基于功能性近红外光谱技术的不同阻力系数动静态任务在卒中后康复训练中的研究
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1)燕山大学电气工程学院,智能康复与神经调控重点实验室,秦皇岛 066004;2)燕山大学电气工程学院,智能控制与神经信息处理教育部重点实验室,秦皇岛 066004;3)宁波市康复医院神经调控科,宁波 315040;4)秦皇岛市第一医院神经内科,秦皇岛 066000

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国家重点研发计划(2022YFE0140400),国家自然科学基金(52207255),河北省重点研发计划(21372001D),中央引导地方项目(236Z2001G)和河北省引进留学人员项目(C20220332)资助。


Study on Kinetic and Static Tasks With Different Resistance Coefficients in Post-stroke Rehabilitation Training Based on Functional Near-infrared Spectroscopy
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1)Key Laboratory of Intelligent Rehabilitation and Neuroregulation, School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, China;2)Key Laboratory of Intelligent Control and Neural Information Processing, Ministry of Education, School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, China;3)Department of Neuromodulation, Ningbo Rehabilitation Hospital, Ningbo 315040, China;4)Department of Neurology, The First Hospital of Qinhuangdao, Qinhuangdao 066000, China

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This work was supported by grants from National Key R&D Program (2022YFE0140400), The National Natural Science Foundation of China (52207255), Hebei Provincial Key R&D Program (21372001D), Centralized Guided Local Projects (236Z2001G), and Hebei Provincial Program for Introducing Overseas Educated Personnel (C20220332).

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    摘要:

    目的 功能性近红外光谱(functional near-infrared spectroscopy,fNIRS)技术作为一种新型的无创脑功能检测方法,结合上肢康复机器人,可以及时获取脑功能变化指标,并应用于神经康复领域。康复机器人设计有被动、主动、阻力3种训练模式,其中阻力模式对具有一定肌力水平的患者有更好的康复效果。阻力模式下的控制方式分为动态控制和静态控制,而有关阻力模式下不同控制方式对于卒中上肢偏瘫病人运动功能的影响尚不清楚,不同控制模式下的重要参数——力度对脑区激活的影响鲜有报道。本研究旨在探讨动态与静态阻力模式在不同阻力水平下对脑卒中患者运动康复期间脑功能变化的影响。方法 本研究共招募20名患有上肢功能障碍的脑卒中患者,并预先进行了适应性训练和两种运动模式下3种不同力度的训练。采集双侧前额叶皮层(prefrontal cortices,PFC)、双侧初级感觉运动皮层(primary motor cortices,M1)、双侧初级躯体感觉皮层(primary somatosensory cortices,S1)和双侧前运动皮层和辅助运动皮层(premotor and supplementary motor cortices,PM)在静息和运动训练状态下的fNIRS数据,并计算样本数据在不同生理状态下的偏侧化指数(lateralization index,LI)、锁相值(phase locking value,PLV)和网络测度,来考察皮层激活特性和脑连接拓扑特性。结果 与静息态相比,动态模式和静态模式显著激活了脑的对侧M1区和同侧的PM区。与动态相比,静态模式对对侧M1区的激活更明显。脑网络分析结果显示,动态和静息状态下的对侧PFC区和对侧M1区(F=4.709,P=0.038),对侧PM区和同侧M1区(F=4.218,P=0.049)的网络连接强度存在显著差异。此外,研究结果显示,动态模式下M1区激活同力度增加呈正相关,静态模式下则相反。结论 动、静态两种阻力训练模式均能激活相应的脑功能区。动态阻力模式比静态阻力模式使脑氧水平变化更大、感兴趣区域(region of interest,ROI)之间的连通性更强,且力度的增加对于不同的模式产生的影响具有差异性。针对脑卒中患者,动态模式可能对运动相关的脑功能区激活有更强的促进作用。

    Abstract:

    Objective Functional near-infrared spectroscopy (fNIRS), a novel non-invasive technique for monitoring cerebral activity, can be integrated with upper limb rehabilitation robots to facilitate the real-time assessment of neurological rehabilitation outcomes. The rehabilitation robot is designed with 3 training modes: passive, active, and resistance. Among these, the resistance mode has been demonstrated to yield superior rehabilitative outcomes for patients with a certain level of muscle strength. The control modes in the resistance mode can be categorized into dynamic and static control. However, the effects of different control modes in the resistance mode on the motor function of patients with upper limb hemiplegia in stroke remain unclear. Furthermore, the effects of force, an important parameter of different control modes, on the activation of brain regions have rarely been reported. This study investigates the effects of dynamic and static resistance modes under varying resistance levels on cerebral functional alterations during motor rehabilitation in post-stroke patients.Methods A cohort of 20 stroke patients with upper limb dysfunction was enrolled in the study, completing preparatory adaptive training followed by 3 intensity-level tasks across 2 motor paradigms. The bilateral prefrontal cortices (PFC), bilateral primary motor cortices (M1), bilateral primary somatosensory cortices (S1), and bilateral premotor and supplementary motor cortices (PM) were examined in both the resting and motor training states. The lateralization index (LI), phase locking value (PLV), network metrics were employed to examine cortical activation patterns and topological properties of brain connectivity.Results The data indicated that both dynamic and static modes resulted in significantly greater activation of the contralateral M1 area and the ipsilateral PM area when compared to the resting state. The static patterns demonstrated a more pronounced activation in the contralateral M1 in comparison to the dynamic patterns. The results of brain network analysis revealed significant differences between the dynamic and resting states in the contralateral PFC area and contralateral M1 area (F=4.709, P=0.038), as well as in the contralateral PM area and ipsilateral M1 area (F=4.218, P=0.049). Moreover, the findings indicated a positive correlation between the activation of the M1 region and the increase in force in the dynamic mode, which was reversed in the static mode.Conclusion Both dynamic and static resistance training modes have been demonstrated to activate the corresponding brain functional regions. Dynamic resistance modes elicit greater oxygen changes and connectivity to the region of interest (ROI) than static resistance modes. Furthermore, the effects of increasing force differ between the two modes. In patients who have suffered a stroke, dynamic modes may have a more pronounced effect on the activation of exercise-related functional brain regions.

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付灵弟,窦佳轩,应婷婷,尹立勇,唐敏,梁振虎.基于功能性近红外光谱技术的不同阻力系数动静态任务在卒中后康复训练中的研究[J].生物化学与生物物理进展,2025,52(7):1890-1903

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  • 收稿日期:2024-12-19
  • 最后修改日期:2025-07-15
  • 接受日期:2025-04-01
  • 在线发布日期: 2025-04-01
  • 出版日期: 2025-07-28