脑计算机接口联合腕关节被动活动治疗在慢性期脑卒中患者中的应用初探

Investigation of brain computer interface combined with wrist passive motion training in chronic stroke patients

目的探究基于运动想象的脑计算机接口技术联合腕关节被动活动训练对慢性期脑卒中偏瘫患者伸腕功能改善的可行性和有效性。方法 2017年3月-2018年6月纳入15例慢性期脑卒中患者,平均年龄(47.60±14.66)岁。治疗前首先确定受试者的脑电信号基线准确率,之后应用脑计算机接口联合腕关节被动活动装置干预。治疗前后评估患侧腕关节主动活动度和Barthel指数。结果在纳入的15例脑卒中慢性期患者中,12例完成了治疗,3例未能通过首次运动想象基线评定。在完成全部治疗和随访的12例患者中,脑电控制得到改善,有9例在治疗后出现自主伸腕,其他3例治疗后仍未出现,出现主动伸腕受试者所占比例为75%;所有患者的日常生活活动能力在治疗前后未出现明显变化,每日治疗后均未出现相关不适。结论在慢性期伸腕功能障碍的脑卒中患者中,基于运动想象的脑计算机接口联合腕关节被动活动治疗是可行并有效的。

Objective To investigate the feasibility and effectiveness of motor imagery based brain computer interface with wrist passive movement in chronic stroke patients with wrist extension impairment. Methods Fifteen chronic stroke patients with a mean age of (47.60±14.66) years were recruited from March 2017 to June 2018. At baseline, motor imagery ability was assessed first. Then motor imagery based brain computer interface with wrist passive movement was given as an intervention. Both range of motion of paretic wrist and Barthel index was assessed before and after the intervention. Results Among the 15 chronic stroke patients admitted in the study, 12 finished the whole therapy, and 3 failed to pass the initial assessment. After the therapy, the 12 participants who completed the whole sessions of the treatment and follow up had improved ability of control electroencephalogram, in whom 9 regained the ability to actively extend the affected wrist, and the other 3 failed to actively extend their wrist (the rate of active extending wrist was 75%). The activity of daily life of all the participants did not change significantly before and after intervention, and no discomfort was found after daily treatment. Conclusion In chronic stroke patients with wrist extension impairment, motor imagery based brain computer interface with wrist passive movement training is feasible and effective.