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增强颈脊髓损伤患者的手部感觉运动功能:一种采用多基线设计的新型触觉辨别反馈方法。

Enhancing Hand Sensorimotor Function in Individuals with Cervical Spinal Cord Injury: A Novel Tactile Discrimination Feedback Approach Using a Multiple-Baseline Design.

作者信息

Kitai Ken, Nishigaya Kaichi, Mizomoto Yasuhisa, Ito Hiroki, Yamauchi Ryosuke, Katayama Osamu, Morita Kiichiro, Murata Shin, Kodama Takayuki

机构信息

Rehabilitation Department, Maizuru Red Cross Hospital, Maizuru City 624-0906, Kyoto, Japan.

Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto City 607-8175, Kyoto, Japan.

出版信息

Brain Sci. 2025 Mar 28;15(4):352. doi: 10.3390/brainsci15040352.

DOI:10.3390/brainsci15040352
PMID:40309804
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12026407/
Abstract

: This study evaluated the effects of a tactile-discrimination compensatory real-time feedback device on hand sensorimotor function in cervical spinal cord injury patients. The study assessed changes in hand numbness, dexterity, and electroencephalogram (EEG) activity, particularly γ-wave power in the sensorimotor area during skilled finger movements. : Three patients with cervical spinal cord injury who presented with hand sensorimotor dysfunction underwent treatment with this device. All cases underwent the intervention using an AB design; A is the exercise task without the system device, and B is the exercise task under the system device. To confirm the reproducibility and minimize the influence of confounding factors, a multiple-baseline design, in which the intervention period was staggered for each subject, was applied. To determine efficacy, the hand numbness numerical rating scale, peg test, and EEG were measured daily, and Tau-U calculations were performed. : In two of three cases, moderate or very large changes were observed in numbness in B. In all cases, there was a large or very large change in the peg test results in the B. Regarding EEG activity, the non-skilled participants showed amplification of γ-wave power in the sensorimotor area during the B. Conversely, in the skilled participants, the γ-wave power of the sensorimotor area was attenuated during skillful movements. : These findings indicate that the ability of the brain to compare and align predictive control with sensory feedback might be compromised in patients with damage to the afferent pathways of the central nervous system. Moreover, the use of this device appears to have played a role in supporting functional recovery.

摘要

本研究评估了一种触觉辨别补偿实时反馈装置对颈脊髓损伤患者手部感觉运动功能的影响。该研究评估了手部麻木、灵活性和脑电图(EEG)活动的变化,特别是在熟练手指运动期间感觉运动区域的γ波功率。

三名存在手部感觉运动功能障碍的颈脊髓损伤患者接受了该装置的治疗。所有病例均采用AB设计进行干预;A是无系统装置的运动任务,B是系统装置下的运动任务。为了确认可重复性并尽量减少混杂因素的影响,采用了多基线设计,即每个受试者的干预期错开。为了确定疗效,每天测量手部麻木数字评定量表、钉板试验和脑电图,并进行Tau-U计算。

在三例中的两例中,观察到B期麻木有中度或非常大的变化。在所有病例中,B期钉板试验结果有很大或非常大的变化。关于脑电图活动,非熟练参与者在B期感觉运动区域的γ波功率增强。相反,在熟练参与者中,感觉运动区域的γ波功率在熟练运动期间减弱。

这些发现表明,中枢神经系统传入通路受损的患者,大脑将预测控制与感觉反馈进行比较和匹配的能力可能会受到损害。此外,使用该装置似乎在支持功能恢复方面发挥了作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdc4/12026407/cc1a9f7696db/brainsci-15-00352-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdc4/12026407/cbc18d1996cc/brainsci-15-00352-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdc4/12026407/cc1a9f7696db/brainsci-15-00352-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdc4/12026407/cbc18d1996cc/brainsci-15-00352-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdc4/12026407/cc1a9f7696db/brainsci-15-00352-g002.jpg

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The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review.诊断为退行性颈椎脊髓病患者的症状频率:一项范围综述的结果
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