Sun Yao, Wei Wei, Luo Zhizeng, Gan Haitao, Hu Xiaohua
a College of Electric Engineering , Zhejiang University , Hangzhou , Zhejiang , China.
b Robot Research Institute , Hangzhou Dianzi University , Hangzhou , Zhejiang , China.
Top Stroke Rehabil. 2016 Aug;23(4):245-53. doi: 10.1080/10749357.2016.1141472. Epub 2016 Feb 17.
Action observation (AO) has the potential to improve motor imagery (MI) practice in stroke patients. However, currently only a few results are available on how to use AO effectively.
The aim of this study is to investigate whether MI practice can be improved more effectively by synchronous AO than by asynchronous AO.
Ten patients with upper limb motor dysfunction following stroke were selected as the participants. They were divided into two groups to perform MI practice combined with a daily conventional rehabilitation for four consecutive weeks. The control group was asked to perform MI guided by asynchronous AO (MIAAO), and the experimental group was asked to perform the same MI but guided by synchronous AO (MISAO). The event-related power decrease (ERD) in sensorimotor rhythms of electroencephalograph was calculated to reflect the sensorimotor cortex activation and to assess the cortex excitability during MI. Fugl-Meyer assessment (FMA) and pinch strength test (PST) were used to assess the limb motor recovery.
The ERD pattern of the experimental group not only had greater amplitude and longer duration, but also included more frequency components. Furthermore, the effect sizes of ERD values between the two groups continuously increased (dES > 0.8) during the course of treatment. Moreover, the FMA and PST scores achieved with MISAO were also significantly higher than those achieved with MIAAO (p < 0.05).
Compared with MIAAO, MISAO can enhance the excitation of sensorimotor cortex more effectively and lead to a more rapid neurorehabilitation of stroke patients.
动作观察（AO）有潜力改善中风患者的运动想象（MI）训练。然而，目前关于如何有效使用AO的研究结果较少。
本研究旨在探讨与异步动作观察相比，同步动作观察是否能更有效地改善运动想象训练。
选取10例中风后上肢运动功能障碍患者作为研究对象。将他们分为两组，连续四周进行结合日常传统康复治疗的运动想象训练。对照组在异步动作观察引导下进行运动想象训练（MIAAO），实验组在同步动作观察引导下进行相同的运动想象训练（MISAO）。计算脑电图感觉运动节律中的事件相关功率下降（ERD），以反映感觉运动皮层激活情况并评估运动想象过程中的皮层兴奋性。采用Fugl-Meyer评估（FMA）和捏力测试（PST）评估肢体运动恢复情况。
实验组的ERD模式不仅幅度更大、持续时间更长，而且包含更多频率成分。此外，两组之间ERD值的效应量在治疗过程中持续增加（dES>0.8）。而且，MISAO组的FMA和PST评分也显著高于MIAAO组（p<0.05）。
与MIAAO相比，MISAO能更有效地增强感觉运动皮层的兴奋性，使中风患者的神经康复进程更快。
