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基于运动想象的脑机接口控制电刺激对脑卒中急性期偏瘫患者下肢功能的影响:一项随机对照研究。

Effects of motor imagery-based brain-computer interface-controlled electrical stimulation on lower limb function in hemiplegic patients in the acute phase of stroke: a randomized controlled study.

作者信息

Luo Xi

机构信息

North Sichuan Medical College, Nanchong, China.

Pan Zhihua Integrated Traditional Chinese and Western Medicine Hospital, Panzhihua, China.

出版信息

Front Neurol. 2024 Aug 30;15:1394424. doi: 10.3389/fneur.2024.1394424. eCollection 2024.

Abstract

BACKGROUND

Lower limb motor dysfunction is one of the most serious consequences of stroke; however, there is insufficient evidence for optimal rehabilitation strategies. Improving lower limb motor function through effective rehabilitation strategies is a top priority for stroke patients. Neuroplasticity is a key factor in the recovery of motor function. The extent to which neuroplasticity-based rehabilitation therapy using brain-computer interface (BCI) is effective in treating lower limb motor dysfunction in acute ischemic stroke patients has not been extensively investigated.

OBJECTIVE

This study aimed to assess the impact of BCI rehabilitation on lower limb motor dysfunction in individuals with acute ischemic stroke by evaluating motor function, walking ability, and daily living activities.

METHODS

This study was conducted in a randomized controlled trial, involving 64 patients with acute ischemic stroke who experienced lower limb motor dysfunction. All patients were divided into two groups, with 32 patients assigned to the control group was given conventional rehabilitation once a day for 70 min, 5 times a week for 2 weeks, and the experimental group ( = 32) was given BCI rehabilitation on top of the conventional rehabilitation for 1 h a day, 30 min of therapy in the morning and an additional 30 min in the afternoon, for a total of 20 sessions over a two-week period. The primary outcome was lower extremity motor function, which was assessed using the lower extremity portion of the Fugl-Meyer Rating Scale (FMA-LE), and the secondary endpoints were the Functional Ambulation Scale (FAC), and the Modified Barthel index (MBI).

RESULTS

After 20 sessions of treatment, both groups improved in motor function, walking function, and activities of daily living, and the improvements in FMA-LE scores ( < 0.001), FAC ( = 0.031), and MBI ( < 0.001) were more pronounced in the experimental group compared with the control group.

CONCLUSION

Conventional rehabilitation therapy combined with BCI rehabilitation therapy can improve the lower limb motor function of hemiplegic patients with stroke, enhance the patient's ability to perform activities of daily living, and promote the improvement of walking function, this is an effective rehabilitation policy to promote recovery from lower extremity motor function disorders.

摘要

背景

下肢运动功能障碍是中风最严重的后果之一;然而,关于最佳康复策略的证据并不充分。通过有效的康复策略改善下肢运动功能是中风患者的首要任务。神经可塑性是运动功能恢复的关键因素。基于神经可塑性的脑机接口(BCI)康复治疗在治疗急性缺血性中风患者下肢运动功能障碍方面的有效性尚未得到广泛研究。

目的

本研究旨在通过评估运动功能、步行能力和日常生活活动,来评估BCI康复对急性缺血性中风患者下肢运动功能障碍的影响。

方法

本研究采用随机对照试验,纳入64例急性缺血性中风且伴有下肢运动功能障碍的患者。所有患者分为两组,32例患者被分配到对照组,每天接受一次常规康复治疗,每次70分钟,每周5次,共2周;实验组(n = 32)在常规康复治疗的基础上,每天接受1小时的BCI康复治疗,上午治疗30分钟,下午额外治疗30分钟,两周内共进行20次治疗。主要结局是下肢运动功能,采用Fugl-Meyer评定量表(FMA-LE)的下肢部分进行评估,次要终点是功能性步行量表(FAC)和改良Barthel指数(MBI)。

结果

经过20次治疗后,两组患者的运动功能、步行功能和日常生活活动均有所改善,与对照组相比,实验组FMA-LE评分(P < 0.001)、FAC(P = 0.031)和MBI(P < 0.001)的改善更为显著。

结论

常规康复治疗联合BCI康复治疗可改善中风偏瘫患者的下肢运动功能,增强患者的日常生活活动能力,促进步行功能的改善,这是促进下肢运动功能障碍恢复的有效康复策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87e8/11418395/ce7e399cebc4/fneur-15-1394424-g001.jpg

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