| Stroke is a group of diseases caused by a variety of causes of cerebral blood vessel damage.Brain tissue damage is the pathological basis of clinical symptoms.Some disorders often remain after the onset of stroke,such as sensory and motor dysfunction(hemiplegia),lalopathy and dysphagia(aphasia or dysarthria),cognitive impairment(dysmnesia,agnosia,unilateral ignorance))and so on.Stroke is the third most fatal disease in the world after coronary heart disease and cancer.It has the characteristics of high morbidity and high morbidity,and it seriously affects human health.The incidence of upper limb dysfunction after stroke is as high as 80%.Given the poor prognosis,which means it is difficult to recover and has a low cure rate,upper limb dysfunction has become a key problem to be solved clinically.Therefore,how to use effective methods to regain upper extremity function of the patient has become a difficulty in rehabilitation.A brain-computer interface based on motor imagery for rehabilitation of paralyzed limbs has gained valuable clinical efficacy.In the process of clinical implementation,motor imagery therapy requires good compliance and long-time attention for patients to achieve ideal results.How to overcome brain fatigue and brain computer interface false triggering directly affects the effect of rehabilitation.The SW cerebral reflex therapy stimulates the supraorbital nerves to generate impulses on the human body.It can increase the excitability of cerebral cortical neurons and the sensitivity of the brain to various stimuli.This experiment aims to overcome the deficiencies in the MI-BCI rehabilitation process through SW cerebral reflex therapy,so as to improve the efficacy of motor imagery therapy,and ultimately achieve the purpose of further improving the upper limb motor function.Objective Explore the advantages of SW cerebral reflex therapeutic instrument combined with MI-BCI training compared with MI-BCI alone in the treatment of upper extremity motor function in patients with chronic stroke,and to explore better rehabilitation methods for patients with severe hemiplegia to help them restore upper limb function and improve their quality of life.Methods Thirty-two chronic stroke patients with moderate or severe upper limb dysfunction were randomly assigned into a study group(n=16)and a control group(n=16).Both groups were treated with routine rehabilitation 5 times/week and MI-BCI training 3 times/week,1h/time.Each patient in study group also received a 20 min SW cerebral reflex therapeutic instrument treatment before the BCI training,the whole treatment lasted for 4 weeks,and there will be a follow-up at 4 weeks after the end of the experiment.The two groups of patients were assessed by the Fugl—Meyer Motor Assessment(FMA)of upper extremity and the Wolf Motor Function Test(WMFT)to evaluate the upper limb motor function,modified barthel index(MBI)to evaluate the activities of daily living(ADL)activities,the surface electromyography(s EMG)to describe the level of muscle activation,and event-related desynchronization(ERD)during motor imagery to evaluate changes in electroencephalogram signals at pre-,post-training and a 4-week follow-up.Results(1)After treatment and during follow-up,the FMA scores of both groups were significantly increased(P<0.01),and the increase in the experimental group was significantly higher than that in the control group(P<0.05).(2)After treatment and during follow-up,the WMFT scores of both groups were significantly increased(P<0.01),and the increase in the experimental group was significantly higher than that in the control group(P<0.05).(3)After treatment and during follow-up,the MBI scores of both groups were significantly increased(P<0.05),and the increase in the experimental group was significantly higher than that in the control group(P<0.05).(4)After treatment and during follow-up,the RMS values of the triceps brachii and the wrist extensors in the involved side were significantly increased(P<0.01),and the increase in the experimental group was significantly higher than that in the control group(P<0.05).The RMS values of the biceps brachii and the wrist flexors in the involved side were increased,but the change was not statistically significant(P>0.05).There was no significant difference in the RMS values of the biceps brachii,triceps brachii,wrist extensors and flexors in the uninvolved side(P>0.05).(5)After treatment and during follow-up,the ERD intensity of both groups were significantly increased(P<0.01),and the increase in the experimental group was significantly higher than the control group(P<0.05).Conclusion MI-BCI training can effectively improve upper limb motor function in patients with chronic stroke;SW cerebral reflex therapy combined with MI-BCI training can significantly improve upper limb motor function in patients with chronic stroke;its recovery mechanism may be related to the patients' involved brain regions,optimizing the reorganisation of the brain. |
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