肩关节特定屈曲角度训练联合脑机接口训练对卒中后上肢运动功能障碍患者上肢运动功能及认知功能的影响  

Effect of Specific Flexion Angle of the Shoulder Joint Training Combined with Brain-Computer Interfaces Training on Upper Limb Motor Function and Cognitive Function in Patients with Motor Dysfunction of the Upper Limbs after Stroke

作　　者：王建文 王辉 党瑞 WANG Jianwen;WANG Hui;DANG Rui(Department of Spinal Cord Rehabilitation,Xi'an International Medical Center Hospital,Xi'an 710100,China)

机构地区：[1]西安国际医学中心医院脊柱脊髓康复科,陕西省西安市710100

出　　处：《实用心脑肺血管病杂志》2024年第11期115-119,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：陕西省重点研发计划项目(2022SF-567)。

摘　　要：目的探讨肩关节特定屈曲角度联合脑机接口对卒中后上肢运动功能障碍患者上肢运动功能及认知功能的影响。方法选取2021年10月—2023年4月西安国际医学中心医院收治的卒中后上肢运动功能障碍患者96例,采用随机数字表法将其分为对照组和研究组,每组48例。所有患者入组后进行常规物理康复训练,此外,对照组接受脑机接口训练,研究组在对照组基础上接受肩关节特定屈曲角度训练。两组均持续干预6周。比较两组干预前后FuglMeyer运动功能评定量表上肢部分(FMA-UE)评分、运动功能评估量表(MAS)评分、肩关节前屈角度实际值与目标值(30°、60°、90°)的差值(Δ30°、Δ60°、Δ90°)、腕掌屈肌力、腕背伸肌力、皮质脊髓束运动诱发电位的潜伏期和波幅、蒙特利尔认知评估(MoCA)量表评分、简易精神状态检查(MMSE)量表评分。结果干预后,两组FMA-UE、MAS评分分别高于本组干预前,且研究组FMA-UE、MAS评分高于对照组(P<0.05)。干预后,两组Δ60°、Δ90°分别小于本组干预前,且研究组Δ60°、Δ90°小于对照组(P<0.05)。干预后,两组腕掌屈肌力、腕背伸肌力分别大于本组干预前,且研究组腕掌屈肌力、腕背伸肌力大于对照组(P<0.05)。干预后,两组皮质脊髓束运动诱发电位波幅分别高于本组干预前,且研究组皮质脊髓束运动诱发电位波幅高于对照组(P<0.05)。干预后,两组MoCA量表、MMSE量表评分分别高于本组干预前,且研究组MoCA量表、MMSE量表评分高于对照组(P<0.05)。结论肩关节特定屈曲角度训练联合脑机接口训练可以促进卒中后上肢运动功能障碍患者上肢运动功能的恢复,提升患者认知功能。Objective To explore the effect of specific flexion angle of the shouldeRjoint training combined with brain-computeRinterfaces training on uppeRlimb motoRfunction and cognitive function in patients with motoRdysfunction of the uppeRlimbs afteRstroke.Methods A lot of 96 patients with uppeRlimb motoRdysfunction afteRstroke admitted to Xi'an International Medical CenteRHospital from OctobeR2021 to April 2023 were selected and divided into the control group and the study group using the random numbeRtable method,with 48 cases in each group.All patients underwent routine physical rehabilitation training afteRenrollment,and the control group received brain-computeRinterfaces intervention.The study group received specific flexion angle of the shouldeRjoint training on the basis of the control group.Both groups continued training for 6 weeks.The Fugl-MeyeRAssessment-UppeRExtremity(FMA-UE)score,MotoRAssessment Scale(MAS)score,the difference between the actual value and the target value(30°,60°,90°)of the shouldeRjoint flexion angle(Δ30°,Δ60°,Δ90°),wrist and palmaRflexion muscle strength,wrist dorsiflexion muscle strength,the latency and amplitude of the corticospinal tract motoRevoked potential,Montreal Cognitive Assessment(MoCA)score,Mini-Mental State Examination(MMSE)score before and afteRintervention were compared between the two groups.Results AfteRintervention,the FMA-UE and MAS scores in both groups were higheRthan those before intervention respectively,and the FMA-UE and MAS scores in the study group were higher than those in the control group(P<0.05).AfteRintervention,theΔ60°andΔ90°in both groups were less than those before intervention respectively,and theΔ60°andΔ90°in the study group were less than those in the control group(P<0.05).After intervention,the wrist and palmaRflexion muscle strength and wrist dorsiflexion muscle strength in both groups were greateRthan those before intervention respectively,and the wrist and palmaRflexion muscle strength and wrist dorsiflexion muscle strength in the

关 键 词：卒中 上肢运动功能障碍 肩关节特定屈曲角度 脑-机接口 认知 

分 类 号：R743[医药卫生—神经病学与精神病学]