康复学报2026，Vol.36Issue(4)：275-284,298,11.DOI:10.3724/SP.J.1329.2026.04008
脑卒中后重度上肢功能障碍的康复评估与治疗
The Rehabilitation Assessment and Treatment of Severe Upper Limb Dysfunction after Stroke
摘要
Abstract
Severe upper limb dysfunction after stroke represents a complex and pressing issue within the domain of clinical rehabilitation.The rehabilitation process encounters a multitude of challenges,including ambiguous assessment criteria,an incom-plete understanding of neural remodeling mechanisms,and substantial bottlenecks in traditional rehabilitation methods.This review article commenced by deliberating on the definition criteria for severe upper limb dysfunction via scale scoring,transcranial magnet-ic stimulation(TMS)assessment,diffusion tensor imaging(DTI),and functional magnetic resonance imaging(fMRI)analysis.It then systematically reviewed the intricate and multi-layered neurobiological mechanisms associated with the rehabilitation of se-vere upper limb dysfunction after stroke,with a particular emphasis on analyzing the plasticity and repair capabilities of the nervous system.To address problems such as the lack of active training ability,spasticity and abnormal movement patterns,poor cardiopul-monary fitness,and restricted windows of neural plasticity,this review elaborated on the application value of"zero-function thresh-old"technology,multidimensional spasticity management strategies,recovery programs for cardiopulmonary fitness and physical re-serve,as well as window advancement and graded intervention strategies.It underscores the significance of early intervention,individ-ualized treatment,and the combined application of multiple technologies,offering theoretical support and practical guidance for sur-mounting the"plateau phase"in the rehabilitation process of severe upper limb dysfunction.关键词
脑卒中/重度上肢功能障碍/新技术/康复策略/评估Key words
stroke/severe upper limb dysfunction/novel technologies/rehabilitation strategies/assessment引用本文复制引用
刘庆芝,徐海东,田婧,李响,王鹤玮..脑卒中后重度上肢功能障碍的康复评估与治疗[J].康复学报,2026,36(4):275-284,298,11.基金项目
国家自然科学基金青年科学基金项目(82102665) （82102665）
山东省医药卫生科技项目(202416010199) （202416010199）
上海市科学技术委员会"扬帆计划"项目(21Y1404600) （21Y1404600）
