柔性足压反馈训练系统对卒中患者脑区功能重塑的纵向研究
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国家自然科学基金(31270998);江苏省教育厅自然科学重大A类项目(17KJA330001);南京市医学科技发展重大项目(ZKX17029)


Longitudinal study of flexible plantar pressure feedback training system on brain function remodeling of stroke patients
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    摘要:

    目的:利用功能磁共振成像分析柔性足压反馈训练系统应用于缺血性脑卒中早期患者的临床康复干预效果,总结其脑功能重塑特征及机制。方法:12例脑卒中患者,随机分2组进行30 d步行训练,研究组为结合柔性足压反馈训练系统训练,对照组为常规训练。对脑区激活的结果进行偏侧化指数(laterality index,LI)分析,并与运动功能评定进行相关性分析。结果:研究组下肢运动功能发生了显著改变,与对照组相比差异有统计学意义(P < 0.001)。同时柔性足压反馈训练系统训练与下肢运动功能恢复之间有极显著的相关,其中卒中患者在偏瘫侧运动时,其LI值与使用足底压力反馈式电刺激治疗相关(r=0.884,P < 0.001),而健侧运动时,LI值与柔性足压反馈训练系统训练也密切相关(r=0.892,P<0.001),特别是使用柔性足压反馈训练系统训练后,卒中患者两侧半球感兴趣区的LI值之间有显著关联(r=0.974,P < 0.001)。结论:卒中患者佩戴由足底压力反馈式电刺激仪构成的柔性足压反馈训练系统,可以显著提高下肢的运动功能,从根本上加速卒中患者的康复进程。

    Abstract:

    Objective:This paper is aimed to analyze the effect of flexible plantar pressure feedback training system on rehabilitation intervention of patients with early ischemic stroke by functional magnetic resonance imaging(fMRI),and to summarize the characteristics and mechanism of brain function remodeling. Methods:Twelve stroke patients were randomly divided into two groups with 30 days walking training,the experimental group for the combination of flexible plantar pressure feedback system training,the control group for traditional training. Lateralization index(LI)was used to analyze the results of brain activation,and the correlation was analyzed with motor function assessment. Results:The locomotion function of the experimental group changed significantly compared with that of the control group(P < 0.001). Meanwhile,there was a significant correlation between the training of flexible plantar pressure feedback training system and the recovery of locomotion function. In hemiplegic side movement,the LI value of hemiplegic side was significantly correlated with the training of flexible plantar pressure feedback system(r=0.884,P < 0.001). The similar results happened in contralateral movement. The LI value of contralateral side was also significantly correlated with the training of flexible plantar pressure feedback system(r=0.892,P < 0.001). Especially after flexible plantar pressure feedback system training,there was a significant correlation between the LI values of ROI in both hemispheres of stroke patients’ brain(r=0.974,P < 0.001). Conclusion:The flexible plantar pressure feedback training system can significantly improve the motor function of lower limbs and fundamentally accelerate the rehabilitation process of stroke patients.

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叶 强,刘 莉,钱竞光,顾小东,高 润.柔性足压反馈训练系统对卒中患者脑区功能重塑的纵向研究[J].南京医科大学学报(自然科学版),2020,(4):563-569

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  • 收稿日期:2019-05-14
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  • 在线发布日期: 2020-05-08
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