《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (10): 1181-1187.doi: 10.3969/j.issn.1006-9771.2025.10.009

• 应用研究 • 上一篇    下一篇

功能性电刺激手摇车对脑卒中患者脑网络功能连接的功能性近红外光谱研究

徐胜1, 张敏1, 杨青青1, 王庆雷2, 耿阿燕2, 王彤2, 郭川2()   

  1. 1.常州市德安医院，江苏常州市 213004
    2.南京医科大学第一附属医院，江苏南京市 210029
  • 收稿日期:2025-06-16 修回日期:2025-09-07 出版日期:2025-10-25 发布日期:2025-11-10
  • 通讯作者: 郭川(1988-)，男，汉族，江苏连云港市人，副教授、副主任技师，硕士研究生导师，主要研究方向：神经系统疾病康复治疗，E-mail： guochuan@njmu.edu.cn
  • 作者简介:徐胜(1991-)，男，汉族，江苏常州市人，硕士，主管治疗师，主要研究方向：神经康复。
  • 基金资助:
    1.国家自然科学基金青年项目(82302882);2.常州市卫健委青年科技项目(QN202336)

Effect of functional electrical stimulation hand cycling on functional connection of brain networks in stroke patients: a study based on functional near-infrared spectroscopy

XU Sheng1, ZHANG Min1, YANG Qingqing1, WANG Qinglei2, GENG Ayan2, WANG Tong2, GUO Chuan2()   

  1. 1. Changzhou De'an Hospital, Changzhou, Jiangsu 213004, China
    2. The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
  • Received:2025-06-16 Revised:2025-09-07 Published:2025-10-25 Online:2025-11-10
  • Contact: GUO Chuan, E-mail: guochuan@njmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China (Youth)(82302882);Changzhou Health Commission Science and Technology Project (Youth)(QN202336)

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摘要：

目的 探讨功能性电刺激(FES)手摇车训练促进脑卒中后上肢运动功能恢复的潜在中枢机制。
方法 选择2023年5月至2024年12月在常州市德安医院康复中心住院的脑卒中患者35例，依次完成FES手摇车训练10 min和单纯手摇车训练10 min，通过掷骰法确定任务顺序。采用功能性近红外光谱(fNIRS)实时采集两个任务过程中脑血氧变化，计算总体功能连接(FC)强度和感兴趣区的FC强度。
结果 与单纯手摇车训练相比，FES手摇车训练期间总体FC强度更高(t = 2.591, P < 0.05)，患侧初级运动皮质(iM1)-患侧体感联合皮质(iSAC)、iM1-健侧体感联合皮质(cSAC)、患侧运动前皮质(iPMC)-iSAC、iPMC-cSAC、iPMC-患侧初级感觉皮质(iS1)、iPMC-iM1、健侧运动前皮质(cPMC)与iSAC间的FC增强(PFDR < 0.05)。
结论 FES手摇车训练可以增强脑卒中患者大脑半球间和半球内FC，重建感觉-运动通路，促进皮质功能重塑。

关键词: 脑卒中, 上肢, 运动功能, 功能性电刺激手摇车, 功能性近红外光谱, 功能连接, 皮质功能重塑

Abstract:

Objective To explore the potential central mechanisms of functional electrical stimulation (FES) hand cycling in promoting upper limb motor recovery after stroke.
Methods A total of 35 stroke patients hospitalized in the Rehabilitation Center of Changzhou De'an Hospital from May, 2023 to December, 2024 were enrolled. They sequentially completed 10-minute FES hand cycling and 10-minute sham stimulation (simple hand cycling) tasks. The task order was randomized via dice rolling. Functional near-infrared spectroscopy (fNIRS) was used to monitor real-time cerebral hemodynamic changes during both tasks to calculate the overall functional connectivity (FC) strength and the FC strength within regions of interest.
Results The overall FC strength was higher during the FES hand cycling task than during the sham task (t = 2.591, P < 0.05), as well as FC between the ipsilateral primary motor cortex (iM1) and ipsilateral somatosensory association cortex (iSAC), iM1 and contralateral somatosensory association cortex (cSAC), ipsilateral pre-motor and supplementary motor cortex (iPMC) and iSAC, iPMC and cSAC, iPMC and ipsilateral primary somatosensory cortex (iS1), iPMC and iM1, and contralateral pre-motor and supplementary motor cortex (cPMC) and iSAC (PFDR < 0.05).
Conclusion FES hand cycling can promote the cortical function remodeling between cerebral hemispheres and the affected hemisphere, to integrate sensory-motor function.

Key words: stroke, upper limb, motor function, functional electrical stimulation hand cycling, functional near-infrared spectroscopy, functional connection, cortical function remodeling

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