座椅前倾对脑卒中患者坐-站转移能力的影响及脑网络研究OA
Effect of anterior seat inclination on sit-to-stand ability in patients with stroke and related brain network
目的 观察座椅前倾对脑卒中患者坐-站转移(STS)能力和平衡功能的影响,并基于功能性近红外光谱(fNIRS)探讨其训练前后脑功能连接的变化. 方法 2024年1月至2025年12月,选取上海市第一康复医院脑卒中偏瘫患者43例,随机分为对照组(n=21)和试验组(n=22).对照组给予常规康复联合平椅STS训练,试验组给予常规康复联合座椅前倾20° STS训练,干预2周.分别于训练前后进行5次坐立测试(FTSST)和Berg平衡量表(BBS)评定,采用fNIRS检测前额叶皮质(PFC)、初级运动皮质(M1)、初级躯体感觉皮质(S1)、前运动皮质(PMC)的脑血氧变化并分析功能连接强度. 结果 训练后,两组FTSST用时均较训练前明显缩短(t>3.469,P<0.01),且试验组短于对照组(t=-2.065,P<0.05);两组BBS评分均较前明显升高(|Z|>4.019,P<0.01),试验组高于对照组(Z=-2.250,P<0.05).fNIRS数据显示,试验组训练后左侧M1(LM1)与右侧PFC、LM1与右侧S1的FC强度均高于训练前(t>3.311,P<0.05). 结论 座椅前倾条件下STS训练可增强相关脑区功能连接,有利于改善脑卒中患者STS能力和平衡功能.
Objective To observe the clinical effect of anterior seat inclination on sit-to-stand(STS)ability and balance function in patients with stroke,as well as brain functional connectivity based on functional near-infrared spectroscopy(fNIRS). Methods From January,2024 to December,2025,43 patients with stroke were randomly divided into control group(n=21)and experimental group(n=22).The control group received conventional rehabilitation combined with STS training on a flat seat,while the experimental group received conventional rehabilitation plus STS training with a 20° anterior seat inclination,for two weeks.Five-times sit-to-stand test(FTSST)and Berg Balance Scale(BBS)were assessed before and after training.fNIRS was used to detect changes in cerebral blood oxygenation in the prefrontal cortex(PFC),primary motor cortex(M1),primary somatosensory cortex(S1)and premotor cortex(PMC),and to analyze functional connectivity strength. Results After training,FTSST time shortened in both groups(t>3.469,P<0.01),and was shorter in the experimental group than in the control group(t=-2.065,P<0.05);BBS scores increased in both groups(|Z|>4.019,P<0.01),and was higher in the experimental group than in the control group(Z=-2.250,P<0.05).fNIRS showed that after training,the functional connectivity strength between the left M1 and the right PFC increased,as well as between the left M1 and the right S1 in the experimental group(t>3.311,P<0.05). Conclusion STS training with anterior seat inclination can enhance functional connectivity in relevant brain regions,which may contribute to improvements of STS ability and balance function in patients with stroke.
沈小花;陈芳元;荣积峰;饶彪琴;孔令轩;田威;陈志群;李丽
上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090上海市第一康复医院,上海市 200090
医药卫生
脑卒中坐-站转移座椅前倾功能性近红外光谱脑功能网络
strokesit-to-stand transitionseat inclinationfunctional near-infrared spectroscopybrain functional networks
《中国康复理论与实践》 2026 (9)
1061-1067,7
上海市杨浦区科学技术委员会、杨浦区卫生健康委员会面上项目(No.YPM202313No.YPM202406) Supported by General Project of Science and Technology Commission&Health Commission of Yangpu District,Shanghai(No.YPM202313No.YPM202406)
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