脑机接口联合上肢康复机器人对脑卒中患者上肢功能的影响

doi:10.3969/j.issn.1006-9771.2025.06.011

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (6): 703-710.doi: 10.3969/j.issn.1006-9771.2025.06.011

脑机接口联合上肢康复机器人对脑卒中患者上肢功能的影响

刘璇¹^,², 高玲¹^,², 褚凤明¹^,², 陈杰¹^,², 张明¹^,²^,³()

1.徐州医科大学附属徐州康复医院，江苏徐州市 221003
2.徐州医科大学徐州临床学院/徐州市中心医院，江苏徐州市 221009
3.中国矿业大学机电工程学院，江苏徐州市 221116

收稿日期:2025-01-20 修回日期:2025-04-08 出版日期:2025-06-25 发布日期:2025-06-16
通讯作者: 张明(1985-)，男，硕士，副教授、主任治疗师，硕士研究生导师。E-mail：zm1455@163.com E-mail:zm1455@163.com
作者简介:刘璇(2001-)，女，汉族，江苏徐州市人，硕士研究生，主要研究方向：神经康复。
基金资助:
徐州市医学重点人才项目(XWRCHT20220045)

Effect of brain-computer interface combined with upper limb rehabilitation robot on upper limb function of stroke patients

LIU Xuan¹^,², GAO Ling¹^,², CHU Fengming¹^,², CHEN Jie¹^,², ZHANG Ming¹^,²^,³()

1. Xuzhou Rehabilitation Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221003, China
2. Xuzhou Clinical College of Xuzhou Medical University/Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, China
3. School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, Jiangsu 221116, China

Received:2025-01-20 Revised:2025-04-08 Published:2025-06-25 Online:2025-06-16
Contact: E-mail: zm1455@163.com E-mail:zm1455@163.com
Supported by:
Xuzhou Medical Key Talent Project(XWRCHT20220045)

摘要/Abstract

摘要：

目的观察基于运动表象的脑机接口(BCI)联合上肢康复机器人对脑卒中患者上肢功能的影响。

方法 2024年5月至12月，选取徐州医科大学附属徐州康复医院和徐州市中心医院住院的脑卒中患者45例，随机分为BCI组(n = 15)、机器人组(n = 15)和联合组(n = 15)。3组均接受常规康复治疗，BCI组增加基于运动表象的BCI治疗，机器人组增加机器人治疗，联合组增加BCI和机器人治疗。治疗前和治疗4周后分别采用Fugl-Meyer 评定量表上肢部分(FMA-UE)、上肢动作研究量表(ARAT)和改良Barthel指数(MBI)进行评定，采用定量脑电图记录平均头皮δ-α比(DAR)。

结果 FMA-UE、ARAT、MBI和DAR评分组内效应(F > 101.870, P < 0.001)和交互效应(F > 7.891, P < 0.001)均显著，事后两两比较显示，联合组各项指标均优于BCI组和机器人组(P < 0.05)，BCI组和机器人组各项指标无显著性差异(P > 0.05)。

结论 BCI联合上肢康复机器人能促进脑卒中患者上肢功能的恢复，提高日常生活活动能力。

关键词: 脑卒中, 上肢, 运动功能, 脑机接口, 上肢康复机器人

Abstract:

Objective To explore the effect of motor imagery brain-computer interface (BCI) combined with upper limb rehabilitation robot on upper limb function of stroke patients.

Methods From May to December, 2024, 45 stroke inpatients from Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital were recruited and randomly divided into BCI group (n = 15), robot group (n = 15) and combined group (n = 15). All the groups received conventional rehabilitation therapy. On this basis, the BCI group received motor imagery based BCI training, the robot group received upper extremity rehabilitation robot training, and the combined group received BCI combined with upper extremity rehabilitation robot training. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI) before and four weeks after treatment, while they were measured delta-alpha ratio (DAR) using the quantitative electroencephalogram.

Results The intra-group effect (F> 101.870, P< 0.001) and interaction effect (F> 7.891, P< 0.001) were significant in the scores of FMA-UE, ARAT and MBI, and DAR. Post Hoc test showed that all the indexes were better in the combined group than in BCI group and the robot group (P < 0.05), and there was no significant difference in the indexes between BCI group and the robot group (P > 0.05).

Conclusion BCI combined with upper limb rehabilitation robot can promote the recovery of upper limb function and activities of daily living of stroke patients.

Key words: stroke, upper limb, motor function, brain-computer interface, upper limb rehabilitation robots

中图分类号:

R743.3

刘璇, 高玲, 褚凤明, 陈杰, 张明. 脑机接口联合上肢康复机器人对脑卒中患者上肢功能的影响[J]. 《中国康复理论与实践》, 2025, 31(6): 703-710.

LIU Xuan, GAO Ling, CHU Fengming, CHEN Jie, ZHANG Ming. Effect of brain-computer interface combined with upper limb rehabilitation robot on upper limb function of stroke patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 703-710.

图/表 6

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参考文献 43

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组别	n	性别(男/女)/n	年龄/岁	病程/d	病变性质(缺血/出血)/n	偏瘫侧(左/右)/n
脑机接口组	15	5/10	56.13±10.83	52.80±13.17	4/11	7/8
机器人组	15	4/11	57.00±9.59	61.33±22.28	2/13	7/8
联合组	15	5/10	61.60±6.85	64.80±19.48	5/10	6/9
χ²/F值		0.211	1.516	1.635	1.780	0.180
P值		0.900	0.231	0.207	0.411	0.914

变量	组别	治疗前		治疗后
变量	组别	均值	标准差	均值	标准差
FMA-UE	脑机接口组	28.00	3.85	33.80	3.82
	机器人组	27.73	5.50	33.40	5.60
	联合组	25.87	6.55	38.93	8.56
ARAT	脑机接口组	10.20	4.46	16.07	4.17
	机器人组	11.67	5.86	15.93	5.48
	联合组	12.13	5.25	22.67	5.43
MBI	脑机接口组	54.40	10.95	60.27	10.26
	机器人组	52.53	9.53	59.80	9.14
	联合组	56.27	6.95	67.27	7.08
DAR	脑机接口组	3.22	1.17	2.51	0.99
	机器人组	3.12	0.77	2.57	0.80
	联合组	3.30	1.33	1.71	0.93

变量		平方和	自由度	均方	F值	P值
FMA-UE	组内	1504.711	1	1504.711	342.846	< 0.001
	组间	57.222	2	28.611	0.443	0.645
	组内×组间	268.956	2	134.478	30.641	< 0.001
ARAT	组内	953.878	1	953.878	336.851	< 0.001
	组间	183.267	2	91.633	1.683	0.198
	组内×组间	44.689	2	22.344	7.891	< 0.001
MBI	组内	1456.044	1	1456.044	662.316	< 0.001
	组间	523.756	2	261.878	1.599	0.214
	组内×组间	105.622	2	52.811	24.022	< 0.001
DAR	组内	20.268	1	20.268	101.870	< 0.001
	组间	2.466	2	1.233	0.657	0.523
	组内×组间	4.756	2	2.378	11.953	< 0.001

变量	组别	治疗前后平均值差	平均值差标准差	P值	95%CI
变量	组别	治疗前后平均值差	平均值差标准差	P值	下限	上限
FMA-UE	脑机接口组	-5.800	1.821	< 0.001	-7.344	-4.256
	机器人组	-5.667	1.633	< 0.001	-7.210	-4.123
	联合组	-13.067	4.511	< 0.001	-14.610	-11.523
ARAT	脑机接口组	-5.867	1.995	< 0.001	-7.107	-4.627
	机器人组	-5.200	1.373	< 0.001	-6.440	-3.960
	联合组	-8.467	3.335	< 0.001	-9.707	-7.227
MBI	脑机接口组	-5.867	1.457	< 0.001	-6.959	-4.774
	机器人组	-7.267	1.831	< 0.001	-8.359	-6.174
	联合组	-11.000	2.777	< 0.001	-12.093	-9.907
DAR	脑机接口组	0.712	0.450	< 0.001	0.383	1.041
	机器人组	0.543	0.249	0.002	0.215	0.872
	联合组	1.592	0.964	< 0.001	1.263	1.921

变量	组别	组别	均值差	P值	95%CI
变量	组别	组别	均值差	P值	下限	上限
FMA-UE	脑机接口组	机器人组	0.267	0.893	-3.722	4.256
	脑机接口组	联合组	2.133	0.287	-1.856	6.122
	机器人组	联合组	1.867	0.350	-2.122	5.856
ARAT	脑机接口组	机器人组	-0.800	0.695	-4.887	3.287
	脑机接口组	联合组	-1.933	0.345	-6.021	2.154
	机器人组	联合组	-1.133	0.579	-5.221	2.954
MBI	脑机接口组	机器人组	1.867	0.585	-4.981	8.714
	脑机接口组	联合组	-1.867	0.585	-8.714	4.981
	机器人组	联合组	-3.733	0.277	-10.581	3.114
DAR	脑机接口组	机器人组	0.109	0.791	-0.714	0.931
	脑机接口组	联合组	-0.077	0.850	-0.900	0.745
	机器人组	联合组	-0.186	0.650	-1.009	0.637

脑机接口联合上肢康复机器人对脑卒中患者上肢功能的影响

Effect of brain-computer interface combined with upper limb rehabilitation robot on upper limb function of stroke patients

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变量	组别	组别	均值差	P值	95%CI
变量	组别	组别	均值差	P值	下限	上限
FMA-UE	脑机接口组	机器人组	0.400	0.863	-4.245	5.045
	脑机接口组	联合组	-5.133	0.031	-9.779	-0.488
	机器人组	联合组	-5.533	0.021	-10.179	-0.888
ARAT	脑机接口组	机器人组	-0.133	0.944	-3.927	3.660
	脑机接口组	联合组	-4.533	0.020	-8.327	-0.740
	机器人组	联合组	-4.400	0.024	-8.193	-0.607
MBI	脑机接口组	机器人组	0.467	0.887	-6.111	7.044
	脑机接口组	联合组	-7.000	0.038	-13.578	-0.422
	机器人组	联合组	-7.467	0.027	-14.044	-0.889
DAR	脑机接口组	机器人组	-0.060	0.858	-0.731	0.611
	脑机接口组	联合组	0.803	0.020	0.132	1.473
	机器人组	联合组	0.863	0.013	0.192	1.533