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一名53岁截肢者康复训练中的生理和神经变化:病例研究

Physiological and Neural Changes with Rehabilitation Training in a 53-Year Amputee: A Case Study.

作者信息

Mao Lin, Lu Xiao, Yu Chao, Yin Kuiying

机构信息

Nanjing Research Institute of Electronic Technology, Nanjing 210019, China.

Department of Rehabilitation Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China.

出版信息

Brain Sci. 2022 Jun 26;12(7):832. doi: 10.3390/brainsci12070832.

Abstract

Many people who received amputation wear sEMG prostheses to assist in their daily lives. How these prostheses promote muscle growth and change neural activity remains elusive. We recruited a subject who had his left hand amputated for over 53 years to participate in a six-week rehabilitation training using an sEMG prosthesis. We tracked the muscle growth of his left forearm and changes in neural activity over six weeks. The subject showed an increase in fast muscle fiber in his left forearm during the training period. In an analysis of complex networks of neural activity, we observed that the α-band network decreased in efficiency but increased in its capability to integrate information. This could be due to an expansion of the network to accommodate new movements enabled by rehabilitation training. Differently, we found that in the β-band network, a band frequency related to motor functions, the efficiency of the network initially decreased but started to increase after approximately three weeks. The ability to integrate network information showed an opposite trend compared with its efficiency. rMT values, a measure that negatively correlates with cortical excitability, showed a sharp decrease in the first three weeks, suggesting an increase in cortical excitability. In the last three weeks, there was little to no change. These data indicate that rehabilitation training promoted fast muscle fiber growth and introduced neural activity changes in the subject during the first three weeks of training. Our study gave insights into how rehabilitation training with an sEMG prosthesis could lead to physiological and neural changes in amputees.

摘要

许多接受截肢的人佩戴表面肌电假肢以辅助日常生活。这些假肢如何促进肌肉生长以及改变神经活动仍不清楚。我们招募了一名左手截肢超过53年的受试者,让其使用表面肌电假肢参与为期六周的康复训练。我们跟踪了他左前臂的肌肉生长情况以及六周内神经活动的变化。在训练期间,该受试者左前臂的快肌纤维有所增加。在对神经活动复杂网络的分析中,我们观察到α波段网络的效率下降,但信息整合能力增强。这可能是由于网络扩展以适应康复训练带来的新动作。不同的是,我们发现,在与运动功能相关的频段β波段网络中,网络效率最初下降,但在大约三周后开始上升。网络信息整合能力与其效率呈现相反趋势。rMT值(一种与皮质兴奋性呈负相关的指标)在前三周急剧下降,表明皮质兴奋性增加。在最后三周,几乎没有变化。这些数据表明,康复训练在前三周促进了快肌纤维生长,并使受试者的神经活动发生了变化。我们的研究深入了解了使用表面肌电假肢的康复训练如何导致截肢者的生理和神经变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db3b/9313058/cd6a54c6cbc5/brainsci-12-00832-g001.jpg

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