影响脑卒中患者脑机接口上肢训练效果的相关因素

doi:10.3969/j.issn.1006-9771.2021.03.004

Abstract

Abstract: Objective

To explore the factors affecting curative effect of motor imagery brain-computer interface (MI-BCI) training on upper limb paralysis for subacute stroke patients.

Methods

From January, 2018 to July, 2019, 23 inpatients with post-stroke upper limb paralysis accepting MI-BCI training were reviewed. The gender, age, course of disease, aphasia, location and nature of lesion, history of Botulinum toxin, hemisphere injured and modified Ashworth Scale (MAS) score of affected fingers were recorded, and they were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and four weeks after MI-BCI training. According to improvement of FMA-UE wrist and hand scores (≥ 2), the patients were divided into effective group (n = 11) and inefficacy group (n = 12).

Results

The MAS scores before MI-BCI training (t = 2.677, P < 0.05) and history of botulinum toxin (Z = 0.000, P < 0.05) were more in the inefficacy group than in the efficacy group. FMA-UE scores (total and dimensions) after training were correlated to their baseline levels (r > 0.831, P < 0.01), FMA-UE total scores (Eta = 0.453, P < 0.05) and upper arms scores (Eta = 0.506, P < 0.05) were correlated to aphasia, FMA-UE scores of hands were correlated with MAS (r = -0.521, P < 0.05).

Conclusion

Poor baseline motor function, spasticity and complication with aphasia were the factors unfavorable to MI-BCI training for subacute stroke patients with upper limb paralysis.

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

CLC Number:

R743.3

Qiong WU,Yun-xiang GE,Di MA,Xue PANG,Ying-yu CAO,Yu PAN,Wei-bei DOU. Factors Related to Curative Effect of Brain-computer Interface Training on Upper Limb Paralysis after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(3): 269-276.

Figures/Tables 8

References 36

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项目		统计值
性别(n)	男性	17
性别(n)	女性	6
年龄(岁)		58.30±10.70
病程(月)		2.00(1.00, 5.00)
病变性质(n)	脑出血	7
病变性质(n)	脑梗死	16
病变部位(n)	部分前循环	20
病变部位(n)	后循环	3
是否使用肉毒毒素(n)	是	17
是否使用肉毒毒素(n)	否	6
是否伴失语(n)	是	4
是否伴失语(n)	否	19
损伤半球(n)	右侧	9
损伤半球(n)	左侧	14

项目	训练前	训练后	t/Z值	P值
MAS	1.000(1.00, 2.00)	1.000(1.00, 2.00)	1.732	0.083
FMA-UE总分	23.17±16.40	33.87±17.45	-5.180	< 0.001
FMA腕手分	4.00(0.00, 11.00)	10.00(4.00, 15.00)	3.628	< 0.001
FMA上臂分	11.00(3.00, 17.00)	21.00(9.00, 28.00)	3.748	< 0.001

组别	n	训练前	训练后	差值	t值^a	P值^a
非显效组	12	19.08±14.53	24.42±15.05	5.33±4.10	-4.509	0.001
显效组	11	27.64±17.82	44.18±14.02	16.55±11.18	-4.907	0.001
t值		-1.266	-3.250	3.138
P值		0.219	0.004	0.008

组别	n	训练前	训练后	差值	Z值^a	P值^a
非显效组	12	5.00(0.00, 10.75)	6.33±5.85	0.50(0.00, 2.00)	-2.271	0.023
显效组	11	3.00(0.00, 12.00)	14.82±6.40	8.00(5.00, 10.00)	-2.938	0.003
Z/t值		0.339	-3.322	4.112
P值		0.735	0.003	< 0.001

组别	n	训练前	训练后	差值	Z值^a	P值^a
非显效组	12	7.50(2.00, 16.75)	9.50(5.00, 22.00)	3.50(1.00, 5.80)	-2.763	0.006
显效组	11	13.00(3.00, 30.00)	23.00(16.00, 30.00)	6.00(0.00, 17.00)	-2.527	0.012
Z值		-1.139	2.349	1.175
P值		0.255	0.019	0.240

Factors Related to Curative Effect of Brain-computer Interface Training on Upper Limb Paralysis after Stroke

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组别	n	训练前	训练后	Z值	P值
非显效组	12	2.00(1.25, 2.00)	2.00(1.10, 2.00)	1.414	1.000
显效组	11	1.00(0.00, 1.00)	1.00(0.00, 1.00)	0.157	0.317
Z值		2.677	2.968
P值		0.007	0.003

项目		非显效组(n = 12)	显效组(n = 11)	χ²/t/Z值	P值
性别(n)	男	11	6	9.167	0.069
	女	1	5
年龄(岁)		54.17±11.33	62.82±8.24	-2.077	0.050
病程(月)		3.50(1.10, 6.50)	1.00(1.00, 4.00)	1.305	0.192
病变性质(n)	脑出血	4	3	1.333	1.000
	脑梗死	8	8
病变部位(n)	部分前循环	11	9	0.409	0.590
	后循环	1	2
是否使用肉毒毒素(n)	是	6	11	0.000	0.014
	否	6	0
是否伴失语(n)	是	3	1	3.333	0.590
	否	9	10
损伤半球(n)	右侧	5	4	1.251	1.000
	左侧	7	7

项目	相关系数	训练后FMA-UE总分	训练后FMA-UE腕手分	训练后FMA-UE上臂分
性别	Eta值	0.312	0.302	0.284
	t值	1.474	1.425	-1.487
	P值	0.155	0.169	0.152
病变性质	Eta值	0.014	0.212	0.154
	t值	-0.059	-1.711	-0.104
	P值	0.561	0.102	0.918
病变部位	Eta值	0.362	0.340	0.340
	t值	1.759	1.642	-1.734
	P值	0.087	0.121	0.083
是否使用肉毒毒素	Eta值	0.201	0.143	0.218
	t值	0.928	0.657	1.019
	P值	0.364	0.518	0.320
是否伴失语	Eta值	0.453	0.314	0.506
	t值	2.332	1.498	2.767
	P值	0.030	0.149	0.012
损伤半球	Eta值	0.103	0.152	0.047
	t值	-0.437	-0.714	-0.066
	P值	0.667	0.483	0.948
年龄	r值	-0.065	0.070	-0.123
	P值	0.767	0.750	0.576
病程	r值	0.117	0.088	0.207
	P值	0.596	0.690	0.343
训练前MAS评分	r值	-0.409	-0.521	-0.319
	P值	0.052	0.011	0.138
训练前FMA-UE总分	r值	0.831	0.727	0.804
	P值	< 0.001	< 0.001	< 0.001
训练前FMA腕手分	r值	0.685	0.725	0.613
	P值	< 0.001	< 0.001	0.002
训练前FMA上臂分	r值	0.807	0.663	0.806
	P值	< 0.001	0.001	< 0.001

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