Research On Mirror Therapy For Upper Limb Unilateral Motor Dysfunction Based On Functional Electrical Stimulation

Mirror therapy(MT)and functional electrical stimulation(FES)can both achieve good results for the rehabilitation of upper limb motor dysfunction after stroke.Motor imagery(MI)has also been used in motor dysfunction rehabilitation for its advantages of neural remodeling and increasing the activity of the sensorimotor cortex.Because the optimal time for rehabilitation of poststroke motor dysfunction is the first 3months after symptom stabilization,many patients with poststroke motor dysfunction miss the optimal time for rehabilitation because they do not receive it promptly or because of inappropriate rehabilitation measures taken.The measurement of the efficacy of rehabilitation therapy for patients in the clinic is usually the motor function evaluation.Motor function evaluation is able to quantify not only the degree of motor dysfunction in patients,but also the clinical effects after the intervention.When studying means of rehabilitation training for motor function,an accurate and objective evaluation method of rehabilitation effect is necessarily needed.Based on the above issues,in this paper,an active rehabilitation training approach with MT+FES+MI is proposed for the rehabilitation of unilateral upper limb motor dysfunction after stroke.And to characterize sensorimotor cortex activity by extracting the power spectral density(PSD)of the mu rhythm resting interval by electroencephalography(EEG),and to extract the ERD energy change rate characteristic of the mu rhythm motor imagined interval(E)to characterize sensorimotor cortex motor imagined characteristic,from the sensorimotor cortex activity and motor imagined characteristic to analyze the effect of this rehabilitation training method.When studying MT + FES + MI rehabilitation training methods,two features extracted from EEG were used to evaluate the training effect.The main content and innovation points of this paper are as follows:(1)An active rehabilitation training program with MT + FES + MI has been proposed for unilateral upper limb motor dysfunction after stroke.This method combines MT + MI training with contralateral control functional electrical stimulation training.When trained,the subject made the same movement imagining of the upper limbs bilaterally,and the healthy side actually performed the movement,and the subject viewed the image of the healthy side’s movement in the mirror while gesturing recognition based on the surface electromyography(s EMG)+ acceleration(ACC)signal collected from the healthy side motion,controlling the affected side to perform FES stimulation of the muscles corresponding to the movement.(2)In response to the problems associated with the current methods of motor function evaluation,from the theoretical basis of the deep connection between motor function recovery after stroke and sensorimotor cortex activity,neural remodeling,etc.,PSD in the resting interval of mu rhythm and the rate of ERD energy change(E)in the motor imagery interval were extracted by EEG as indicators of rehabilitation evaluation,and these two characteristics were used to verify the effectiveness of the MT + FES + MI training method.In this paper,we tested the effectiveness of MT +FES + MI training on the improvement of activity and features in the sensorimotor cortex of the brain.The changes in PSD and E were consistent with the results of rehabilitation training under other rehabilitation evaluations and could be used as indicators of rehabilitation evaluation.(3)According to the effects exhibited by the active rehabilitation training method with MT + FES + MI in the control experiment,a deeper study was conducted on the effects of MT + MI training and FES training when combined.We designed a control experiment of MT training and FES training to investigate the effects of MT training and FES training on the sensorimotor cortex,while investigating the effects of MT and FES on cortical activity and MI.MT versus FES control experimental procedures the subjects were trained with flexed elbow by MT,FES,respectively,and the EEG before and after training was collected for both groups to calculate the power spectral density PSD of resting interval of mu rhythm versus flexed elbow motion imagining characteristics E.Instead of delving deeper into which factors in the motor sensory cortex contribute to the changes in PSD and E,we quantitatively analyzed the activity and motor imagery characteristics of the sensorimotor cortex before and after MT training and FES training by the changes in PSD and E,and then investigated the effects of MT training and FES training.In both PSD and E,the main effect of active rehabilitation training with MT + FES + MI on motor cortex activation was found for MT + MI training,while both MT + MI training and FES training showed fusion promoting effects on motor cortex activation.Research efforts have provided more feasible methods and technical means for the evaluation of the effects of rehabilitation and rehabilitation processes after stroke,and enriched the research results in this direction.