Research Progress of Motor Imagery Combined with Occupational Therapy in Rehabilitation Training of Stroke Patients
Zhao Xin1#, Wu Haixia1, Chen Long2*, Wang Zhongpeng1, Gu Bin1, Ming Dong1,2#
1(College of Precision Instruments & Optoelectronics Engineering,Tianjin University,Tianjin 300072,China) 2(Academy of Medical Engineering and Translational Medicine,Tianjin University,Tianjin 300072,China)
Abstract:As traditional rehabilitation methods,motor imagery(MI) and occupational therapy(OT) have been widely used in the clinical rehabilitation of stroke patients. This paper first briefly described the basic principles of OT and MI in stroke rehabilitation training, and the specifically reviewed the relevant research progress in the clinical application of OT and MI in the treatment of different functional disorders such as motor function and cognitive function in stroke rehabilitation. Among them, MI has the advantages of being simple and easy to implement, low cost, and can fully mobilize the subjective initiative of patients. However, it has the disadvantages of being single in form and difficult to control the process. The OT experiment paradigm is simple and has fixed mode guidance, with numerous actions and fits in with daily life, which can add situational and task-oriented training mode to MI. Finally, the research progress of MI combined with OT in stroke rehabilitation training was reviewed. The study showed that the combination of MI and OT could give play to the advantages of both, and is expected to further improve the rehabilitation process of patients. In the future, it will be continuously optimized and improved in terms of training methods, neural mechanism and system classification performance.
赵欣, 武海霞, 陈龙, 王仲朋, 顾斌, 明东. 运动想象结合作业疗法在脑卒中患者康复训练中的研究进展[J]. 中国生物医学工程学报, 2021, 40(2): 228-236.
Zhao Xin, Wu Haixia, Chen Long, Wang Zhongpeng, Gu Bin, Ming Dong. Research Progress of Motor Imagery Combined with Occupational Therapy in Rehabilitation Training of Stroke Patients. Chinese Journal of Biomedical Engineering, 2021, 40(2): 228-236.
[1] Kwakkel G,Kollen BJ,Vand GJ,et al. Probability of regaining dexterity in the flaccid upper limb:Impact of severity of paresis and time since onset in acute stroke[J]. Stroke,2003,34(9):2181-2186. [2] Brewer L. Stroke rehabilitation:Recent advances and future therapies[J]. Qjm Monthly Journal of the Association of Physicians,2013,106(1):11-25. [3] 《中国脑卒中防治报告》编写组.《中国脑卒中防治报告2019》概要[J]. 中国脑血管病杂志,2020,17(5):272-281. [4] Krishnamurthi RV,Ikeda T,Feigin VL. Global,regional and country-specific burden of ischaemic stroke,intracerebral haemorrhage and subarachnoid haemorrhage:A systematic analysis of the global burden of disease study 2017[J]. Neuroepidemiology,2020,54(2):171-179. [5] Zorowitz R,Gillard P,Brainin M. Post stroke spasticity:Sequelae and burden on stroke survivors and caregivers[J]. Neurology,2013,80(Suppl.2):S45-S52. [6] 席友缘.多模式手部运动想象下的经颅磁刺激运动诱发电位研究[D].天津:天津大学,2012. [7] Arya KN,Verma R,Garg RK,et al.Meaningful task-specific training (MTST) for stroke rehabilitation:A randomized controlled trial[J].Topics in Stroke Rehabilitation,2012,19(3):193-211. [8] Hara Y.Brain plasticity and rehabilitation in stroke patients [J].Journal of Nippon Medical School,2015,82(1):4-13. [9] Sun Y,Zehr EP.Training-induced neural plasticity and strength are amplified after stroke[J]. Exercise and Sport Sciences Reviews,2019,47(4):223-229. [10] Ryan E,Simons J. Cognitive demand,imagery,and frequency of mental rehearsal as factors influencing acquisition of motor skills[J]. Journal of Sport Psychology,1981,3(1):35-45. [11] Van Peppen RP,Kwakkel G,Wood-Dauphinee S,et al. The impact of physical therapy on functional outcomes after stroke:What's the evidence[J]. Clinical Rehabilitation,2004,18(8):833-862. [12] Steultjens E,Dekker J,Bouter LM,et al. Occupational therapy for stroke patients:A systematic review occupational therapy for stroke patients:when,where,and how[J]. Stroke,2003,34(3):676-687. [13] 杨璐萍,钟冬灵,胡益娟,等.运动想象(MI)在脑卒中患者临床康复训练中的应用进展[J].世界最新医学信息文摘,2018,18(24):75-78. [14] Ietswaart M,Johnston M,Dijkerman H,et al. Mental practice with motor imagery in stroke recovery:Randomized controlled trial of efficacy[J].Brain,2011,134(5):1373-1386. [15] Ruffino C,Papaxanthis C. Neural plasticity during motor learning with motor imagery practice:Review and perspectives[J]. Neuroscience,2017,341:61. [16] Malouin F,Jackson P,Richards C. Towards the integration of mental practice in rehabilitation programs:A critical review[J]. Frontiers in Human Neuroscience,2013,7(39):576. [17] Oostra K,Oomen A,Vanderstraeten G,et al. Influence of motor imagery training on gait rehabilitation in sub-acute stroke:A randomized controlled trial[J]. Journal of Rehabilitation Medicine,2015,47(3):204-209. [18] Morioka S,Osumi M,Nishi Y,et al. Motor-imagery ability and function of hemiplegic upper limb in stroke patients[J]. Annals of Clinical & Translational Neurology,2019,6(3):596-604. [19] Kawakami M,Okuyama K,Takahashi Y,et al. Change in reciprocal inhibition of the forearm with motor imagery among patients with chronic stroke[J]. Neural Plasticity,2018:1-9. [20] 程欣欣,高润,刘莉.基于运动想象疗法的神经机制在脑卒中后运动功能障碍中的研究进展[J].中国康复,2019,34(6):324-327. [21] Tong Y,Pendy JT,Li WA,et al. Motor imagery-based rehabilitation:Potential neural correlates and clinical application for functional recovery of motor deficits after stroke [J]. Aging & Disease,2017,8(3):364-371. [22] Carrasco DG,Cantalapiedra JA. Effectiveness of motor imagery or mental practice in functional recovery after stroke:A systematic review[J]. Neurologia,2016,31(1):43-52. [23] Legg LA,Lewis SR,Schofield-Robinson OJ,et al. Occupational therapy for adults with problems in activities of daily living after stroke[J]. Stroke,2017,7(7):CD003585. [24] 赵素伟,曹中慧. 作业疗法可提高脑卒中患者的自我效能及肢体功能[J]. 基因组学与应用生物学,2019,38(2):933-939. [25] 窦祖林. 作业治疗学[M]. 北京:人民卫生出版社,2018:3-4. [26] Arbesman M,Sheard K. Systematic review of the effectiveness of occupational therapy-related interventions for people with amyotrophic lateral sclerosis[J]. American Journal of Occupational Therapy,2014,68(1):20-26. [27] 戴玲. 周围神经损伤的作业治疗[J]. 中国组织工程研究,2000 (11):1608-1609. [28] Roll S,Hardison M. Effectiveness of occupational therapy interventions for adults with musculoskeletal conditions of the forearm,wrist,and hand:A systematic review[J]. American Journal of Occupational Therapy,2017,71(1):7101180010. [29] Arsh A,Anwar Z,Zeb A,et al. Effectiveness of occupational therapy in improving activities of daily living performance in complete cervical tetraplegic patients:A quasi experimental study[J]. Pakistan Journal of Medical Sciences,2020,36(2):96-99. [30] Almhdawi K,Mathiowetz V,White M,et al. Efficacy of occupational therapy task-oriented approach in upper extremity post-stroke rehabilitation[J]. Occupational Therapy International,2016,23(4):444-456. [31] 张丽,刘晓丹,薛炘,等.团体认知行为的作业训练对脑卒中后认知障碍的效果[J].中国康复理论与实践,2019,25(9):1070-1074. [32] 郑颖力.浅谈作业治疗对脑卒中患者认知功能的改善作用[J]. 世界最新医学信息文摘(电子版),2016,16(43):62. [33] 罗爱华,张慈凤,方杰,等.作业疗法治疗脑卒中后单侧空间忽略患者的康复疗效[J].中国老年学杂志,2014,34(11):3141-3142. [34] 由丽,饶江,刘莉,等.作业疗法改善脑卒中后偏侧感觉障碍及手功能的效果[J].中国康复理论与实践,2012,18(7):638-639. [35] Shin JH,Kim MY,Lee JY,et al. Effects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life:A single-blinded,randomized controlled trial[J].Journal of Neuroengineering & Rehabilitation,2016,13:17. [36] Schuster-Amft C,Eng K,Suica Z,et al. Effect of a four-week virtual reality-based training versus conventional therapy on upper limb motor function after stroke:A multicenter parallel group randomized trial[J]. PLoS ONE,2018,13(10):e0204455. [37] Grazia Maggio M. Virtual reality and cognitive rehabilitation in people with stroke:An overview[J]. Journal of Neuroscience Nursing,2019,51(2):101-105. [38] Benedikt L,Alexander K,Albert G.Mental imagery and colour cues can prevent interference between motor tasks[J]. Neuropsychologia,2019,124:202-207. [39] Afrouzeh M,Sohrabi E,Haghkhan A,et al. Effectiveness of PETTLEP imager on performance of passing skill in volleyball[J]. The Journal of Sports Medicine and Physical Fitness,2015, 55(1-2):30-36. [40] Guillot A,Rienzo FD,Pialoux V,et al. Implementation of motor imagery during specific aerobic training session in young tennis players[J].PLoS ONE,2015,10(11):e0143331. [41] Boschker M,Bakker F,Rietberg B. Retroactive interference effects of mentally imagined movement speed[J]. Journal of Sports Sciences,2000,18(8):593-603. [42] Yue G,Cole K. Strength increases from the motor program: Comparison of training with maximal voluntary and imagined muscle contractions[J]. Journal of Neurophysiology,1992,67(5):1114-1123. [43] Taube W,Lorch M,Zeiter S,et al. Non-physical practice improves task performance in an unstable,perturbed environment:Motor imagery and observational balance training[J].Frontiers in Human Neuroscience,2014,8:972. [44] Frolov A,Husek D,Bobrov P,et al. Localization of brain electrical activity sources and hemodynamic activity foci during motor imagery[J]. Human Physiology,2014,40(3):273-283. [45] Sharma N,Pomeroy VM,Baron JC. Motor imagery:A backdoor to the motor system after stroke[J]. Stroke,2006,37(7):1941-1952. [46] Kruse A,Suica Z,Taeymans J,et al. Effect of brain-computer interface training based on non-invasive electroencephalography using motor imagery on functional recovery after stroke-a systematic review and meta-analysis[J]. BMC Neurology,2020,20(1):1-14. [47] Guerra ZF,Lucchetti ALG,Lucchetti G. Motor imagery training after stroke:A systematic review and meta-analysis of randomized controlled trials[J]. Journal of Neurologic Physical Therapy,2017,41(4):205-214. [48] Pichiorri F,Morone G,Petti M,et al. Brain-computer interface boosts motor imagery practice during stroke recovery[J].Annals of Neurolpgy,2015,77(5):851-865. [49] Carvalho R,Dias N,Cerqueira JJ. Brain-machine interface of upper limb recovery in stroke patients rehabilitation:A systematic review[J]. Physiotherapy Research International,2019,24(2):e1764. [50] Cooper CE,Pryor D,Hall C,et al. NIRS-detected changes in the motor cortex during mental rehearsal of physical activity (imaginary exercise)[J]. Advances in Experimental Medicine & Biology,2006,578:191-196. [51] 漆昌柱,徐培. 表象训练的概念、理论及主要研究领域:现状与分析[J]. 体育科学,2001,3:76-80. [52] Batula AM,Mark JA,Kim YE,et al. Comparison of brain activation during motor imagery and motor movement using fNIRS[J]. Computational Intelligence and Neuroscience,2017,2017:5491296. [53] Sahar S,Mohammad R,Karim F. Fast and efficient four-class motor imagery electroencephalography signal analysis using common spatial pattern-ridge regression algorithm for the purpose of brain-computer interface[J]. Journal of Medical Signals and Sensors,2017,7(2):80-85. [54] Yi Weibo,Qiu Shuang,Wang Kun,et al. EEG oscillatory patterns and classification of sequential compound limb motor imagery[J]. Journal of Neuroengineering and Rehabilitation,2016,13:1-12. [55] Yi Weibo,Zhang Lixin,Wang Kun,et al. Evaluation and comparison of effective connectivity during simple and compound limb motor imagery[C]//2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Chicago:IEEE,2014:4892-4895. [56] Bradley J,Edelman,Bryan B,et al. EEG source imaging enhances the decoding of complex right-hand motor imagery tasks[J]. IEEE Transactions on Biomedical Engineering,2016,63(1):4-14. [57] Yin Xuxian,Xu Baolei,Jiang Changhao,et al. A hybrid BCI based on EEG and fNIRS signals improves the performance of decoding motor imagery of both force and speed of hand clenching[J]. Journal of Neural Engineering,2015,12(3):036004. [58] Losana-Ferrer A,Manzanas-Lopez S. Effects of motor imagery and action observation on hand grip strength, electromyographic activity and intramuscular oxygenation in the hand gripping gesture:A randomized controlled trial[J]. Human Movement Science,2018,58:119-131. [59] 李玉,熊馨,李昭阳,等.基于功能性近红外光谱识别右脚三种想象动作研究[J].生物医学工程学杂志,2020,37(2):262-270. [60] Polli A,Moseley LG,Gioia E,et al. Graded motor imagery for patients with stroke:A non-randomized controlled trial of a new approach[J]. European Journal of Physical and Rehabilitation Medicine,2017,53(1):14-23. [61] Lee S,Cha HG. The effect of motor imagery and mirror therapy on upper extremity function according to the level of cognition in stroke patients[J]. International Journal of Rehabilitation Research,2019,42(4):330-336. [62] 李高权,彭璐琪,王珊玺,等.基于运动想象疗法引导的康复训练对脑卒中后吞咽障碍患者的疗效[J].湘南学院学报(医学版),2020,22(1):31-33. [63] Spector WD,Fleishman JA. Combining activities of daily living with instrumental activities of daily living to measure functional disability[J]. Journals of Gerontology,1998,53(1):S46-S57. [64] Lee WH,Kim E,Seo HG,et al.Target-oriented motor imagery for grasping action:Different characteristics of brain activation between kinesthetic and visual imagery[J]. Science Reports,2019,9(1):12770. [65] 许敏鹏,魏泽,明东.基于脑卒中后运动康复领域的运动想象的研究[J]. 生物医学工程学杂志,2020,37(1):169-173. [66] Gentili R,Han C,Schweighofer N,et al. Motor learning without doing:Trial-by-trial improvement in motor performance during mental training[J]. Journal of Neurophysiology,2010,104(2):774-783. [67] Rozand V,Lebon F,Stapley P,et al. A prolonged motor imagery session alter imagined and actual movement durations:Potential implications for neurorehabilitation[J].Behavioural Brain Research,2016,297:67-75. [68] Rahman M,Hossain M,Rashid M,et al. A blockchain-based non-invasive cyber-physical occupational therapy framework:BCI perspective[J]. IEEE Access,2019,7:34874-34884. [69] 陈波,金星,孟兆祥,等.镜像疗法对脑卒中偏瘫患者上肢功能及生活质量的影响[J].按摩与康复医学,2019,10(23):17-20. [70] Liang Shuang,Choi K,Qin Jing,et al. Improving the discrimination of hand motor imagery via virtual reality based visual guidance[J]. Computer Methods and Programs in Biomedicine,2016,132:63-74. [71] Wriessnegger S,Brunner C,Muller-Putz R. Frequency specific cortical dynamics during motor imagery are influenced by prior physical activity[J]. Frontiers in Psychology,2018(9):1-16. [72] Fernandezgomez E,Sanchezcabeza A. Motor imagery:A systematic review of its effectiveness in the rehabilitation of the upper limb following a stroke[J]. Revista De Neurologia,2018,66(5):137-146. [73] Li Fang,Zhang Tong,Li Binjie,et al. Motor imagery training induces changes in brain neural networks in stroke patients[J].Neural Regeneration Research,2018,13(10):1771-1781. [74] Noelia DL,Pereira EM,Estefania JC,et al. Motor imagery as a complementary technique for functional recovery after stroke:A systematic review[J].Topics in Stroke Rehabilitation,2019,26(8):576-587. [75] 赵天玲.探讨运动表象训练结合作业疗法对脑卒中偏瘫患者上肢和手功能的影响[J].中西医结合心血管病电子杂志,2020,8(9):60-67. [76] 刘桂杉,勾丽洁,马明,等.双侧训练联合运动想象疗法对老年脑卒中患者上肢功能恢复的效果[J].中国老年学杂志,2019,39(13):3179-3182. [77] 官娉,陈妍,张韶辉.作业疗法结合运动想象对脑卒中偏瘫患者的上肢与手功能的影响[J].临床和实验医学杂志,2018(6):647-649. [78] 张裴景,任亚峰,李硕.运动想象疗法结合作业疗法对脑卒中偏瘫患者上肢及手功能的疗效观察[C]//中国康复医学会第十三届全国脑血管病康复学术会议.北京:中国康复医学会脑血管康复委员会,中国康复医学会,2010:150-151. [79] 李文静,陈彤红.脑卒中偏瘫患者作业疗法联合健侧上肢运动想象对患侧上肢机能的影响[C]//第七届北京国际康复论坛论文集(下册).北京:中国康复研究中心,2012:150-157. [80] Nilsen DM,Gillen G,Dirusso T,et al. Effect of imagery perspective on occupational performance after stroke:A randomized controlled trial[J]. American Journal of Occupational Therapy,2012,66(3):320-329.