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机器人辅助手部功能治疗对脑功能机制的影响:一项使用功能近红外光谱技术(fNIRS)和表面肌电图(sEMG)的同步研究

Effects of robot-assisted hand function therapy on brain functional mechanisms: a synchronized study using fNIRS and sEMG.

作者信息

Cheng Changfeng, Liu Tiantian, Zhang Beibei, Wu Xubo, Song Zhenwang, Zhao Zhongzhi, Ren Xue, Zhao Minjun, Su Yajuan, Wang Jiening

机构信息

Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.

The first affiliated hospital of Anhui University of Traditional Chinese Medicine, Anhui, China.

出版信息

Front Med (Lausanne). 2024 Oct 31;11:1411616. doi: 10.3389/fmed.2024.1411616. eCollection 2024.

Abstract

BACKGROUND

Robot-assisted hand function therapy is pivotal in the rehabilitation of patients with stroke; however, its therapeutic mechanism remains elusive. Currently, research examining the impact of robot-assisted hand function therapy on brain function in patients with stroke is scarce, and there is a lack of studies investigating the correlation between muscle activity and alterations in brain function.

OBJECTIVE

This study aimed to investigate the correlation between forearm muscle movement and brain functional activation by employing the synchronized use of functional near-infrared spectroscopy and surface electromyography methods. Moreover, it sought to compare neural activity patterns during different rehabilitation tasks and refine the mechanism of robot-assisted hand function therapy for post-stroke hand function impairments.

METHODS

Stroke patients with hand dysfunction underwent three sessions of robot-assisted hand function therapy within 2 weeks to 3 months of onset. The fNIRS-sEMG synchronous technique was used to observe brain function and forearm muscle activation. Ten participants were randomly assigned to receive mirror, resistance, or passive rehabilitation training. During the intervention, cortical and muscle activation information was obtained using fNIRS and electromyographic signals. The primary outcomes included changes in oxyhemoglobin concentration and root mean square of surface electromyography.

RESULTS

Compared to the resting state, the Oxy-Hb concentration in the brain regions involved in three rehabilitation tasks with robot-assisted hand function therapy significantly increased ( < 0.05). Mirror therapy significantly enhanced the prefrontal cortex and the superior frontal cortex activation levels. In contrast, resistance therapy significantly promoted the activation of the supplementary motor area and the premotor cortex. Passive rehabilitation tasks showed some activation in the target brain area premotor cortex region. Robot-assisted hand function therapy has shown that forearm muscle movement is closely related to oxygenated hemoglobin concentration activity in specific brain regions during different rehabilitation tasks.

CONCLUSION

The simultaneous sEMG-fNIRS study found a significant correlation between muscle movement and brain activity after stroke, which provides an important basis for understanding the treatment mechanism of hand function impairment.

摘要

背景

机器人辅助手功能治疗在中风患者的康复中起着关键作用;然而,其治疗机制仍不清楚。目前,研究机器人辅助手功能治疗对中风患者脑功能影响的研究较少,且缺乏调查肌肉活动与脑功能改变之间相关性的研究。

目的

本研究旨在通过同步使用功能近红外光谱和表面肌电图方法,研究前臂肌肉运动与脑功能激活之间的相关性。此外,它试图比较不同康复任务期间的神经活动模式,并完善机器人辅助手功能治疗对中风后手功能障碍的机制。

方法

手功能障碍的中风患者在发病后2周内至3个月内接受了3次机器人辅助手功能治疗。采用功能近红外光谱-表面肌电图同步技术观察脑功能和前臂肌肉激活情况。10名参与者被随机分配接受镜像、阻力或被动康复训练。在干预过程中,使用功能近红外光谱和肌电信号获取皮质和肌肉激活信息。主要结果包括氧合血红蛋白浓度的变化和表面肌电图的均方根。

结果

与静息状态相比,机器人辅助手功能治疗的三项康复任务所涉及的脑区氧合血红蛋白浓度显著增加(<0.05)。镜像治疗显著提高了前额叶皮质和额上回皮质的激活水平。相比之下,阻力治疗显著促进了辅助运动区和运动前皮质的激活。被动康复任务在目标脑区运动前皮质区域显示出一些激活。机器人辅助手功能治疗表明,在不同的康复任务中,前臂肌肉运动与特定脑区的氧合血红蛋白浓度活动密切相关。

结论

同步表面肌电图-功能近红外光谱研究发现中风后肌肉运动与脑活动之间存在显著相关性,这为理解手功能障碍的治疗机制提供了重要依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab1e/11560759/b162d31e9cdf/fmed-11-1411616-g001.jpg

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