IEEE Trans Neural Syst Rehabil Eng. 2018 Sep;26(9):1897-1905. doi: 10.1109/TNSRE.2018.2864990. Epub 2018 Aug 13.
Mirror visual feedback (MVF) is used widely for motor recovery after stroke, but an optimal training setup and systematic procedure are lacking. New optimization strategies have been proposed, one of which is a camera technique. We investigated the effects of a camera-based MVF setup on motor function and motor processes upstream for upper-limb rehabilitation. Seventy-nine stroke patients were assigned randomly to the MVF group (MG; ${N} = {38}$ ) or conventional group (CG; ${N} = {41}$ ), which, respectively, received camera-based MVF and dosage-equivalent physiotherapy or/and occupational therapy for 1 h/day and five days/week for four weeks. Two clinical scales were used to quantify the effect of the intervention methods: the Fugl-Meyer assessment-upper limb (FMA-UL) subscale and Barthel index. The hand laterality task was used to evaluate the ability of mental rotation, including the reaction time and accuracy. All measurements were improved significantly for both groups following intervention. FMA-UL was improved significantly in the MG compared with that in the CG. In lateralization tasks, the RT of the MG was significantly shorter than that of the CG at the endpoint. For all patients, judgments for the affected side were significantly slower and less accurate than for the less-affected side. Subgroup analyses suggested greater benefits of motor function, the activities of daily life, and mental rotation were achieved in subacute patients after MVF. A trend toward greater improvements in motor function for patients with severe-moderate motor impairment and patients with right-hemisphere damage were also revealed. Camera-based MVF has improved the motor function and ability of mental rotation for stroke patients, especially for patients in the subacute stage, which indicates the potential to improve motor preparation. Further studies might combine mental rotation with electroencephalography to investigate the neuro-mechanism of MVF.
镜像视觉反馈 (MVF) 广泛应用于脑卒中后的运动康复，但缺乏最佳的训练设置和系统的程序。已经提出了新的优化策略，其中之一是相机技术。我们研究了基于相机的 MVF 设置对上肢康复运动功能和运动过程上游的影响。79 例脑卒中患者被随机分为 MVF 组 (MG; ${N} = {38}$ ) 或常规组 (CG; ${N} = {41}$ )，分别接受基于相机的 MVF 和剂量等效的物理治疗或/和作业治疗，每天 1 小时，每周 5 天，持续 4 周。使用两种临床量表来量化干预方法的效果：Fugl-Meyer 上肢评估量表 (FMA-UL) 子量表和 Barthel 指数。使用手偏侧性任务评估心理旋转能力，包括反应时间和准确性。干预后两组的所有测量均显著改善。MG 的 FMA-UL 明显优于 CG。在手偏侧性任务中，MG 的 RT 在终点明显短于 CG。对于所有患者，对患侧的判断明显比对非患侧的判断慢且不准确。亚组分析表明，MVF 后亚急性期患者的运动功能、日常生活活动和心理旋转能力的获益更大。还显示出严重中度运动障碍患者和右脑损伤患者的运动功能改善趋势更大。基于相机的 MVF 改善了脑卒中患者的运动功能和心理旋转能力，特别是对亚急性期患者，这表明其具有改善运动准备的潜力。进一步的研究可能将心理旋转与脑电图相结合，以研究 MVF 的神经机制。
