手部外骨骼机器人联合手运动想象对脑卒中偏瘫患者脑电信号及认知功能的影响  

Effect of hand exoskeleton robot combined with hand motion imagination on EEG signal and cognitive function in stroke patients with hemiplegia

作　　者：顾怡雯 舒锦 GU Yiwen;SHU Jin(Department of Rehabilitation,Shanghai Jing’an District Shibei Hospital,Shanghai 200435,China)

机构地区：[1]上海市静安区市北医院老年康复科,上海200435

出　　处：《机器人外科学杂志（中英文）》2024年第6期1116-1123,共8页Chinese Journal of Robotic Surgery

基　　金：上海市静安区卫生科研课题(2022MS10);上海市静安区卫生系统重点学科建设资助项目(2021ZD03)。

摘　　要：目的:探讨手部外骨骼机器人联合手运动想象对脑卒中偏瘫患者脑电信号及认知功能的影响。方法:选取2022年10月—2023年10月于上海市静安区市北医院老年康复科就诊的脑卒中后偏瘫手功能障碍患者120例,按照不同干预方法将其分为A、B、C三组,各40例。A组予以手运动想象联合常规康复治疗,B组予以手部外骨骼机器人联合常规康复治疗,C组予以手部外骨骼机器人联合手运动想象及常规康复治疗。比较三组患者Fugl-Meyer上肢运动功能量表(FMA-UL)评分、上肢动作研究量表(ARAT)评分、Carroll上肢功能试验(UEFT)评分、Batherl指数(BI)评分、蒙特利尔认知评估量表(MoCA)评分、简易精神状态检查量表(MMSE)评分、上肢肌电积分(i EMG)值、大脑各导联α波绝对功率值及总有效率。结果:治疗后4周,三组患者FMA-UL、ARAT、UEFT、BI评分及前臂伸肌肌群、上肢三角肌、肱三头肌iEMG值比较均显著升高,且C组显著高于A组、B组,差异有统计学意义(P<0.05)。三组患者MoCA、MMSE评分及大脑各导联α波绝对功率值比较均显著升高,且C组均显著高于A组、B组,A组均显著高于B组,差异有统计学意义(P<0.05)。C组总有效率(97.50%)显著高于A组总有效率(82.50%)与B组总有效率(80.00%),差异有统计学意义(P<0.05)。结论:手部外骨骼机器人联合手运动想象可明显改善脑卒中偏瘫患者认知功能与大脑功能状态,提高其日常生活能力及前臂伸肌肌群、上肢三角肌、肱三头肌iEMG值,更好地改善其上肢运动功能障碍。Objective:To investigate the effects of hand exoskeleton robot combined with hand motion imagination on EEG signal and cognitive function of stroke patients with hemiplegia.Methods:A total of 120 hemiplegia patients with hand dysfunction after stroke who were treated in Shanghai Jing’an District Shibei Hospital from October 2022 to October 2023 were selected.They were divided into 3 groups according to different intervention ways,with 40 cases in each group.Group A was given hand movement imagination combined with routine rehabilitation treatment,group B was given hand exoskeleton robot combined with routine rehabilitation treatment,while Group C was given the hand exoskeleton robot combined with hand movement imagination and routine rehabilitation treatment.Fugl-Meyer assessment of upper extremity(FMA-UE),action research arm test(ARAT),upper extremity function test(UEFT),Batherl Index(BI),montreal cognitive assessment(MoCA),mini-mental state examination(MMSE),and intramuscular EMG(iEMG)of the upper limbs,absolute power ofαoscillations of each brain lead and total effective rate were compared among the three groups.Results:4 weeks after treatment,FMA-UL,ARAT,UEFT and BI scores,iEMG values of the forearm extender muscle group,upper limb deltoid muscle,and triceps were significantly improved,while they were significantly better in group C than group A and B(P<0.05).MoCA,MMSE scores,and absolute power values ofαoscillations of brain leads were all increased in the three groups after treatment,while they were significantly better in group C than group A and B,and group A was significantly better than group B,with significant differences(P<0.05).Overall effective rate of Group C(97.50%)was noticeably higher than group A(82.50%)and group B(80.00%),and the differences were statistically significant(P<0.05).Conclusion:Hand exoskeleton robot combined with hand motion imagination can significantly improve the cognitive function,brain function and upper limb motor dysfunction of stroke patients with hemiplegia,as well a

关 键 词：脑卒中 手部外骨骼机器人 运动想象 康复 手功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]