Department of Occupational Therapy, China Rehabilitation Research Center; Faculty of Rehabilitation, Capital Medical University.
College of Sports Health, Tianjin Institute of Physical Education.
J Vis Exp. 2024 Feb 9(204). doi: 10.3791/65996.
To investigate the effects of functional occupational therapy (FOT) combined with different types of exercise on upper limb motor function recovery and brain function remodeling in patients with right hemisphere damage (RHD) by analyzing functional near-infrared spectroscopy (fNIRS). Patients (n = 32) with RHD at Beijing Bo'ai Hospital were recruited and randomly allocated to receive either FOT combined with passive motion (N=16) or FOT combined with assisted active movement (N=16). The passive motion group (FOT-PM) received functional occupational therapy for 20 min and passive exercise for 10 min in each session, while the assisted active movement group (FOT-AAM) received functional occupational therapy for 20 min and assisted active exercise for 10 min. Both groups received conventional drug therapy and other rehabilitation therapy. Treatment was performed once a day, 5 times a week for 4 weeks. The recovery of motor function and activities of daily living (ADL) was assessed using Fugl-Meyer Assessment upper extremity (FMA-UE) and modified Barthel index (MBI) before and after treatment, and brain activation of the bilateral motor area was analyzed with fNIRS. The findings suggested that FOT combined with AAM was more effective than FOT combined with PM in improving the motor function of RHD patients' upper limbs and fingers, improving their ability to perform activities of daily living, and facilitating brain function remodeling of the motor area.
采用功能近红外光谱(fNIRS)分析,探讨功能性作业疗法(FOT)联合不同类型运动对右侧大脑半球损伤(RHD)患者上肢运动功能恢复及脑功能重塑的影响。选取北京博爱医院收治的 32 例 RHD 患者,采用随机数字表法分为接受 FOT 联合被动运动(n=16)或 FOT 联合辅助主动运动(n=16)的观察组。被动运动组(FOT-PM)接受每次 20 min 的功能作业治疗和 10 min 的被动运动,辅助主动运动组(FOT-AAM)接受每次 20 min 的功能作业治疗和 10 min 的辅助主动运动。两组均接受常规药物治疗和其他康复治疗,每天治疗 1 次,每周 5 次,共 4 周。治疗前后采用 Fugl-Meyer 上肢运动功能评定量表(FMA-UE)和改良巴氏指数(MBI)评估上肢运动功能和日常生活活动(ADL)能力,采用功能近红外光谱(fNIRS)分析双侧运动区脑激活情况。结果发现,FOT 联合 AAM 治疗 RHD 患者,在改善上肢和手指运动功能、提高日常生活活动能力及促进运动区脑功能重塑方面,优于 FOT 联合 PM。