基于运动想象足踝脑机接口治疗对脑卒中患者下肢运动功能和平衡能力的影响

关键词：脑卒中  足下垂  运动想象  脑机接口  运动功能

Keywords:stroke  foot droop  motor imagery  brain-computer interface  balance function

摘要：

      摘要 目的：观察并探讨基于运动想象足踝脑机接口治疗对脑卒中患者下肢运动功能和平衡能力康复的疗效。 方法：将脑卒中后偏瘫患者40例按随机数字表法分为试验组和对照组，每组各20例。两组患者均接受常规临床药物和常规康复治疗，对照组在以上治疗方案基础上增加踝关节牵伸机器人训练，每天1次，30min /次，共2周；试验组在以上治疗方案基础上增加基于运动想象足踝脑机接口治疗，每天1次，30min /次，共2周。患者在治疗前、治疗2周后（治疗后）利用Hoggan Micro FET3测试仪测量踝关节背屈肌力、踝关节背屈主动关节活动度（AROM）；采用改良Ashworth肌张力分级（MAS）、Fugl-Meyer下肢运动评分 （FMA-LE）、Berg平衡量表（BBS）、功能性步行分级（FAC）、6min步行试验（6MWT）进行临床功能评估。 结果：对照组脱落3例，试验组脱落3例。治疗后，两组患者的踝关节背屈肌力、踝关节背屈AROM、FMA-LE、BBS、FAC和6MWT评分较组内治疗前均显著改善，差异均有显著性意义（P＜0.05）；治疗后，试验组MAS较组内治疗前显著改善，差异有显著性意义（P＜0.05）；试验组治疗前后AROM、FMA-LE、BBS的差值与对照组比较，差异有显著性意义（P＜0.05）。 结论：基于运动想象足踝脑机接口治疗能有效改善脑卒中偏瘫患者的下肢运动功能和平衡能力。

Abstract:

      Abstract Objective： To observe and explore the therapeutic effect of ankle brain computer interface therapy based on motor imagination on the rehabilitation of lower limb motor function and balance ability in stroke patients with hemiplegia. Method： Total 40 patients with hemiplegia after stroke were randomly divided into an experimental group and a control group using a random number table method， with 20 people in each group. Both groups received conventional clinical medicine and conventional rehabilitation treatment. The control group was given additional ankle stretching robot training， once a day， 30min/times， for 2 weeks. The experimental group was given additional foot and ankle brain-computer interface treatment based on movement imagination， once a day， 30min/time， for 2 weeks， before treatment. After 2 weeks of treatment（after treatment），the Hoggan Micro FET3 tester was used to measure the back flexion muscle strength and active joint range of motion（AROM）；Clinical evaluation was conducted using the modified Ashworth muscle tension scale（MAS），Fugl-Meyer lower limb movement score（FMA-LE）， Berg balance scale （BBS）， functional walking scale（FAC），and 6-minute walk test（6MWT）. Result：Three patients in the control group and three patients in the experimental group dropped off. After 2 weeks of treatments， significant improvements were observed on the dorsiflexion muscle strength， dorsiflexion AROM， FMA-LE， BBS， FAC， and 6MWT（P<0.05）in the two groups. The MAS of the experimental group improved significantly（P<0.05）compared with that before treatment. After treatment，there were significant differences in AROM， FMA-LE， and BBS between the two groups（P<0.05）. Conclusion：Motor imagery-foot and ankle brain-computer interface therapy can effectively improve lower limb motor function and balance in stroke hemiplegic patients.