针对中风患者本体感觉缺陷，定制化机器人训练显著提升手功能与神经敏感性。
Tailored robotic training improves hand function and proprioceptive processing in stroke survivors with proprioceptive deficits: A randomized controlled trial
- 采用机器人外骨骼，设计两种本体感觉定制训练：游戏化增强与减少辅助
- 有本体感觉缺陷者经训练后手功能提升显著，最大改善达7.0块（p=0.002）
- 首次发现脑电新生物标志物，验证训练对神经处理的改善作用
精准康复旨在根据个体需求定制运动训练以提升疗效。本研究测试了本体感觉定制化机器人训练是否可改善中风患者的手功能与神经处理能力。利用机器人手指外骨骼，实施两种定制方案：Propriopixel训练通过机器人辅助的游戏化动作增强本体感觉处理；虚拟辅助训练则减少机器人助力，提高自我反馈依赖。在随机对照试验中，46名慢性中风患者完成9次、每次2小时的标准、Propriopixel或虚拟训练。对于存在本体感觉缺陷的参与者，Propriopixel训练（箱块测试：7 ± 4.2，p=0.002）和虚拟辅助训练（4.5 ± 4.4，p=0.068）均较标准训练（0.8 ± 2.3块）带来更大手功能改善。本体感觉提升与手功能进步显著相关。定制训练增强了大脑对本体感觉线索的神经敏感性，表现为一种新型脑电生物标志物——本体感觉相关的负向变化（proprioceptive Contingent Negative Variation）。结果支持本体感觉定制训练作为精准神经康复的有效路径。
原文摘要 · Abstract (English)
Precision rehabilitation aims to tailor movement training to improve outcomes. We tested whether proprioceptively-tailored robotic training improves hand function and neural processing in stroke survivors. Using a robotic finger exoskeleton, we tested two proprioceptively-tailored approaches: Propriopixel Training, which uses robot-facilitated, gamified movements to enhance proprioceptive processing, and Virtual Assistance Training, which reduces robotic aid to increase reliance on self-generated feedback. In a randomized controlled trial, forty-six chronic stroke survivors completed nine 2-hour sessions of Standard, Propriopixel or Virtual training. Among participants with proprioceptive deficits, Propriopixel ((Box and Block Test: 7 +/- 4.2, p=0.002) and Virtual Assistance (4.5 +/- 4.4 , p=0.068) yielded greater gains in hand function (Standard: 0.8 +/- 2.3 blocks). Proprioceptive gains correlated with improvements in hand function. Tailored training enhanced neural sensitivity to proprioceptive cues, evidenced by a novel EEG biomarker, the proprioceptive Contingent Negative Variation. These findings support proprioceptively-tailored training as a pathway to precision neurorehabilitation.
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