Wang Nan, Xue Yan, Wang Tongyue, Qiu Fengxi, Li Cheng, Wang Zhiyuan, Jiang Jianke, Lu Yi, Shao Yingqi, Bai Zhongfei, Lan Danmei, Hu Qilong, Wu Hengjing
Department of Traditional Chinese Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 201619, China.
Clinical Research Center, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 201619, China.
J Neuroeng Rehabil. 2025 Jul 14;22(1):162. doi: 10.1186/s12984-025-01679-9.
Stroke is a leading cause of death and disability worldwide, especially in China, where its incidence is rising. Post-stroke rehabilitation is crucial for restoring neurological function and improving quality of life. Light therapy, a non-pharmacological intervention, is gaining attention for its potential to promote neuroplasticity and enhance brain circulation. Warm and cold light, characterized by different color temperatures, have demonstrated beneficial effects on sleep quality, neurological recovery, and emotional well-being in stroke patients. However, the underlying mechanisms remain incompletely understood. This study explores the effects of different light color temperatures on stroke recovery to optimize rehabilitation approaches.
The study was designed as a prospective, single-center, randomized controlled trial. 48 patients with ischemic stroke were randomly divided into three groups (1:1:1): warm light group (WLG, 500 lx, 3000 K, n = 16), cold light group (CLG, 500 lx, 6500 K, n = 16), and control group (CG, 500 lx, 5000 K, n = 16). Patients in all three groups received 60 min of rehabilitation therapy daily, from Monday to Friday between 8:30 and 9:30 AM, under light environments with different color temperatures. National Institutes of Health Stroke Scale (NIHSS), Short Form-36 (SF-36), Self-Rating Sleep Scale (SRSS), and levels of interleukin 6 (IL-6), norepinephrine (NE) and melatonin (MT) were measured before and after 4 weeks of intervention.
After 4 weeks intervention, CLG showed a significant reduction of NIHSS when compared to CG(p < 0.001, partial η = 0.316) and WLG(p = 0.003, partial η = 0.237). Although all three groups showed significant reductions in SRSS scores in the within-group comparisons, between-group comparisons revealed that CLG demonstrated a significantly greater reduction in SRSS compared to CG (p = 0.004, partial η = 0.253) and WLG (p = 0.007, partial η = 0.241). Regarding the SF-36, the physical component summary (PCS) score significantly decreased in both CG (Δ = -5.34 ± 7.35, p = 0.011) and WLG (Δ = -3.63 ± 4.68, p = 0.015), while CLG showed a significant improvement (Δ = 4.28 (8.78), p = 0.024). Between-group analysis demonstrated that post-intervention PCS scores were significantly higher in CLG compared to CG (p = 0.001, partial η = 0.323) and WLG (p = 0.002, partial η = 0.326), with no significant difference between CG and WLG (p = 0.104). Mental component summary (MCS) scores showed no statistically significant differences either within or between groups. No significant changes in NE and IL-6 levels were observed across all groups. CLG showed a significant reduction of MT when compared to WLG(p = 0.018, partial η = 0.174). No apparent adverse events were reported.
This study demonstrated that cold light therapy significantly improves neurological function, sleep quality, physical health status, including better performance on the physical component of quality of life in post-stroke patients, while warm light shows moderate benefits in sleep. These results support the integration of light-based interventions as adjunctive strategies in post-stroke care. Trial registration The study was registered in Chinese Clinical Trial Registry as a clinical trial ID (ChiCTR2200057541), March 14, 2022.
中风是全球范围内导致死亡和残疾的主要原因，在中国尤其如此，其发病率正在上升。中风后康复对于恢复神经功能和提高生活质量至关重要。光疗法作为一种非药物干预手段，因其促进神经可塑性和增强脑循环的潜力而受到关注。暖光和冷光具有不同的色温，已证明对中风患者的睡眠质量、神经恢复和情绪健康有有益影响。然而，其潜在机制仍未完全了解。本研究探讨不同光色温对中风恢复的影响，以优化康复方法。
本研究设计为一项前瞻性、单中心、随机对照试验。48例缺血性中风患者被随机分为三组（1:1:1）：暖光组（WLG，500勒克斯，3000开尔文，n = 16）、冷光组（CLG，500勒克斯，6500开尔文，n = 16）和对照组（CG，500勒克斯，5000开尔文，n = 16）。三组患者均在不同色温的光照环境下，每天上午8:30至9:30接受60分钟的康复治疗，周一至周五进行。在干预4周前后测量美国国立卫生研究院卒中量表（NIHSS）、简明健康调查问卷（SF - 36）、自评睡眠量表（SRSS）以及白细胞介素6（IL - 6）、去甲肾上腺素（NE）和褪黑素（MT）水平。
干预4周后，与CG组相比，CLG组NIHSS显著降低（p < 0.001，偏η = 0.316），与WLG组相比也显著降低（p = 0.003，偏η = 0.237）。虽然三组组内比较SRSS评分均显著降低，但组间比较显示，与CG组相比，CLG组SRSS降低更显著（p = 0.004，偏η = 0.253），与WLG组相比也更显著（p = 0.007，偏η = 0.241）。关于SF - 36，CG组（Δ = -5.34 ± 7.35，p = 0.011）和WLG组（Δ = -3.63 ± 4.68，p = 0.015）的身体成分总结（PCS）评分均显著下降，而CLG组则显著改善（Δ = 4.28（8.78），p = 0.024）。组间分析表明，干预后CLG组的PCS评分显著高于CG组（p = 0.001，偏η = 0.323）和WLG组（p = 0.002，偏η = 0.326），CG组和WLG组之间无显著差异（p = 0.104）。心理成分总结（MCS）评分在组内和组间均无统计学显著差异。所有组的NE和IL - 6水平均未观察到显著变化。与WLG组相比，CLG组MT显著降低（p = 0.018，偏η = 0.174）。未报告明显不良事件。
本研究表明，冷光疗法可显著改善中风患者的神经功能、睡眠质量和身体健康状况，包括在生活质量身体成分方面表现更好，而暖光在睡眠方面显示出适度益处。这些结果支持将基于光的干预作为中风后护理的辅助策略。试验注册 本研究于2022年3月14日在中国临床试验注册中心注册为临床试验ID（ChiCTR2200057541）。
