不同时序经颅直流电刺激联合坐位太极拳云手对脑卒中偏瘫患者脑皮质激活影响的功能性近红外光谱研究

doi:10.3969/j.issn.1006-9771.2025.10.002

Abstract

Abstract:

Objective To investigate the immediate effect of transcranial direct current stimulation (tDCS) combined with seated Taijiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiplegia.
Methods From September to December, 2024, 14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospital of Xiamen. Based on the routine medication and rehabilitation, the patients were randomly assigned to a specific intervention sequence, receiving three interventions in a fixed order: tDCS followed by Yunshou (S-Y group), Yunshou followed by tDCS (Y-S group), and simultaneous tDCS and Yunshou (Sim group). Functional near-infrared spectroscopy was used to detect oxyhemoglobin (HbO₂) concentration in bilateral sensorimotor cortex, premotor and supplementary motor cortex, and prefrontal cortex before and after each intervention.
Results Three patients dropped out. In all the regions of interest, inter-group effects were significant in HbO₂ concentrations (F > 3.697, P < 0.05), and interaction effects were significant in some brain regions (F > 3.276, P < 0.05). Post-hoc test showed a general trend of Sim Group ≥ S-Y Group > Y-S Group (P < 0.05), although some variations existed across different brain regions.
Conclusion Both simultaneous intervention (tDCS and Yunshou) and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

Key words: stroke, hemiplegia, transcranial direct current stimulation, Taijiquan, Yunshou, functional near-infrared spectroscopy, brain-limb coordinated rehabilitation

CLC Number:

R743.3

XU Qi, ZHENG Dingzhao, NIU Zhenyuan, YANG Yaling, WEN Weiyou, XU Jingsheng, WU Longqiang, WU Fan, YAN Tiebin. Effect of transcranial direct current stimulation combined with seated Taijiquan Yunshou in different sequences on cerebral cortical activation in stroke patients with hemiplegia: a functional near-infrared spectroscopy study[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(10): 1121-1127.

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References 26

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脑区	组别	治疗前		治疗后
脑区	组别	均值	标准差	均值	标准差
左SMC	电-云组	0.030	0.053	0.050	0.033
	云-电组	0.030	0.033	0.016	0.028
	同步组	0.034	0.034	0.041	0.036
右SMC	电-云组	0.022	0.033	0.028	0.028
	云-电组	0.027	0.043	0.011	0.025
	同步组	0.037	0.035	0.034	0.033
左PMC	电-云组	0.028	0.039	0.045	0.035
	云-电组	0.025	0.023	0.015	0.026
	同步组	0.031	0.030	0.042	0.025
右PMC	电-云组	0.025	0.034	0.028	0.035
	云-电组	0.017	0.033	0.007	0.024
	同步组	0.026	0.038	0.029	0.033
左PFC	电-云组	0.027	0.039	0.026	0.034
	云-电组	0.020	0.030	0.011	0.028
	同步组	0.025	0.041	0.036	0.043
右PFC	电-云组	0.023	0.039	0.020	0.030
	云-电组	0.016	0.026	0.008	0.025
	同步组	0.026	0.038	0.039	0.036

变量		平方和	自由度	均方	F值	P值
左SMC	组间	0.010	2	0.005	3.697	0.027
	时间	0.001	1	0.001	0.664	0.416
	组间×时间	0.009	2	0.005	3.276	0.040
右SMC	组间	0.008	2	0.004	3.723	0.026
	时间	0.001	1	0.001	0.822	0.366
	组间×时间	0.004	2	0.002	1.672	0.191
左PMC	组间	0.018	2	0.009	9.591	< 0.001
	时间	0.003	1	0.003	3.074	0.081
	组间×时间	0.011	2	0.005	5.778	0.003
右PMC	组间	0.015	2	0.008	6.989	0.001
	时间	0.000	1	0.000	0.148	0.701
	组间×时间	0.003	2	0.001	1.246	0.289
左PFC	组间	0.023	2	0.011	8.668	< 0.001
	时间	0.000	1	0.000	0.002	0.964
	组间×时间	0.009	2	0.005	3.473	0.032
右PFC	组间	0.044	2	0.022	20.525	< 0.001
	时间	0.000	1	0.000	0.068	0.794
	组间×时间	0.013	2	0.006	6.021	0.003

变量	组别	组别	平均值差/(mmol·L^-1)	P值	95%CI
变量	组别	组别	平均值差/(mmol·L^-1)	P值	上限	下限
左SMC	电-云组	云-电组	0.017	0.018	0.003	0.031
	电-云组	同步组	0.002	0.752	-0.012	0.017
	云-电组	同步组	-0.015	0.017	-0.027	-0.003
右SMC	电-云组	云-电组	0.006	0.327	-0.006	0.018
	电-云组	同步组	-0.010	0.079	-0.022	0.001
	云-电组	同步组	-0.016	0.011	-0.029	-0.004
左PMC	电-云组	云-电组	0.016	< 0.001	0.007	0.025
	电-云组	同步组	0.000	0.996	-0.009	0.009
	云-电组	同步组	-0.016	< 0.001	-0.024	-0.009
右PMC	电-云组	云-电组	0.014	0.002	0.005	0.023
	电-云组	同步组	-0.002	0.732	-0.011	0.008
	云-电组	同步组	-0.016	0.001	-0.025	-0.007
左PFC	电-云组	云-电组	0.011	0.001	0.005	0.018
	电-云组	同步组	-0.004	0.349	-0.012	0.004
	云-电组	同步组	-0.015	< 0.001	-0.023	-0.008
右PFC	电-云组	云-电组	0.010	0.002	0.004	0.016
	电-云组	同步组	-0.011	0.002	-0.018	-0.004
	云-电组	同步组	-0.021	< 0.001	-0.027	-0.015

Effect of transcranial direct current stimulation combined with seated Taijiquan Yunshou in different sequences on cerebral cortical activation in stroke patients with hemiplegia: a functional near-infrared spectroscopy study

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