Combination of Brain-Computer Interface Training and Goal-Directed Physical Therapy in Chronic Stroke: A Case Report
Combination of Brain-Computer Interface Training and Goal-Directed Physical Therapy in Chronic Stroke: A Case Report
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DOI：
10.1177/1545968310368683
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发表时间：
2010-09-01
影响因子：
4.2
通讯作者：
Birbaumer, Niels
中科院分区：
文献类型：
--
作者：
Broetz, Doris;Braun, Christoph;Birbaumer, Niels
背景资料。对于缺乏残余运动的慢性中风患者，目前还没有公认的有效的康复策略来减少局灶性损害。方法：研究方法。采用脑机接口(BCI)结合特定的面向日常生活的理疗，对一名67岁没有活动手指伸展的偏瘫患者进行了训练。BCI使用脑电活动(EEG)和磁脑活动(MEG)来驱动矫形器和固定在患者受影响的上肢上的机器人，这使他能够移动由m节律活动的自愿调制驱动的瘫痪的手臂和手。此外，患者还进行了目标导向的理疗训练。在一年多的时间里，他完成了3个训练模块。重复评估手臂运动功能、步态能力(使用Fugl-Meyer评估、Wolf运动功能测试、改良的Ashworth量表、10m步行速度和目标实现分数)和脑重组(功能磁共振、脑磁共振仪)。结果。手和手臂的运动能力以及步态的速度和安全性均有明显改善(平均46.6%)。运动功能的改善与患侧运动皮质内MU振荡的增加有关。结论。这项原则验证研究表明，BCI训练与目标导向的、积极的物理治疗相结合，可能会改善慢性中风患者的运动能力，尽管患者最初出现明显的瘫痪。
Background. There is no accepted and efficient rehabilitation strategy to reduce focal impairments for patients with chronic stroke who lack residual movements. Methods. A 67-year-old hemiplegic patient with no active finger extension was trained with a brain-computer interface (BCI) combined with a specific daily life-oriented physiotherapy. The BCI used electrical brain activity (EEG) and magnetic brain activity (MEG) to drive an orthosis and a robot affixed to the patient's affected upper extremity, which enabled him to move the paralyzed arm and hand driven by voluntary modulation of m-rhythm activity. In addition, the patient practiced goal-directed physiotherapy training. Over 1 year, he completed 3 training blocks. Arm motor function, gait capacities (using Fugl-Meyer Assessment, Wolf Motor Function Test, Modified Ashworth Scale, 10-m walk speed, and goal attainment score), and brain reorganization (functional MRI, MEG) were repeatedly assessed. Results. The ability of hand and arm movements as well as speed and safety of gait improved significantly (mean 46.6%). Improvement of motor function was associated with increased mu-oscillations in the ipsilesional motor cortex. Conclusion. This proof-of-principle study suggests that the combination of BCI training with goal-directed, active physical therapy may improve the motor abilities of chronic stroke patients despite apparent initial paralysis.