基于运动想象的康复脑机接口联合重复外周磁刺激对卒中后恢复期患者上肢运动功能的疗效研究

doi:10.3969/j.issn.1673-5765.2025.10.004

中国卒中杂志 ›› 2025, Vol. 20 ›› Issue (10): 1229-1236.DOI: 10.3969/j.issn.1673-5765.2025.10.004

基于运动想象的康复脑机接口联合重复外周磁刺激对卒中后恢复期患者上肢运动功能的疗效研究

李欣^1，2，王东²，石诗萌^2，3，陈云⁴，何志杰⁵，贾杰^1，5

1 新乡 453000 河南医药大学第一附属医院康复医学科
2 成都大学附属医院康复医学科
3 成都大学体育学院
4 复旦大学附属华山医院福建医院康复医学科
5 复旦大学附属华山医院康复医学科

收稿日期:2025-07-16 修回日期:2025-09-25 接受日期:2025-10-02 出版日期:2025-10-20 发布日期:2025-10-20
通讯作者: 贾杰 shannonjj@126.com
基金资助:
四川省自然科学基金（24NSFSC2856）
四川省卫生健康委员会科技项目（24QNMP077）
上海市2024年度“科技创新行动计划”养老科技支撑专项项目（24YL1900200）

Efficacy of Motor Imagery-Based Rehabilitation Brain-Computer Interface Combined with Repetitive Peripheral Magnetic Stimulation on Upper Limb Motor Function in Patients with Convalescent Phase after Stroke

LI Xin^1,2, WANG Dong², SHI Shimeng^2,3, CHEN Yun⁴, HE Zhijie⁵, JIA Jie^1,5

1 Department of Rehabilitation Medicine, The First Affiliated Hospital of Henan Medical University, Xinxiang 453000, China
2 Department of Rehabilitation Medicine, Affiliated Hospital of Chengdu University, Chengdu 610081, China
3 College of Physical Education of Chengdu University, Chengdu 610000, China
4 Department of Rehabilitation Medicine, Fujian Hospital, Huashan Hospital, Fudan University, Fuzhou 350000, China
5 Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China

Received:2025-07-16 Revised:2025-09-25 Accepted:2025-10-02 Online:2025-10-20 Published:2025-10-20
Contact: JIA Jie, E-mail: shannonjj@126.com

摘要/Abstract

摘要： 目的探索基于运动想象的康复脑机接口联合重复外周磁刺激对卒中后恢复期患者上肢运动功能的影响。
方法前瞻性连续纳入2025年5—8月在成都大学附属医院康复医学科住院治疗的卒中后恢复期患者，将其随机分为试验组和对照组。两组均给予4周的常规康复训练与重复外周磁刺激治疗，试验组在此基础上增加4周基于运动想象的康复脑机接口治疗（每周5 d，每日1次，每次30 min）。干预前后采用Fugl-Meyer运动功能评定量表上肢部分（Fugl-Meyer motor assessment-upper extremity，FMA-UE）评价上肢运动功能，采集患者患侧腕伸肌的表面肌电信号，记录其均方根（root mean square，RMS）值和积分肌电（integrated electromyography，iEMG）值以评价运动单位的募集程度。
结果共纳入30例卒中后恢复期患者，试验组和对照组各15例。干预前，两组FMA-UE总分、FMA-UE肩肘部分评分、FMA-UE腕手部分评分、RMS值和iEMG值的差异均无统计学意义。干预4周后试验组FMA-UE总分[（39.9±7.8）分 vs.（30.7±7.8）分，P=0.003]、FMA-UE腕手部分评分[（14.5±3.5）分 vs.（9.3±3.1）分，P＜0.001]、RMS值[（47.90±14.94）μV vs.（32.33±7.84）μV，P=0.002]、iEMG值[（82.69±14.32）μV vs.（66.22±10.88）μV，P=0.001]均优于对照组，差异有统计学意义。
结论基于运动想象的康复脑机接口联合重复外周磁刺激可有效提高卒中后恢复期患者的上肢运动功能，且该治疗策略对上肢远端运动功能的改善效果更佳。

文章导读： 本研究将基于运动想象的康复脑机接口与重复外周磁刺激联合应用于卒中后恢复期患者的治疗，发现该联合康复方案可以更好地改善患者的上肢运动功能与其患侧腕伸肌群的运动募集能力，为脑机接口的临床应用提供了实践与证据参考。

关键词: 卒中; 脑机接口; 重复外周磁刺激; 上肢运动功能

Abstract: Objective To explore the effect of motor imagery-based rehabilitation brain-computer interface combined with repetitive peripheral magnetic stimulation on upper limb motor function in patients with convalescent phase after stroke.
Methods Patients in the convalescent phase after stroke who were hospitalized in the Department of Rehabilitation Medicine, Affiliated Hospital of Chengdu University from May to August 2025 were prospectively and consecutively enrolled. They were randomly divided into the experimental group and the control group. Both groups received 4 weeks of conventional rehabilitation training and repetitive peripheral magnetic stimulation therapy. On this basis, the experimental group received 4 weeks of motor imagery-based rehabilitation brain-computer interface therapy (5 days a week, once a day, 30 minutes per session). Upper limb motor function was evaluated by the Fugl-Meyer motor assessment-upper extremity (FMA-UE) before and after the intervention. Surface electromyography signals were collected from the extensor carpi muscles on the affected side, and the root mean square (RMS) and integrated electromyography (iEMG) values were recorded to evaluate the degree of motor unit recruitment.
Results A total of 30 patients in the convalescent phase after stroke were included, with 15 cases in both the experimental group and the control group. Before intervention, there were no statistically significant differences between the two groups in the total score of FMA-UE, FMA-UE shoulder/elbow subscore, FMA-UE wrist/hand subscore, RMS value, and iEMG value. After 4 weeks of intervention, the experimental group showed better results than the control group in the total score of FMA-UE [(39.9±7.8) points vs. (30.7±7.8) points, P=0.003], FMA-UE wrist/hand subscore [(14.5±3.5) points vs. (9.3±3.1) points, P<0.001], RMS value [(47.90±14.94) μV vs. (32.33±7.84) μV, P=0.002], and iEMG value [(82.69±14.32) μV vs. (66.22±10.88) μV, P=0.001], and the differences were statistically significant.
Conclusions Motor imagery-based rehabilitation brain-computer interface combined with repetitive peripheral magnetic stimulation can effectively improve upper limb motor function in patients with convalescent phase after stroke, and this protocol has a better effect on improving distal upper limb motor function.

Key words: Stroke; Brain-computer interface; Repetitive peripheral magnetic stimulation; Upper limb motor function

中图分类号:

李欣, 王东, 石诗萌, 陈云, 何志杰, 贾杰. 基于运动想象的康复脑机接口联合重复外周磁刺激对卒中后恢复期患者上肢运动功能的疗效研究[J]. 中国卒中杂志, 2025, 20(10): 1229-1236.

LI Xin, WANG Dong, SHI Shimeng, CHEN Yun, HE Zhijie, JIA Jie. Efficacy of Motor Imagery-Based Rehabilitation Brain-Computer Interface Combined with Repetitive Peripheral Magnetic Stimulation on Upper Limb Motor Function in Patients with Convalescent Phase after Stroke[J]. Chinese Journal of Stroke, 2025, 20(10): 1229-1236.

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基于运动想象的康复脑机接口联合重复外周磁刺激对卒中后恢复期患者上肢运动功能的疗效研究

Efficacy of Motor Imagery-Based Rehabilitation Brain-Computer Interface Combined with Repetitive Peripheral Magnetic Stimulation on Upper Limb Motor Function in Patients with Convalescent Phase after Stroke

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