| 摘要: |
| ［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光谱技术（fNIRS）探讨其神经机制。方法 选取2025年4月至10月首都医科大学附属北京康复医院收治的30例脑卒中偏瘫患者，随机分为观察组和对照组，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），观察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，采用改良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FMA-UE、MBI评分均较治疗前显著提高（P<0.05）。观察组治疗后FMA-UE评分上升幅度显著大于对照组（P<0.05）。观察组治疗后MBI评分显著高于对照组（P<0.05）。fNIRS检测结果显示，观察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、额叶眼动区及颞皮层脑区氧合血红蛋白的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 功能性近红外光谱技术 |
| DOI：10.3969/j.issn.1674-3806.2026.04.02 |
| 分类号: |
| 基金项目:国家重点研发计划项目（编号：2025YFE0117700）；北京市科技计划课题（编号：Z221100007422113） |
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| Effects of hand rehabilitation robot training based on mirror therapy on hand function in post-stroke hemiplegic patients: an fNIRS study |
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WANG Congxiao1, LIANG Zhirong2, PU Xinyu2, ZHANG Xiaoying1, OUYANG Shengzhang1, QIE Shuyan1
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1.Center for Rehabilitation Diagnosis and Treatment, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China; 2.Beijing Rehabilitation Medical College, Capital Medical University, Beijing 100144, China
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| Abstract: |
| ［Abstract］ Objective To observe the effects of hand rehabilitation robot training based on mirror therapy on hand function in post-stroke hemiplegic patients, and to explore its neural mechanism by combining functional near-infrared spectroscopy(fNIRS) brain imaging technique. Methods Thirty post-stroke hemiplegic patients admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from April 2025 to October 2025 were selected and randomly divided into observation group and control group, with 15 patients in each group. The control group received conventional rehabilitation therapy(including occupational therapy and traditional mirror therapy), while the observation group received the same conventional rehabilitation therapy as the control group plus hand rehabilitation robot training based on mirror therapy of electromyography pattern recognition. Both groups received continuous treatments for 4 weeks. Before and after the treatment, the upper limb motor function was assessed using the Fugl-Meyer Assessment of the Upper Extremity(FMA-UE) scale, and the ability to perform activities of daily living 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, the FMA-UE and MBI scores in the two groups were significantly increased compared with those before treatment(P<0.05). After treatment, the increase in the FMA-UE scores of the observation group was significantly greater than that of the control group(P<0.05). The MBI scores in the observation group were significantly higher than those in the control group after treatment(P<0.05). The detection results using fNIRS indicated that the observation group exhibited significantly higher oxygenated hemoglobin concentration(beta value) in brain regions such as the dorsolateral prefrontal cortex, pre-motor and supplementary motor areas, primary somatosensory cortex, frontal pole area, frontal eye fields and temporal cortex compared with the control group(P<0.05). Conclusion Hand rehabilitation robot training based on mirror therapy can more effectively improve the hand function and activities of daily living in post-stroke hemiplegic patients. The mechanisms 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 spectroscopy(fNIRS) |
