目的：探讨手部外骨骼机器人联合手运动想象对脑卒中偏瘫患者脑电信号及认知功能的影响。方法：选 取 2022 年 10 月—2023 年 10 月于上海市静安区市北医院老年康复科就诊的脑卒中后偏瘫手功能障碍患者 120 例， 按照不同干预方法将其分为 A、B、C 三组，各 40 例。A 组予以手运动想象联合常规康复治疗，B 组予以手部外骨 骼机器人联合常规康复治疗，C 组予以手部外骨骼机器人联合手运动想象及常规康复治疗。比较三组患者 Fugl-Meyer 上肢运动功能量表（FMA-UL）评分、上肢动作研究量表（ARAT）评分、Carroll 上肢功能试验（UEFT）评分、 Batherl 指数（BI）评分、蒙特利尔认知评估量表（MoCA）评分、简易精神状态检查量表（MMSE）评分、上肢肌 电积分（iEMG）值、大脑各导联 α 波绝对功率值及总有效率。结果：治疗后 4 周，三组患者 FMA-UL、ARAT、 UEFT、BI 评分及前臂伸肌肌群、上肢三角肌、肱三头肌 iEMG 值比较均显著升高，且 C 组显著高于 A 组、B 组， 差异有统计学意义（P<0.05）。三组患者 MoCA、MMSE 评分及大脑各导联 α 波绝对功率值比较均显著升高，且 C 组均显著高于 A 组、B 组，A 组均显著高于 B 组，差异有统计学意义（P<0.05）。C 组总有效率（97.50%）显著高 于 A 组总有效率（82.50%）与 B 组总有效率（80.00%），差异有统计学意义（P<0.05）。结论：手部外骨骼机器人 联合手运动想象可明显改善脑卒中偏瘫患者认知功能与大脑功能状态，提高其日常生活能力及前臂伸肌肌群、上肢 三角肌、肱三头肌 iEMG 值，更好地改善其上肢运动功能障碍。

Objective: To investigate the effects of hand exoskeleton robot combined with hand motion imagination on EEG signal and cognitive function of stroke patients with hemiplegia. Methods: A total of 120 hemiplegia patients with hand dysfunction after stroke who were treated in Shanghai Jing’an District Shibei Hospital from October 2022 to October 2023 were selected. They were divided into 3 groups according to different intervention ways, with 40 cases in each group. Group A was given hand movement imagination combined with routine rehabilitation treatment, group B was given hand exoskeleton robot combined with routine rehabilitation treatment, while Group C was given the hand exoskeleton robot combined with hand movement imagination and routine rehabilitation treatment. Fugl-Meyer assessment of upper extremity (FMA-UE), action research arm test (ARAT), upper extremity function test (UEFT), Batherl Index (BI), montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), and intramuscular EMG (iEMG) of the upper limbs, absolute power of α oscillations of each brain lead and total effective rate were compared among the three groups. Results: 4 weeks after treatment, FMA-UL, ARAT, UEFT and BI scores, iEMG values of the forearm extender muscle group, upper limb deltoid muscle, and triceps were significantly improved, while they were significantly better in group C than group A and B (P<0.05). MoCA, MMSE scores, and absolute power values of α oscillations of brain leads were all increased in the three groups after treatment, while they were significantly better in group C than group A and B, and group A was significantly better than group B, with significant differences (P<0.05). Overall effective rate of Group C (97.50%) was noticeably higher than group A (82.50%) and group B(80.00%), and the differences were statistically significant (P<0.05). Conclusion: Hand exoskeleton robot combined with hand motion imagination can significantly improve the cognitive function, brain function and upper limb motor dysfunction of stroke patients with hemiplegia, as well as improve their daily living ability and iEMG values of forearm extensors, upper deltoid muscles and triceps.

收稿日期：2024-04-16  录用日期：2024-05-18 

Received Date: 2024-04-16  Accepted Date: 2024-05-18 

基金项目：上海市静安区卫生科研课题（2022MS10）；上海市静安区卫生系统重点学科建设资助项目（2021ZD03） 

Foundation Item: Health Research Project of Shanghai Jing’an District (2022MS10); Health System Key Discipline Construction Support Project of Shanghai Jing’an District (2021ZD03) 

通讯作者：舒锦，Email：Shu_jin@126.com 

Corresponding Author: SHU Jin, Email: Shu_jin@126.com 

引用格式：顾怡雯，舒锦 . 手部外骨骼机器人联合手运动想象对脑卒中偏瘫患者脑电信号及认知功能的影响 [J]. 机器人外科学杂志 （中英文），2024，5（6）：1116-1123. 

Citation: GU Y W, SHU J. Effect of hand exoskeleton robot combined with hand motion imagination on EEG signal and cognitive function in stroke patients with hemiplegia[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1116-1123.

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