| 引用本文: | 王丛笑,梁智蓉,蒲心语,张晓颖,欧阳胜璋,郄淑燕.基于镜像疗法的手康复机器人训练对脑卒中偏瘫患者手功能的影响：一项fNIRS研究[J].中国临床新医学,0,():-. |
| .基于镜像疗法的手康复机器人训练对脑卒中偏瘫患者手功能的影响：一项fNIRS研究[J].中国临床新医学,0,():-. |
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| 摘要: |
| 目的：观察基于镜像疗法的手康复机器人训练对脑卒中偏瘫患者手功能的影响，并结合功能性近红外脑功能成像（fNIRS）技术探讨其神经机制。方法：选取2025年4月至2025年10月本院收治的30例脑卒中偏瘫患者，随机分为试验组和对照组，每组15例。对照组接受常规康复治疗（包括作业疗法和传统镜像疗法），试验组在常规康复治疗基础上增加基于肌电识别的镜像疗法手康复机器人训练。两组均连续治疗4周。治疗前后分别采用Fugl-Meyer运动功能评定量表上肢部分（FMA-UE）评估上肢运动功能，改良Barthel指数（MBI）评估日常生活活动能力，并利用fNIRS检测大脑皮层激活情况。结果：治疗4周后，两组患者FMA-UE、MBI评分均较治疗前显著提高（P＜0.001）。两组FMA-UE治疗前后变化差值比较，试验组优于对照组，差异有统计学意义（P＜0.001）；试验组MBI评分优于对照组（P＜0.05）。fNIRS结果显示，试验组在背外侧前额叶皮层、运动前区和辅助运动区、初级躯体感觉皮层、额极区、额叶眼动区等脑区的氧合血红蛋白β值显著高于对照组（P＜0.05）。结论：基于镜像疗法的手康复机器人训练能更有效改善脑卒中偏瘫患者的手功能和日常生活活动能力，其机制可能与促进运动规划、感觉整合及认知控制相关脑区的协同激活与功能重塑有关。 |
| 关键词: 脑卒中 手功能 镜像疗法 手康复机器人 功能性近红外脑功能成像 |
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| 基金项目:北京市科技计划课题（编号：Z221100007422113） |
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| The impact of hand rehabilitation robot training based on mirror therapy on hand function in stroke hemiplegic patients: An fNIRS study |
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Beijing Rehabilitation Hospital Affiliated to Capital Medical University
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| Abstract: |
| Objective: To observe the impact of hand rehabilitation robot training based on mirror therapy on hand function in stroke patients with hemiplegia, and to explore its neural mechanism by combining functional near-infrared spectroscopy (fNIRS) technology. Methods: Thirty stroke hemiplegia patients admitted to our hospital from April 2025 to October 2025 were selected and randomly divided into an experimental group and a control group, with 15 patients in each group. The control group received conventional rehabilitation therapy (including occupational therapy and traditional mirror therapy), while the experimental group received additional mirror therapy hand rehabilitation robot training based on electromyography recognition on top of conventional rehabilitation therapy. Both groups underwent continuous treatment for 4 weeks. Before and after treatment, the upper limb motor function was assessed using the Fugl-Meyer Assessment of Motor Function Upper Extremity (FMA-UE), the ability of daily living activities was assessed using the Modified Barthel Index (MBI), and the activation of the cerebral cortex was detected using fNIRS. Results: After 4 weeks of treatment, both groups showed significant improvements in FMA-UE and MBI scores compared to before treatment (P<0.001). When comparing the changes in FMA-UE scores between the two groups, the experimental group demonstrated superiority over the control group, with the difference being statistically significant (P<0.001). Additionally, the MBI scores of the experimental group were higher than those of the control group (P<0.05). fNIRS results indicated that the experimental group exhibited significantly higher oxygenated hemoglobin beta values in brain regions such as the dorsolateral prefrontal cortex, premotor and supplementary motor areas, primary somatosensory cortex, frontal pole, and frontal eye fields compared to the control group (P<0.05). Conclusion: Hand rehabilitation robot training based on mirror therapy can more effectively improve hand function and activities of daily living in stroke hemiplegic patients. The mechanism may be related to the synergistic activation and functional remodeling of brain regions involved in motor planning, sensory integration, and cognitive control. |
| Key words: stroke hand function mirror therapy hand rehabilitation robot functional near-infrared brain imaging |
