| Background: Stroke is one of the disease characterized by high morbility,high disability rate and low cure rate in China,resulting in many functional disorders.Among which motor function of distal joint of upper limb has been a key problem in clinical treatment because of its long treatment time and poor prognosis.At present,with the development of artificial intelligence technology,brain computer interface technology,which is different from the conventional peripheral treatment and directly acts on the brain for treatment,can be treated without the influence of the patient's own peripheral nerves and muscles.At present,brain-computer interface technology has certain applications in the treatment of upper extremity motor dysfunction in patients with stroke,but the treatment of distal joint motor dysfunction of upper extremity in patients with subacute stage of stroke by combining brain-computer interface technology and upper limb robot device is less studied,and the corresponding randomized controlled study is also less carried out.Objective: To explore the effect of 4-week brain computer interface(BCI)combined with routine rehabilitation therapy on the motor dysfunction of distal upper limb joints in patients with stroke at the subacute stage,so as to provide clinical basis for the application of BCI in the treatment of distal upper extremity joint motor dysfunction in patients with stroke at the subacute stage.Methods: 30 stroke patients who were recruited from the department of rehabilitation medicine in Huashan hospital,were divided into experimental group and control group according to the method of random number table.Both groups received routine rehabilitation treatment,including exercise therapy(20 minutes),manipulation therapy(40 minutes)and electronic biofeedback(20 minutes),both groups had the same time to participate in the treatment.On the basis of routine rehabilitation treatment,the experimental group received daily brain-machine interface system therapy.Brainmachine interface system therapy included exercise imagination training(5 minutes)and joint activity training(25 minutes)for a total of 30 minutes per session,5 consecutive times per week for 4 weeks.On the basis of conventional rehabilitation treatment,the control group received continuous passive activity system treatment of wrist every day for 30 minutes/time,5 times a week and lasted for 4 weeks.The assessment included Fugl-Meyer assessment of upper extremity(FMA-UE),modified Barthel index(MBI),modified Ashworth score(MAS)of Dorsal extensor carpal muscle,manual muscle test(MMT)of Dorsal extensor carpal muscle.The electroencephalography(EEG)classification rates,which were performed at baseline and 4 weeks after the treatment.All the measurement data were expressed in the way of mean ± standard deviation,and SPSS 22.0 statistical software was used for statistical analysis.Set P<0.05 as statistically significant.Results:1.Fugl-Meyer Assessment of Upper Extremity: After a 4-week treatment,the FuglMeyer assessment of upper extremity of the two groups was significantly higher than that before treatment(P <0.001,(95%CI =-4.47,-1.00),ES = 0.22,t =-3.385 in the control group;P <0.001,(95%CI =-15.16,-8.04),ES = 1.13,t =-6.994 in the test group).After treatment,there was no significant difference between the two groups in the Fugl-Meyer assessment of upper extremity(P = 0.213,t =-1.275).2.Modified Barthel Index: After a 4-week treatment,the scores of modified Barthel Index in the two groups were significantly higher than those before treatment(P = 0.003,(95%CI =-23.02,-5.65),ES = 1.37,t =-3.540 in the control group;P <0.001,(95%CI =-39.60,-21.06),ES = 3.36,t =-7.018 in the test group).After treatment,the scores of modified Barthel index of the two groups were statistically different(P = 0.013,(95%CI = 3.93,30.07),ES = 0.97,t = 2.664).3.Manual Muscle Test of Dorsal Extensor Carpal Muscle: After a 4-week treatment,the dorsal extensor carpal muscle muscle strength in the two groups was significantly higher than that before treatment(P = 0.007,z =-2.716 in the control group;P <0.001,z =-3.482 in the test group).After treatment,there was statistical difference in the score of dorsal extensor carpal muscle between the two groups(P = 0.029,z =-2.188).4.Modified Ashworth Score of Dorsal Extensor Carpal Muscle: After a 4-week treatment the score of dorsal extensor carpal muscle tension in the two groups was lower than that before treatment(P = 0.006,z =-2.266 in the control group;P = 0.015,z =-2.434 in the test group).After treatment,there was no significant difference between the two groups(P = 0.591,z =-0.537).5.Electroencephalography Classification Rates: After a 4-week treatment,the improvement of the electroencephalography classification rates in the experimental group was not significant compared with that before treatment(P = 0.219,t =-1.286)..Conclusion: It is feasible to use the brain-computer interface system for the rehabilitation of the distal joint of the upper extremity in the acute stage of stroke patients.A 4-week brain-computer interface system combined with routine rehabilitation can improve the motor function of the distal joint of the upper extremity in the acute stage of stroke patients. |
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