功能性电刺激“环路干预”模式在脑卒中手功能康复中的研究进展  

Research progress of functional electrical stimulation-based'Loop Intervention'model in hand function rehabilitation after stroke

作　　者：王语纯 陈树耿 贾杰 Wang Yuchun;Chen Shugeng;Jia Jie(Department of Rehabilitation Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China;National Clinical Research Center for Geriatric Diseases(Huashan),Shanghai 200040,China;National Center for Neurological Diseases,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院康复医学科,上海200040 [2]国家老年疾病临床医学研究中心(华山),上海200040 [3]国家神经疾病医学中心,上海200040

出　　处：《现代仪器与医疗》2025年第1期9-15,共7页Modern Instruments & Medical Treatment

基　　金：国家自然科学基金资助项目(82202798);上海扬帆专项(22YF1404200)。

摘　　要：脑卒中患者手功能康复“环路干预”基于“中枢-外周-中枢”闭合环路,通过有机融合中枢干预与外周干预,构建“闭环”式信息反馈,精准作用于患者特定或功能相关脑区。该模式以大脑可塑性和神经通路重塑为基础,充分发挥“外周干预”与“中枢干预”的互补功能,直击脑损伤后皮质功能改变的关键问题,有效促进中枢重塑和外周控制,提高患者手功能。功能性电刺激(Functional Electrical Stimulation,FES)有多种外周干预模式,如联动FES、任务导向训练FES、实时FES等,其常见组合使用的中枢干预方法有重复经颅磁刺激、经颅直流电刺激、脑机接口等,二者结合形成“环路干预”模式。“环路干预”致力于为临床脑卒中患者手功能康复提供更具成效的治疗方案,对于提升患者日常生活活动能力、改善生活质量意义具有很好的应用价值,有望切实改善脑卒中患者康复现状,具有深远的社会价值。The‘loop intervention’for the hand function rehabilitation of stroke patients is based on the‘central-peripheral-central’closed loop.By organically integrating central intervention and peripheral intervention,it constructs a‘closed-loop’information feedback system,which precisely acts on the specific or functionally related brain regions of patients.This model is based on brain plasticity and the remodeling of neural pathways,giving full play to the complementary functions of‘peripheral intervention’and‘central intervention’.It directly addresses the key issue of the change in cortical function after brain injury,effectively promoting central remodeling and peripheral control,and improving the hand function of patients.Functional electrical stimulation(FES)has various peripheral intervention modes,such as linked FES,task-oriented training FES,real-time FES,etc.The commonly combined central intervention methods include repetitive transcranial magnetic stimulation,transcranial direct current stimulation,brain-computer interface,etc.The combination of the two forms the‘loop intervention’model.The‘loop intervention’is committed to providing a more effective treatment plan for the hand function rehabilitation of clinical stroke patients.It has great application value in improving patients'ability to perform daily activities and their quality of life.It is expected to effectively improve the rehabilitation status of stroke patients and has far-reaching social value.

关 键 词：手功能 功能性电刺激 外周干预 中枢干预 脑卒中1 

分 类 号：TH77[机械工程—仪器科学与技术] R49[机械工程—精密仪器及机械]