脑机接口联合末端驱动型下肢机器人对脑卒中患者平衡及步行功能的影响

Effects of a brain-computer interface combined with an end-driven lower limb robot on the balance and walking function in stroke patients

目的:观察脑机接口(brain computer interfaces,BCI)联合GEO System?下肢机器人(G-EO gait-therapy system,G-EO)对脑卒中患者平衡及步行功能的影响。方法:在无锡市中心康复医院招募40例脑卒中患者,随机分为对照组和试验组,每组20例。对照组患者在常规康复治疗基础上进行下肢主被动踏车训练和G-EO训练,试验组患者在常规康复治疗基础上进行脑机接口下肢踏车训练和G-EO训练。两组患者均在治疗前、治疗4周后采用Fugl-Meyer下肢运动功能量表(FMA-LE)、Berg平衡量表(Berg balance scale,BBS)、Tecnobody平衡评估系统和Gait Watch三维步态分析仪进行评估。结果:治疗前,两组患者FMA-LE、BBS、压力中心运动椭圆面积、压力中心运动轨迹长度、稳定极限、步频、步态周期、步幅、步速、步长对称性比、踝最大背屈角度无显著性差异(P>0.05)。治疗4周后,两组患者组内比较FMA-LE、BBS、压力中心运动椭圆面积、压力中心运动轨迹长度、稳定极限、步频、步态周期、步幅、步速、步长对称性比、踝最大背屈角度均比治疗前显著性改善(P<0.05)。组间比较,试验组FMA-LE、BBS、压力中心运动椭圆面积、压力中心运动轨迹长度、稳定极限、步频、步态周期、步幅、步速比对照组显著性改善(P<0.05)。结论:4周的BCI联合G-EO训练能够有效改善脑卒中患者的下肢运动功能,提高脑卒中患者平衡及步行能力,具有近期效果。

Objective:To observe the effects of brain-computer interface(BCI)combined with GEO system®lower limb robot(G-EO)on the balance and walking function in stroke patients.Method:Forty stroke patients were recruited from Wuxi central rehabilitation hospital,randomly divided into a control group and an experimental group,with 20 cases in each group.The patients in the control group underwent lower limb active-passive bicycle training and G-EO training on the basis of conventional rehabilitation treatment.The patients in the experimental group underwent BCI training and G-EO training on the basis of conventional rehabilitation treatment.Patients in both groups were assessed using the Fugl-Meyer lower limb motor function scale(FMA-LE),the Berg balance scale(BBS),the tecnobody balance assessment system and the Gait Watch 3D gait analyzer before treatments and after 4 weeks of treatments.Result:Before treatment,there were no significant differences between the control group and the experimental group(P>0.05).After 4 weeks of treatment,the FMA-LE,BBS,elliptical area of pressure center motion,length of the pressure center trajectory,stability limit,cadence,gait cycle,stride,stride speed,step length symmetry ratio and maximum ankle dorsiflexion in both groups were significantly better than before treatment(P<0.05).Compared with the control group,the FMA-LE,BBS,elliptical area of pressure center motion,length of the pressure center trajectory,stability limit,cadence,gait cycle,stride,stride speed of the experimental group were significantly improved(P<0.05).Conclusion:The 4-weeks BCI combined with G-EO training can effectively improve the lower limb movement function,the balance and the walking ability of stroke patients,demonstrating immediate effects.