| 骆丽,董宏利,张国栋,封盼盼,储雨菲,徐丹丹,刘振峰.具身认知视角下双侧训练对脑卒中偏瘫患者上肢运动功能的影响[J].中国康复,2026,41(1):3-7 |
| 具身认知视角下双侧训练对脑卒中偏瘫患者上肢运动功能的影响 |
| The influence of bilateral training from the perspective of embodied cognition on the upper limb motor function of hemiplegic patients after stroke |
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| DOI：10.3870/zgkf.2026.01.001 |
| 中文关键词: 具身认知 双侧训练 静息运动阈值 运动功能 脑卒中 |
| 英文关键词: embodied cognition bilateral training resting motor threshold motor function stroke |
| 基金项目:江苏省重点研发计划（社会发展）重点项目(BE2021661) |
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| 中文摘要: |
| 目的:探讨具身认知视角下双侧训练对脑卒中偏瘫患者上肢运动功能障碍的治疗效果。方法：选取81例脑卒中偏瘫患者，采用随机数字表法分为双侧训练组（BIT组）、具身认知视角下的双侧训练组（具身BIT组）、对照组，每组27例。对照组和BIT组各有1例因故退出，最终3组分别为26、27、26例。3组患者均接受常规康复训练，对照组增加单侧任务训练及功能性电刺激（FES），BIT组增加常规双侧训练，具身BIT组增加具身认知视角下的双侧训练。均治疗4周。治疗前及治疗4周后，3组患者均采用静息运动阈值（rMT）评估健侧M1区运动皮质兴奋性，采用简化Fugl-Meyer运动功能量表上肢部分（FMA-UE）评估上肢运动功能，采用偏瘫上肢功能测试-香港版（FTHUE-HK）评估上肢的日常作业活动能力。结果：治疗前，3组患者健侧M1区rMT、FMA-UE评分、FTHUE-HK评分比较差异均无统计学意义。治疗4周后，3组患者健侧M1区rMT、FMA-UE评分、FTHUE-HK评分均较治疗前增加（均P<0.01），且具身BIT组上述各项结果均高于对照组和BIT 组（均P<0.05），BIT组M1区rMT、FMA-UE评分高于对照组（均P<0.05）。结论：具身认知视角下的双侧训练可有效降低健侧脑区的兴奋性，提高脑卒中偏瘫患者上肢运动功能和日常作业活动能力，且疗效优于常规康复训练及双侧训练。 |
| 英文摘要: |
| Objective: To explore the therapeutic effect of bilateral training (BIT) from the perspective of embodied cognition on upper limb motor dysfunction in hemiplegic patients after stroke. Methods: A total of 81 patients with post-stroke hemiplegia were selected. They were divided into a BIT group, an embodied cognition-based BIT group (embodied BIT group), and a control group using a random number table method, with 27 cases in each group. In the control group and the BIT group, one participant each withdrew from the study for reasons，resulting in final sample sizes of 26, 27 and 26 participants in the three groups, respectively.All patients in the three groups received routine rehabilitation training. The control group recieved unilateral task training and functional electrical stimulation.The BIT group received additional conventional BIT, and the embodied BIT group received additional BIT from the perspective of embodied cognition. All treatments lasted for 4 weeks. Before and 4 weeks after treatment, the three groups of patients were evaluated for motor cortex excitability of the ipsilateral M1 area using resting motor threshold (rMT), upper limb motor function using the upper limb section of the simplified Fugl-Meyer assessment (FMA-UE), and upper limb daily activity ability using the hemiplegic upper limb function test-Hong Kong version (FTHUE-HK). Results: Before treatment, there were no significant differences in rMT of the M1 area on the healthy side, FMA-UE, and FTHUE-HK among the three groups. After treatment, rMT of the M1 area on the healthy side, FMA-UE, and FTHUE-HK in all three groups were significantly improved as compared with those before treatment (all P<0.01), and the improvement in the embodied BIT group was significantly greater than that in the control group and the BIT group (all P<0.05). Conclusion: BIT from the perspective of embodied cognition can effectively reduce the excitability of the healthy brain region, improve upper limb motor function and the ability to perform daily activities in hemiplegic patients after stroke, and its therapeutic effect is superior to that of conventional rehabilitation training and BIT. |
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