上肢康复机器人辅助训练对脑卒中患者上肢功能的效果:基于功能性近红外光谱

Effect of upper limb robot-assisted therapy on upper limb function in stroke patients:based on functional near-infrared spectroscopy

目的 采用功能性近红外光谱(fNIRS)研究上肢康复机器人辅助训练对脑卒中患者上肢功能与大脑皮质激活的影响。方法 2022年1月至2023年1月浙江康复医疗中心32例脑卒中患者,随机分为对照组(n=16)和试验组(n=16),两组均接受神经内科常规治疗和常规康复训练,对照组每天进行常规上肢训练,试验组每天进行上肢机器人辅助训练。治疗前和治疗4周后分别采用Fugl-Meyer评定量表上肢部分(FMA-UE)、fNIRS进行评定,采用NIRS_SPM进行激活分析,Homer2进行血氧浓度分析。结果 治疗后,两组FMA-UE评分均显著改善(|t|> 5.910,P <0.001),试验组优于对照组(t=-2.348,P <0.05)。fNIRS激活结果显示,治疗后,试验组通道17激活明显增加(F=9.354,P <0.01),且优于对照组(F=5.217,P <0.05)。fNIRS血氧浓度结果显示,治疗后试验组通道17血氧浓度明显增加(F=12.179,P <0.01),且优于对照组(F=4.883,P <0.05)。结论 上肢康复机器人辅助训练能改善脑卒中患者上肢运动功能和大脑皮质激活。

Objective To study the effect of upper limb robot-assisted therapy on upper limb function and cerebral cortex activation in stroke patients using functional near-infrared spectroscopy(fNIRS).Methods From January,2022 to January,2023,32 stroke patients in Zhejiang Rehabilitation Medical Center were randomly divided into control group(n=16)and experimental group(n=16).Both groups received routine neurological medication and routine rehabilitation.The control group received routine upper limb exercises,the experimental group received upper limb robot-assisted therapy.They were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and fNIRS(oxyhemoglobin,deoxyhemoglobin,and total hemoglobin)before and four weeks after treatment.NIRS_SPM was used for activation analysis,Homer2 was used for blood oxygen concentration analysis.Results After treatment,the score of FMA-UE increased in both groups(|t|>5.910,P<0.001),and was higher in the experimental group than in the control group(t=-2.348,P<0.05).fNIRS activation results showed that,the activation increased in the experimental group after treatment in channel 17(F=9.354,P<0.01),and it was more than that in the control group(F=5.217,P<0.05).fNIRS blood oxygen concentration results showed that,the blood oxygen concentration increased in the experimental group after treatment in channel 17(F=12.179,P<0.01),and it was more than that in the control group(F=4.883,P<0.05).Conclusion The upper limb robot-assisted therapy can improve the upper limb motor function and cerebral cortex activation of stroke patients.