Clinical Study Of The Effect Of CCFES On Upper Limb Function And Brain Function Of Stroke Patients

Objectives:To explore the influence of contralateral controlled functional electrical stimulation(CCFES)on the neurological function,upper limb motor function,daily living ability of patients with hemiplegia in the recovery period of basal ganglia ischemic stroke and the neuroimaging changes of related brain functions.Methods:A total of 40 patients with upper limb dysfunction in the recovery period of ischemic stroke in the basal ganglia were selected and randomly divided into 15 cases in the CCFES group,15 cases in the FES group,and 10 cases in the conventional group.All patients in the three groups were given basic drug therapy and conventional rehabilitation therapy.The CCFES group was given contralateral controlled functional electrical stimulation therapy,and the FES group was given functional electrical stimulation therapy.Before and after treatment,the National Institutes of Health Stroke Scale(NIHSS),the Fugl-Meyer Upper Extremity Motor Function Test Evaluation Scale(FMA-UE),the modified Barthel Index(MBI),and the wrist joint back extension active joint mobility(AROM)were used Assess the patient's neurological deficits,upper extremity motor function,ability of daily living,range of joint activities,etc.And using diffusion tensor imaging(DTI)to measure the anisotropy score(FA)value of the affected internal capsule posterior limb(PLIC)area and the corresponding area of the cortical spinal cord(CST)to calculate the anisotropy of the affected side and the healthy side Heterosexual score ratio(rFA),to evaluate the integrity of CST and nerve conduction ability.The functional connection(FC)value between the bilateral primary motor areas(M1)was measured by resting functional magnetic resonance(rs-fMRI),and the changes of the functional connection between the primary motor areas of the bilateral cerebral hemispheres were observed.Explore the effects and related mechanisms of CCFES on the recovery of hemiplegic upper limb function in the recovery period of ischemic stroke in thebasal ganglia.Results:1.Age,gender,course of disease,hemiplegic side,left and right hand,NIHSS,FMA-UE,MBI,dorsal wrist extension AROM,affected side FA,healthy side FA,rFA,M1-M1 rs-FC There was no statistically significant difference(P>0.05).2.After treatment,the three groups of NIHSS,FMA-UE total score,FMA-UE upper limb score,MBI,and dorsal wrist extension AROM have statistically significant differences before treatment(P<0.05),while FMA-UE wrist and hand scores Only the CCFES group and FES group had statistical significance(P<0.05).After treatment,the CCFES group had a statistically significant difference in FMA-UE wrist score andAROM in dorsal wrist extension compared to the FES group(P<0.05).3.After treatment,the three groups of affected FA,healthy FA,M1-M1 rs-FC were statistically different from before treatment(P<0.01),only the rFA of CCFES group was statistically significant(P<0.05).Compared with the FES group and the conventional group,the difference between M1-M1 rs-FC in the CCFES group wasstatistically significant(P<0.05)4.The FA value and M1-M1 rs-FC before treatment were significantly and negatively correlated with NIHSS after treatment(P<0.01),and were significantly and positively correlated with FMA-UE(P<0.01).There was no significant correlation between rFAvalue before treatment and NIHSS and FMA-UE after treatment.Conclusions:1.Conventional rehabilitation treatment,conventional rehabilitation treatment combined with CCFES and FES treatment can promote the recovery of upper limb function.Combined use of CCFES and FES is better than the conventional rehabilitation treatment in wrist and hand function recovery,and CCFES can promote wrist function recovery more than FES2.Conventional rehabilitation treatment,conventional rehabilitation treatment combined with CCFES and FES treatment can promote the recovery of CST and functional connection between the brain,and CCFES can promote the recovery of CST and promote the connection of related brain regions more closely.3.The baseline FA value and M1-M1 rs-FC value may be closely related to the prognosis of nerve function and motor function,and to a certain extent,it can predict the prognosis of stroke.