基于近红外脑功能成像技术指导下运动想象训练在脑卒中后上肢运动功能康复中的应用  

Application of mental imagery based on fNIRS in rehabilitation of stroke patients with upper limb paralysis

作　　者：周静 杨远滨[1] 田浩林 朱朝喆[2] 段炼[2] Zhou Jing;Yang Yuanbin;Tian Haolin(Department of Rehabilitation,WangJing Hospital of CACMS,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院康复一科,北京100102 [2]北京师范大学认知神经科学与学习国家重点实验室,北京100875

出　　处：《中国康复》2024年第3期131-134,共4页Chinese Journal of Rehabilitation

基　　金：中国中医科学院创新工程项目(CI2021A03010);科技部国家重大科学仪器设备开发专项项目(2012YQ120046)。

摘　　要：目的:观察运用近红外脑功能成像(fNIRS)技术筛选出想象策略的运动想象训练对脑卒中后上肢功能障碍的疗效,并探讨其作用机制。方法:将28例脑卒中患者随机分为对照组与研究组各14例。2组均给予常规康复治疗,研究组运用fNIRS技术筛选出有效的想象策略进行运动想象训练,对照组不固定想象内容进行运动想象训练。治疗前后采用上肢运动功能评定量表(FMA-UE)、上肢动作研究量表(ARAT)及改良Barthel指数评定量表(MBI)进行评定。结果:治疗4周后,2组患者的FMA-UE、ARAT及MBI评分均较治疗前显著提高(P<0.01),且研究组高于对照组(P<0.05)。结论:运用fNIRS技术筛选出的想象策略进行运动想象训练,可以更好地改善脑卒中患者的上肢运动功能及日常生活能力,其机制可能与提高运动相关脑区兴奋性有关。Objective:To investigate the effect of mental imagery(MI)therapy based on functional near-infrared spectroscopy(fNIRS)on upper limbs motor function following stroke and to explore its mechanism.Methods:A total of 28 patients were assigned to a control group and a treatment group randomly.Both two groups received conventional rehabilitation.In addition,treatment group received MI therapy in which imaginary content was screened by fNIRS.Control group received MI therapy in which imaginary content was flexible.The FMA-UE,ARAT and MBI were used to evaluate the upper limbs function and the activities of daily living before and after the treatment.Results:FMA-UE scores,ARAT scores and MBI scores before treatment in both groups were significantly higher than those before treatment(P<0.01).FMA-UE scores,ARAT scores and MBI scores in the treatment group were obviously higher than those in the control group(P<0.05).Conclusion:Imagery therapy based on fNIRS were feasible to improve the upper limbs motor function and daily life activity in stroke patients,which may be related to the activation in supplementary motor area.

关 键 词：脑卒中 上肢运动功能障碍 运动想象 近红外脑功能成像 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]