交叉迁移训练对脑卒中患者的康复疗效研究：基于功能性近红外光谱

Study on the Rehabilitation Effect of Cross-Education Training on Stroke Patients: Based on Functional Near-Infrared Spectroscopy

摘要: 目的：通过功能性近红外光谱技术(fNIRS)及临床量表评估交叉迁移训练对脑卒中患者的康复疗效。方法：将于40例脑卒中偏瘫患者随机分为实验组(n = 20)和对照组20 (n = 20)。两组均进行常规的康复训练，实验组每天除了常规康复训练外再进行交叉迁移训练。治疗前和治疗2周后分别采用Fugl-Meyer量表进行上肢功能的评定、NIHSS量表评定神经功能损伤程度、运用fNIRS技术分析大脑皮层血氧浓度的变化。结果：与治疗前对比，治疗后两组FMA-UE量表评分均显著改善(|t| > 4.568, P < 0.05)，试验组优于对照组(t = 3.308, P < 0.05)；治疗后两组NIHSS量表评分均显著降低(|t| > 4.570, P < 0.05)，试验组优于对照组(t = 4.578, P < 0.05)。fNIRS血氧浓度结果显示，治疗后试验组cPFC及iM1脑区血氧浓度明显增加(|t| > 2.186, P < 0.05)，且优于对照组(t = 2.170, P < 0.05)。结论：交叉迁移训练能提高脑卒中患者上肢运动功能、改善神经功能损伤程度、增强大脑皮质激活程度。

Abstract: Objective: To evaluate the rehabilitation effect of cross-education training on stroke patients by functional near-infrared spectroscopy (fNIRS) and clinical scale. Methods: 40 patients with hemiplegia after stroke were randomly divided into test group (n = 20) and control group (n = 20). Both groups received routine rehabilitation training, and the test group received cross-education training in addition to routine rehabilitation training every day. Fugl-Meyer scale was used to evaluate the upper limb function before treatment and 2 weeks after treatment, NIHSS scale was used to evaluate the degree of nerve function injury, and fNIRS was used to analyze the changes of cerebral cortex blood oxygen concentration. Results: Compared with before treatment, the scores of FMA-UE in both groups were significantly improved after treatment (|t| > 4.568, P < 0.05), and the test group was better than the control group (t = 3.308, P < 0.05). NIHSS scale scores of both groups were significantly decreased after treatment (|t| > 4.570, P < 0.05), and the test group was better than the control group (t = 4.578, P < 0.05). The results of blood oxygen concentration of fNIRS showed that the cerebral oxygen concentrations of cPFC and iM1 in test group were significantly increased after treatment (|t| > 2.186, P < 0.05), and were better than those in control group (t = 2.170, P < 0.05). Conclusion: Cross-education training can improve upper limb motor function, improve nerve function injury and enhance cerebral cortex activation in stroke patients.