size:12.0pt;">سکته</span> <span style="font-size:12.0pt;">مغزی</span> <span style="font-size:12.0pt;">است</span><span dir="LTR"><span style="font-size:12.0pt;">.</span></span><br> <strong><span style="font-size:12.0pt;">روش:</span></strong> <span style="font-size:12.0pt;">۲۰ بیمار</span> <span style="font-size:12.0pt;">دچار</span> <span style="font-size:12.0pt;">سکته</span> <span style="font-size:12.0pt;">مغزی</span> <span style="font-size:12.0pt;">در</span> <span style="font-size:12.0pt;">این</span> <span style="font-size:12.0pt;">پژوهش</span> <span style="font-size:12.0pt;">به‌صورت</span> <span style="font-size:12.0pt;">مساوی</span> <span style="font-size:12.0pt;">در</span> <span style="font-size:12.0pt;">دو</span> <span style="font-size:12.0pt;">گروه</span> <span style="font-size:12.0pt;">آزمایشی</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">کنترل</span> <span style="font-size:12.0pt;">قرار</span> <span style="font-size:12.0pt;">گرفتند</span><span dir="LTR"><span style="font-size:12.0pt;">. </span></span><span style="font-size:12.0pt;">تمامی</span> <span style="font-size:12.0pt;">بیماران</span> <span style="font-size:12.0pt;">دو</span> <span style="font-size:12.0pt;">بار</span><span dir="LTR"><span style="font-size:12.0pt;">) </span></span><span style="font-size:12.0pt;">پیش</span> <span style="font-size:12.0pt;">آزمون</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">پس</span> <span style="font-size:12.0pt;">آزمون</span><span dir="LTR"><span style="font-size:12.0pt;">(</span></span><span style="font-size:12.0pt;">توسط</span> <span style="font-size:12.0pt;">آزمون</span> <span style="font-size:12.0pt;">حافظه</span> <span style="font-size:12.0pt;">کاری</span> <span style="font-size:12.0pt;">وکسلر،</span> <span style="font-size:12.0pt;">آزمون</span> <span style="font-size:12.0pt;">توجه</span> <span style="font-size:12.0pt;">متمرکز</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">پراکنده</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">آزمون</span> <span style="font-size:12.0pt;">مرتب</span> <span style="font-size:12.0pt;">کردن</span> <span style="font-size:12.0pt;">کارت</span> <span style="font-size:12.0pt;">های</span> <span style="font-size:12.0pt;">ویسکانسین</span> <span style="font-size:12.0pt;">بررسی</span> <span style="font-size:12.0pt;">شدند</span><span dir="LTR"><span style="font-size:12.0pt;">. </span></span><span style="font-size:12.0pt;">سپس</span> <span style="font-size:12.0pt;">بر</span> <span style="font-size:12.0pt;">روی</span> <span style="font-size:12.0pt;">افراد</span> <span style="font-size:12.0pt;">قرارگرفته</span> <span style="font-size:12.0pt;">در</span> <span style="font-size:12.0pt;">گروه</span> <span style="font-size:12.0pt;">آزمایشی،</span> <span style="font-size:12.0pt;">طی</span><span dir="LTR"><span style="font-size:12.0pt;"> ۵ </span></span><span style="font-size:12.0pt;">هفته</span> <span style="font-size:12.0pt;">و</span><span dir="LTR"><span style="font-size:12.0pt;"> ۵ </span></span><span style="font-size:12.0pt;">روز هفته</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">به</span> <span style="font-size:12.0pt;">مدت ۳۰-۴۰</span> <span style="font-size:12.0pt;">دقیقه</span> <span style="font-size:12.0pt;">برنامه</span> <span style="font-size:12.0pt;">کامپیوتری</span> <span style="font-size:12.0pt;">توان‌بخشی</span> <span style="font-size:12.0pt;">اجرا</span> <span style="font-size:12.0pt;">شد</span><span dir="LTR"><span style="font-size:12.0pt;">.</span></span><br> <strong><span style="font-size:12.0pt;">یافته</span></strong> <strong><span style="font-size:12.0pt;">ها</span></strong>: <span style="font-size:12.0pt;">تحلیل</span> <span style="font-size:12.0pt;">کواریانس</span> <span style="font-size:12.0pt;">تک</span> <span style="font-size:12.0pt;">متغیره</span> <span style="font-size:12.0pt;">نشان</span> <span style="font-size:12.0pt;">می</span> <span style="font-size:12.0pt;">دهد</span> <span style="font-size:12.0pt;">که</span> <span style="font-size:12.0pt;">توان‌بخشی</span> <span style="font-size:12.0pt;">شناختی</span> <span style="font-size:12.0pt;">بر توجه</span> <span style="font-size:12.0pt;">انتخابی</span> <span style="font-size:12.0pt;">افراد</span> <span style="font-size:12.0pt;">بزرگ‌سال</span> <span style="font-size:12.0pt;">دچار</span> <span style="font-size:12.0pt;">سکته</span> <span style="font-size:12.0pt;">مغزی</span> <span style="font-size:12.0pt;">در</span> <span style="font-size:12.0pt;">مقایسه</span> <span style="font-size:12.0pt;">با</span> <span style="font-size:12.0pt;">افراد</span> <span style="font-size:12.0pt;">گروه</span> <span style="font-size:12.0pt;">کنترل</span> <span style="font-size:12.0pt;">تأثیر</span> <span style="font-size:12.0pt;">دارد</span> <span style="font-size:12.0pt;">اما</span> <span style="font-size:12.0pt;">بر</span> <span style="font-size:12.0pt;">توجه</span> <span style="font-size:12.0pt;">پراکنده</span> <span style="font-size:12.0pt;">و</span> <span style="font-size:12.0pt;">کارکرد</span> <span style="font-size:12.0pt;">اجرایی</span> <span style="font-size:12.0pt;">تأثیر</span> <span style="font-size:12.0pt;">ندارد</span><span dir="LTR"><span style="font-size:12.0pt;">.</span></span> <span dir="LTR"><span style="font-size:12.0pt;">F</span></span><span style="font-size:12.0pt;"> محاسبه شده (۲۲/۲۳) در سطح معنی داری &nbsp;۰/۰۵</span> <span dir="LTR"><span style="font-size:12.0pt;">p<</span></span><span style="font-size:12.0pt;">معنی دار و </span><span dir="LTR"><span style="font-size:12.0pt;">F</span></span> <span style="font-size:12.0pt;">های محاسبه شده(۰/۰۶، ۹۷/۳) در سطح معنی داری ۰/۰۵</span> <span dir="LTR"><span style="font-size:12.0pt;">p<</span></span><span style="font-size:12.0pt;">معنی دار نیست.</span><br> <strong><span dir="RTL"><span style="font-size:12.0pt;">نتیجه</span></span> <span dir="RTL"><span style="font-size:12.0pt;">گیری:</span></span> </strong><span dir="RTL"><span style="font-size:12.0pt;">نتایج</span></span><span style="font-size:12.0pt;"> <span dir="RTL">نشان</span> <span dir="RTL">داد</span> <span dir="RTL">که</span> <span dir="RTL">بهبودی</span> <span dir="RTL">معنی‌داری</span> <span dir="RTL">در</span> <span dir="RTL">توجه</span> <span dir="RTL">انتخابی</span> <span dir="RTL">توسط</span> <span dir="RTL">برنامه</span> <span dir="RTL">توان‌بخشی</span> <span dir="RTL">شناختی</span> <span dir="RTL">وجود</span> <span dir="RTL">دارد که</span> <span dir="RTL">ممکن</span></span> <span dir="RTL"><span style="font-size:12.0pt;">است</span></span><span style="font-size:12.0pt;"> <span dir="RTL">در</span> <span dir="RTL">نتیجه</span> <span dir="RTL">تغییرات</span> <span dir="RTL">در</span> <span dir="RTL">سازمان‌دهی</span> <span dir="RTL">عصبی</span> <span dir="RTL">در</span> <span dir="RTL">پاسخ</span> <span dir="RTL">به</span> <span dir="RTL">آسیب</span> <span dir="RTL">رخ</span> <span dir="RTL">دهد</span>. <span dir="RTL">به</span> <span dir="RTL">نظر</span> <span dir="RTL">می‌رسد</span> <span dir="RTL">عدم</span> <span dir="RTL">بهبود</span> <span dir="RTL">مشاهده</span> <span dir="RTL">شده</span> <span dir="RTL">در</span> <span dir="RTL">توجه</span> <span dir="RTL">پراکنده</span></span> <span dir="RTL"><span style="font-size:12.0pt;">و</span></span><span style="font-size:12.0pt;"> <span dir="RTL">کارکرد</span> <span dir="RTL">اجرایی</span> <span dir="RTL">ناشی</span> <span dir="RTL">از</span> <span dir="RTL">عدم</span> <span dir="RTL">هماهنگی</span> <span dir="RTL">و</span> <span dir="RTL">پردازش</span> <span dir="RTL">موازی</span> <span dir="RTL">در</span> <span dir="RTL">مناطق</span> <span dir="RTL">مختلف</span> <span dir="RTL">مغزی</span> <span dir="RTL">به</span> <span dir="RTL">علت</span> <span dir="RTL">بافت</span> <span dir="RTL">انفارکت</span> <span dir="RTL">شده</span> <span dir="RTL">است</span>.</span></span></div> <div style="text-align: justify;"><strong>Introduction: </strong>Stroke is a sudden onset of a neurological disorder that can be attributed to a focal vascular cause. Working memory defects are one of the most commonly occurring phenomena after brain damage. Working memory is the core of executive functions. Cognitive rehabilitation is a cognitive and neuropsychological intervention program designed to rehabilitate cognitive defects.<br> <strong>Aim:</strong> The purpose of this study was to investigate the effect of cognitive rehabilitation on the divided attention, selective attention and executive function of adults with stroke.<br> <strong>Method: </strong>20 patients with stroke in this study were equally divided into experimental and control groups. All patients were examined by Wechsler&#39;s working memory test, divided and selective attention test, and Wisconsin Card sorting test. The experimental group trained 5 weeks and 5 days for 30-40 minutes with a computerized rehabilitation program.<br> <strong>Results: </strong>Analysis of univariate covariance shows that cognitive rehabilitation has effect on selective attention, but does not affect the divided attention and executive function. The calculated F in the level of significance (P <0.05) was significant (22.23) and (0.6 and 97.3) was not significant. Improvement in selective attention may occur as a result of changes in neural organization in response to injury.</div> <div style="text-align: justify;"><strong>Conclusion: </strong>It seems that the lack of improvement in divided attention and the executive function is due to the lack of harmony and parallel exercise in different regions of the brain because of infective tissue.</div> توان‌بخشی شناختی, توجه انتخابی, توجه پراکنده, کارکرد اجرایی, سکته مغزی Cognitive rehabilitation, Selective attention, Divided attention, Executive function, Stroke 81 94 http://shenakht.muk.ac.ir/browse.php?a_code=A-10-461-1&slc_lang=fa&sid=1 Zeynab khanjani زینب خانجانی zeynabkhanjaani@gmail.com 10031947532846003811 10031947532846003811 No Psychology, Tabriz University , Faculty of Psychology دانشکده روانشناسی و علوم تربیتی mehdi farhoudi مهدی فرهودی farhoudim@tbzmed.ac.ir 10031947532846003812 10031947532846003812 No neurology, Tabriz University of Medical Science, Neurosciences Research Center دانشگاه علوم پزشکی تبریز mohammadali nazari محمدعلی نظری nazaripsycho@yahoo.com 10031947532846003813 10031947532846003813 No Neuroscience, Tabriz University, Division of Cognitive Neuroscience علوم اعصاب شناختی، دانشگاه تبریز، بخش علوم اعصاب شناختی mohammadtaghi saeedi محمدتقی سعیدی saeedi_m@tabrizu.ac.ir 10031947532846003814 10031947532846003814 No of Cognitive Neuroscience, Tabriz University, Division of Cognitive Neuroscience کاندیدای دکتری علوم اعصاب شناختی، دانشگاه تبریز، بخش علوم اعصاب شناختی parya abravani پریا آب روانی parya_abravani@yahoo.com 10031947532846003815 10031947532846003815 Yes in psychology(Corresponding Author*) Tabriz University, 29 Bahman Boulevard, Faculty of Psychology دانشگاه تبریز