毫秒级节律反馈训练技术在中枢神经康复中的应用

Interactive metronome applied in the rehabilitative treatment of the central nervous system

背景:互动节拍技术也称为毫秒级节律反馈技术,是神经可塑性的理论支撑的康复治疗技术之一,关注大脑内部毫秒级节律反馈情况对了解神经认知及运动产生的机制是必要的。目的:综述毫秒级节律反馈训练技术在中枢神经康复中的应用进展。方法:由第一作者用计算机检索中国期刊全文数据库(CNKI:2001至2016年)、Medline(1989至2016年)及Imedpub(2015至2017年)数据库。检索词分别为:"毫秒级节律反馈、互动节拍器、认知、运动行为"和"Millisecond rhythm feedback,Cognition,motor behavior"等,语言分别设定为中文和英文。从脑定时功能的理论基础研究、毫秒级节律运动技术对脑定时功能的影响机制、该技术的操作方法及临床应用效果进行归纳并评价。结果与结论:共纳入26篇文章。毫秒级节律反馈训练技术是针对改善大脑行动计划和加工能力障碍评价和治疗的方法:(1)在机制研究方面,毫秒级节律反馈训练技术可提升白质纤维束处理信息的速度和效率,能够增强注意力控制系统机能,达到改善脑组织时间节律紊乱的目的;(2)在临床应用方面,毫秒级节律反馈训练技术主要针对儿童学习障碍、成人颅脑损伤性认知障碍以及脑卒中偏瘫改善明显;(3)技术特点:毫秒级节律反馈训练技术是在传统的中枢神经康复训练模式基础上,强调律动性康复训练,值得未来进一步研究和推广应用。

BACKGROUND： Interactive metronome （IM）, also known as millisecond rhythm feedback, is a rehabilitative treatment technology supported by neural plasticity theory. Cerebral immediate feedback measured in milliseconds is helpful for understanding neurocognitive mechanisms. OBJECTIVE： To overview the progress of IM applied in the rehabilitation of central nervous system. METHODS： The first author retrieved CNKI （2001-2016）, Medline （1989-2016） and Imedpub （2015-2017） databases using the keywords of ＂millisecond rhythm feedback, cognition, motor behavior＂ in English and Chinese, respectively. Data such as theoretical researches on cerebral timing function, the mechanism underlying IM affecting cerebral timing function, and IM operation skills and application were evaluated. RESULTS AND CONCLUSION： A total of 26 eligible articles were enrolled. IM is an objective assessment and training tool that improves neural synchronization and function. IM can accelerate the speed and the efficiency of processing information of white matter tracts, and enhance the function of attention control system in order to improve the disorder of the cerebral timing. IM achieves satisfactory outcomes in the treatment of learning disabilities in children, cognitive impairment after brain injury and cerebral stroke with hemiplegia in adults. Based on the traditional rehabilitative training in the central nervous system, IM addresses critical brain timing skills, which is a promising technology in the future rehabilitation of the central nervous system.