Study On The Brain Mechanism Of Rotator Cuff Injury Based On FNIRS Technique

ObjectiveThe purpose of this study is to study the mechanism of Functional near-infrared spectroscopy(fNIRS)on the brain of patients with rotator cuff injury.First,the fNIRS technique was used to understand the changes in the brain regions of patients with rotator cuff injury and healthy adults.Further,based on the treatment of rotator cuff injury with exercise therapy,fNIRS technology was used to monitor the changes of brain region of patients with rotator cuff injury before and after exercise therapy,and to explore the influence of exercise therapy on shoulder joint movement disorder after rotator cuff injury from the perspective of brain mechanism,so as to provide evidence for the treatment of rotator cuff injury with exercise therapy.Methods1.In the first part,30 patients with partial rotator cuff injury and 25 healthy subjects admitted to the Department of Rehabilitation Medicine,the First Affiliated Hospital of Gannan Medical University from March 2021 to September 2022 were selected.The patients were divided into left rotator cuff injury group,right rotator cuff injury group and healthy group,and f NRIS data were collected respectively in the three groups.Hb O signal integral value calculation method was used to observe the changes of brain regions in the rotator cuff injury group and the healthy group.2.In the second part,30 patients with partial rotator cuff injury admitted to the Department of Rehabilitation Medicine,the First Affiliated Hospital of Gannan Medical University from March 2021 to September 2022 were selected to be included in the rotator cuff injury group,which was divided into the left rotator cuff injury group and the right rotator cuff injury group.The rotator cuff injury groups were treated with exercise therapy(joint loosening therapy,joint motion training,muscle strength training),and the treatment period was 4 weeks.Before and after treatment,Shoulder flexion,extension,abductor range of motion,Visual Analog Scale(VAS)Pain score,Shoulder Pain and Disability Index,SPADI and Simple Shoulder Test(SST)were performed once each.f NRIS data were collected before and after treatment to compare the changes of brain regions of shoulder joint movement task in patients with rotator cuff injury before and after exercise therapy.Results1.In the first part,the two groups with rotator cuff injury and the healthy group successfully completed the evaluation,and finally 13 cases in the left rotator cuff injury group,11 cases in the right rotator cuff injury group and 25 cases in the healthy group were included in the statistical analysis.In the regions of interest between the rotator cuff injury group and the healthy group,the brain regions with changes in Hb O signal scores in the left rotator cuff injury group included the left and right motor and auxiliary motor regions.Compared with the healthy group,channel 10,channel 15,channel 16,channel 21 and channel 25 showed a significant inhibitory trend,with statistical significance(P < 0.05).In the right rotator cuff injury group,the Hb O signal integral value changed in the left and right motor and auxiliary motor areas,which showed an overall inhibitory trend compared with the healthy group.2.In the second part,24 cases of rotator cuff injury group were included in statistical analysis.Immediately after 4 weeks of treatment,compared with before treatment,the anterior flexion activity of shoulder joint,posterior extension activity of shoulder joint,abductive range of motion of shoulder joint,SPADI shoulder joint score and SST shoulder joint score of the two groups were significantly increased,while the VAS score was significantly decreased,with statistical significance(P <0.05).Before and after exercise therapy for rotator cuff injury in the two groups,in the areas of interest,the changes in Hb O signal integral value of left rotator cuff injury patients included left,right motor and auxiliary motor areas.Compared with before treatment,channel 16,channel 20,channel 21 and channel 25 showed a significant activation trend,and the differences were statistically significant(P <0.05).In the right rotator cuff injury group,the Hb O signal integral value changed in the left and right anterior motor and auxiliary motor areas.Compared with before treatment,the left anterior motor and auxiliary motor areas showed an overall activation trend after treatment.Conclusion1.Compared with the healthy group,the brain regions with changes in the rotator cuff injury group were mainly located in the frontal and parietal lobes,which were closely related to the emotion and movement of patients,indicating that patients with rotator cuff injury may have motor dysfunction.2.The changes of motor and auxiliary motor areas in brain areas related to motor and autonomic nervous function may be the central action mechanism of motor therapy in the treatment of rotator cuff injury,providing empirical evidence for the mechanism of motor therapy intervention in promoting cerebral cortex recovery in patients with rotator cuff injury.3.Our study shows that fNIRS captures cortical activation patterns associated with shoulder movement in healthy adults and patients with rotator cuff injuries.These findings are therefore relevant to the predictive assessment of upper limb motor recovery in patients with rotator cuff injury or other motor dysfunction,since the ability to perform such movements predicts upper limb function recovery after rotator cuff injury.The diagnosis and prediction of motor recovery in this population is helpful for clinicians to make optimal rehabilitation strategies and effective use of medical resources.4.fNIRS consume less time and resources than traditional neuroimaging methods,and can assess brain function more quickly,with more freedom of body movement during measurement.The new insights revealed in this study will benefit the clinical application and implementation of fNIRS in patients with rotator cuff injury.