康复机器人上肢偏瘫训练策略及中枢机制研究

This study is a randomized controlled study on the use of rehabilitation robotic training for the treatment of upper limb hemiplegia. Its purpose is to establish an optimal robotic rehabilitation training strategy which is superior to traditional rehabilitation training methods, to obtain the correlation between the clinical and quantitative evaluations of the hemiplegic upper limb abnormal synergies, and to establish a quantitative evaluation system of the abnormal synergies of the hemiplegic upper limb which based on the rehabilitation robotics. EEG / EMG coherence analysis is applied to changes of the brain's exciting area and peripheral muscle coherence corresponding to reduce of the abnormal synergies after the robotic training. We will explore the relationship between decrease of abnormal synergies after the robotic rehabilitation training and the motor area overlapping by multi-lead EEG inverse for source analysis methods, and the relationship between the decrease of abnormal synergies after the robotic training and the brain plasticity by fMRI analysis methods. In conclude, it is obtained that the optimal strategy of robotic training for hemiplegia and its central mechanism.

本研究拟在康复机器人训练上肢偏瘫的随机对照研究基础上，建立一种优于传统康复训练方法的机器人康复训练最优策略，得出偏瘫上肢异常协同模式的临床评价和定量评价的相关关系， 建立基于机器人的偏瘫上肢异常协同模式的定量评价系统。应用 EEG/EMG相干分析机器人康复训练前后异常协同模式减轻相应的大脑兴奋区和与外周肌肉相干性的变化。应用多导联EEG进行脑电求逆求源分析，探索出机器人康复训练前后异常协同模式减轻与运动区重叠现象的关系。应用fMRI分析方法，探索出机器人康复训练前后异常协同模式减轻和大脑可塑性的关系。最后得出康复机器人训练偏瘫的最优策略并探索其中枢机制。

脑卒中后最常见的功能障碍是上肢运动与协调的功能障碍。本研究拟在建立一种优于传统康复训练方法的机器人康复训练最优策略，得出偏瘫上肢异常协同模式的临床评价和定量评价的相关关系，建立基于机器人的偏瘫上肢异常协同模式的定量评价系统并探索其中枢机制。现本研究已设计了一套偏瘫患者手臂静力力量测量的支架系统，通过测量过程的定量分析，对脑卒中患者的肩肘关节产生力量的变异性进行分析，实现了对脑卒中偏瘫患者上肢肩肘运动功能障碍的力量控制的量化评估；采用表面肌电及脑电测量了脑卒中偏瘫患者异常协同的电生理学特征，为偏瘫患者上肢异常协同的可能机制提供了研究方向，为指导康复治疗提供了依据；同时，我们还建立了脑卒中上肢康复机器人训练系统并进行了定量评估测试。