脑机接口结合外骨骼机器手对脑梗死患者手功能障碍的闭环康复效果OA北大核心CSTPCD
The clinical efficacy of closed-loop rehabilitation therapy by brain-computer interface combined with exo-skeleton robotic hand for patients with hand dysfunction after cerebral infarction
目的 观察基于闭环干预理论的脑机接口结合外骨骼机器手训练对脑梗死患者手功能恢复的疗效,并分析患者认知功能和内在运动想象能力对脑机接口识别率的影响.方法 选取50例脑梗死患者,随机分配至观察组和对照组,每组各25例.两组患者均接受常规康复项目,观察组在此基础上额外接受脑机接口闭环康复训练.治疗前后比较两组患者的Fugl-Meyer运动功能量表上肢部分(FMA-UE)、手臂动作调查测试(ARAT)、WOLF运动功能评定(WMFT)和腕指屈肌肌张力的改良Ashworth评分(MAS).干预前使用心理旋转测试和蒙特利尔认知评估量表(MoCA)判断观察组患者基线内在运动想象能力和认知能力,分析影响脑机接口闭环康复疗效的相关因素.结果 两组患者治疗前各评分差异均无统计学意义(P>0.05),干预后观察组FMA-UE、ARAT及WMFT的评分均较对照组提高,腕指屈肌MAS评分较对照组有所下降,差异有统计学意义(均P<0.05).此外,脑机接口识别通过率与心理旋转试验正确率、MoCA认知功能评分呈正相关(P<0.05),与心理旋转试验反应时间呈负相关(P<0.05).结论 基于闭环干预理论的脑机接口结合外骨骼机器手可以促进脑梗死患者上肢和手运动功能的恢复.同时,进行脑机接口干预前应对患者的内在运动想象能力以及认知功能进行筛查,以筛选适合接受训练的患者.
Objective To observe the clinical efficacy of closed-loop rehabilitation therapy by brain-computer interface(BCI)combined with exoskeleton robotic hand in patients with hand dysfunction after cerebral infarction and analyze the influence of patients'cognitive function and implicit motor imagery ability on the recognition rate of BCI.Methods A total of 50 patients with cerebral infarction were randomly assigned to the observation group and the control group,25 patients in each group.Both groups received routine rehabilitation programs.In addition to the conventional rehabilitation treatment,the observation group received the closed-loop BCI rehabilitation trainingby brain-computer interface(BCI)combined with exoskeleton robotic hand.The scores of Fugl-Meyer Assessment of the Upper Extremity(FMA-UE),Action Research Arm Test(ARAT),Wolf Motor Function Test(WMFT),and Modified Ashworth scale(MAS)of the wrist flexors were compared between the two groups before and after treatment.Before intervention,the mental rotation test and Montreal Cognitive Assessment(MoCA)were used to assess the baseline implicit motor imagery ability and cognitive level of patients in the observation group.The correlation analysis between these scores and the recognition rate of BCI was conducted to analyze the relevant factors affecting the closed-loop rehabilitation effects of BCI.Results The two groups showed no significant difference in all outcomes before treatment(both P>0.05).After intervention,the observation group exhibited the significantly higher scores of FMA-UE,ARAT,and WMFT(all P<0.05),and significantly lower MAS scores of wrist and finger flexors compared with the control group(all P<0.05).In addition,the recognition rate of BCI was positively correlated with the accuracy of mental rotation test and MoCA score(P<0.05),and negatively corre-lated with the reaction time of mental rotation test(P<0.05).Conclusions Closed-loop rehabilitation training with BCI combined with exoskeleton robot hand can promote the recovery of upper limbs and hand motor function in patients with cerebral infarction.Additionally,the implicit motor imagery ability and cognitive function of patients are suggested to be used for screening the patients suitable for BCI training before the implementation of BCI treatment.
邹贵娣;陈小凯;谭卉虹;李翊;李楠;曹叶凡;王鹤玮
惠州市第三人民医院康复医学科(广东惠州 516002)复旦大学华山医院康复医学科(上海 200040)
临床医学
脑梗死脑机接口外骨骼机器手手功能障碍运动想象
cerebral infarctionbrain-computer interfaceexoskeleton robotic handhand dysfunc-tionmotor imagery
《实用医学杂志》 2024 (017)
2395-2400 / 6
国家自然科学青年基金项目(编号:82102665);上海市科委"扬帆计划"基金项目(编号:21YF1404600);惠州市科技计划项目(编号:2021WCO106174)
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