Study On The Mechanism Of The Effect Of Intelligent Lower Limb Rehabilitation Robot On Function Of Stroke Patients By Functional Magnetic Resonance Imaging

Objectives:The lower limb rehabilitation robot is widely used in stroke rehabilitation,but its impact on brain function and mechanism are not clear.This study uses clinical evaluation scales,Amplitude of Low Frequency Fluctuation(ALFF),Regional Homogeneity(Re Ho),seed based functional connectivity as evaluation indicators to explore the impact of intelligent lower limb rehabilitation robot training on lower limb motor function,quality of life and brain function of stroke.Methods:20 patients with stroke who met the inclusion and exclusion conditions were selected for 2-weeks rehabilitation training.The experimental group included 10 patients for intelligent lower limb rehabilitation robot training combined with routine physical therapy,while the control group included 10 patients for routine physical therapy.Both groups of patients underwent corresponding clinical functional evaluation and resting-states functional magnetic resonance imaging(rs-f MRI)before and after treatment.The lower limb motor function,balance function,walking ability,activities of daily living ability and quality of life of patients were assessed by using the modified Rankin scale(MRS),Fugl-Meyer Assessment of lower extremity(FMA-LE),Berg balance scale(BBS),Time Up and Go test(TUG),modified Barthel index(MBI)and 36-Item Short-Form Health Survey(SF-36).Rs-f MRI data were used to analyze the changes of brain function of patients before and after treatment by analyzing ALFF,Re Ho and functional connectivity(FC).Results:1.After 2 weeks of training,the scores of FMA-LE,BBS,TUG and MBI in the two groups were improved,and the difference was statistically significant(P<0.05).The improvement of FMA-LE and BBS in the experimental group was better than the control group,and the difference was statistically significant(P<0.05).2.After 2 weeks of training,in the SF-36,the emotional function in both groups was improved,and the difference was statistically significant(P<0.05).In terms of physical function,general health status,energy,mental health,total score of physical health,and total score of mental health,the difference only in experimental group was statistically significant(P<0.05).The improvement of energy in the experimental group was better than the control group,and the difference was statistically significant(P<0.05).3.After treatment,the ALFF in bilateral Brodmann 6 area in the experimental group increased(P<0.01);the Re Ho in the left calcarine increased(P<0.01).In the control group,the ALFF of left medial and paracingulate gyrus,left anterior cingulate gyrus and paracingulate gyrus,right middle temporal gyrus,right middle frontal gyrus and brainstem decreased(P<0.01),and the Re Ho in left superior temporal gyrus,left medial and paracingulate gyrus decreased(P<0.01);No brain area with significant FC alteration was found in the two groups after treatment.After treatment,compared with the control group,the Re Ho in the right precuneus in the experimental group increased(P<0.01).No brain regions with significant differences in ALFF and FC between the two groups were found.4.The change of FMA-LE in the experimental group before and after treatment was positively correlated with the change of the right precuneus(r=0.886,P=0.003).Conclusions:1.Intelligent lower limb rehabilitation robot training and routine physical therapy can improve the lower limb motor function,balance function,walking function,daily living ability and emotional function of stroke;The lower limb rehabilitation robot has a stronger gain effect in improving lower limb motor function,balance function,energy,and mental health compared to routine physical therapy;The intelligent lower limb rehabilitation robot training improves the lower limb motor function of stroke patients,which is positively correlated with the activation of precuneus.2.The intelligent lower limb rehabilitation robot training can activate the Brodmann 6 area,calcarine and precuneus,enhance the functional activities of the local brain area,which may be the mechanism of the intelligent lower limb rehabilitation robot training to improve the motor function of stroke patients.