远程康复
医学
物理疗法
康复
皮质脊髓束
冲程(发动机)
初级运动皮层
物理医学与康复
神经可塑性
运动皮层
远程医疗
磁共振成像
内科学
磁共振弥散成像
医疗保健
经济
工程类
放射科
精神科
机械工程
经济增长
刺激
作者
Jing Chen,Dalong Sun,Shufan Zhang,Yonghui Shi,Fenglei Qiao,Yafei Zhou,Jun Liu,Chuancheng Ren
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2020-10-01
卷期号:95 (17)
被引量:74
标识
DOI:10.1212/wnl.0000000000010821
摘要
Objective
To determine the effects of a 12-week home-based motor training telerehabilitation program in patients with subcortical stroke by combining motor function assessments and multimodality MRI analysis methods. Methods
Fifty-two patients with stroke and hemiplegia were randomly assigned to either a home-based motor training telerehabilitation (TR) group or a conventional rehabilitation (CR) group for 12 weeks. The Fugl-Meyer assessment (FMA) for upper and lower extremities and the modified Barthel Index were used as primary outcomes. The secondary outcomes included resting-state functional connectivity (rsFC) between the bilateral M1 areas, gray matter volumes of the primary motor cortex (M1) areas, and white matter integrity of the corticospinal tract. Analysis of covariance was applied to examine the effects of the home-based motor training TR program on neural function recovery and brain plasticity. Results
Compared with the CR group, the TR group showed significant improvement in the FMA (p = 0.011) and significantly increased M1-M1 rsFC (p = 0.031) at the end of the rehabilitation. The M1-M1 rsFC change was significantly positively correlated with the FMA change in the TR group (p = 0.018). Conclusion
This study showed a beneficial effect of the home-based motor training telerehabilitation program on motor function in patients with stroke, which was accompanied by enhanced interhemispheric functional connectivity of the M1 areas. We inferred that it is feasible, safe, and efficacious for patients with stroke to receive professional rehabilitation training at home. The combined use of imaging biomarkers should be encouraged in motor training clinical studies in patients with stroke. Classification of evidence
This study provides Class II evidence that for patients with stroke with hemiplegia, home-based telerehabilitation compared to conventional rehabilitation significantly improves some motor function tests.
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