CAJ | 학술논문

目的通过静息态功能磁共振成像(rs-fMRI)技术观察交互抑制疗法治疗脑卒中前、后患者脑功能网络连接变化情况.方法采用随机数字表法将30例脑卒中患者分为对照组与治疗组,每组15例.2组患者均给予内科对症治疗及常规康复干预,治疗组在此基础上增加交互抑制手法治疗,每天1次,每次30 min,每周6次,连续4周.于治疗前、治疗4周后分别采用加拿大神经功能缺损评分(CNS)、Frenchay活动量表(FAI)及运动力指数(MI)对2组患者进行评定,同时检测2组患者治疗前、后双侧大脑运动皮质功能连接情况,并分析其与CNS、FAI及MI评分间的相关性.结果经治疗4周后,发现2组患者CNS、FAI及MI评分均较治疗前明显改善(P＜0.05),并以治疗组FAI评分[(54.68±4.62)分]、MI评分[(40.02±2.73)分]的改善幅度较显著,与对照组间差异均具有统计学意义(P＜0.05).治疗后2组患者双侧大脑运动皮质功能连接系数[治疗组为(0.674±0.126),对照组为(0.738±0.122)]均较治疗前显著下降(P＜0.05);通过相关性分析发现,治疗组双侧大脑运动皮质连接系数与MI评分具有负相关性(P＜0.05,r=-0.01).结论交互抑制疗法能加速早期脑卒中患者肢体运动功能改善,并促其大脑运动皮质功能连接系数显著降低,其大脑运动皮质功能连通性改变与肢体运动功能改善具有显著相关性.
목적 통과정식태공능자공진성상(rs-fMRI)기술관찰교호억제요법치료뇌졸중전、후환자뇌공능망락련접변화정황.방법 채용수궤수자표법장30례뇌졸중환자분위대조조여치료조,매조15례.2조환자균급여내과대증치료급상규강복간예,치료조재차기출상증가교호억제수법치료,매천1차,매차30 min,매주6차,련속4주.우치료전、치료4주후분별채용가나대신경공능결손평분(CNS)、Frenchay활동량표(FAI)급운동력지수(MI)대2조환자진행평정,동시검측2조환자치료전、후쌍측대뇌운동피질공능련접정황,병분석기여CNS、FAI급MI평분간적상관성.결과 경치료4주후,발현2조환자CNS、FAI급MI평분균교치료전명현개선(P＜0.05),병이치료조FAI평분[(54.68±4.62)분]、MI평분[(40.02±2.73)분]적개선폭도교현저,여대조조간차이균구유통계학의의(P＜0.05).치료후2조환자쌍측대뇌운동피질공능련접계수[치료조위(0.674±0.126),대조조위(0.738±0.122)]균교치료전현저하강(P＜0.05);통과상관성분석발현,치료조쌍측대뇌운동피질련접계수여MI평분구유부상관성(P＜0.05,r=-0.01).결론 교호억제요법능가속조기뇌졸중환자지체운동공능개선,병촉기대뇌운동피질공능련접계수현저강저,기대뇌운동피질공능련통성개변여지체운동공능개선구유현저상관성.
Objective To investigate the effects of reciprocal inhibition on motor function connectivity in the brains of stroke patients.Methods Thirty patients with stroke were randomly divided into a treatment group (n =15) and a control group (n =15).The control group underwent normal limb positioning,medium frequency electrotherapy,circulated compression of the limbs,etc.The treatment group received conventional rehabilitation treatment plus reciprocal inhibition treatment for 30 min daily,6 times a week for 4 weeks.All of the patients were assessed before and after treatment using the Canadian neurological scale (CNS),the Frenchay activities index (FAI),the motricity index (MI) and functional magnetic resonance imaging of the motor cortex in a resting state (rs-fMRI).Results In both groups the average CNS,FAI and MI scores improved significantly.Compared with the control group,the changes in FAI and MI scores in the treatment group improved significantly more.The coefficient of functional connectivity of the bilateral motor cortex decreased significantly after treatment in both groups.In the treatment group the motor cortex functional connectivity correlated significantly with the improvements in MI scores.Conclusions Reciprocal inhibition can accelerate the improvement of extremity motor function and ability in the activities of daily living significantly after stroke.It reduces functional connectivity in the bilateral motor cortex in ways significantly correlated with improvements in motor function.