中文摘要：

目的：探讨虚拟现实结合减重平板训练（VR＋BWSTT）在急性脑卒中患者步行功能早期恢复中的作用和机制.方法：将11例急性缺血性脑卒中患者随机分入跑台组（6例）和常规组（5例）,分别采用不同的康复训练方案,并在康复训练前及训练后3周、3个月和6个月各行一次脑功能成像和下肢运动功能评定.结果：跑台组步行速度和下肢Fugl-Meyer评分进步程度较常规组显著,跑台组进步较大的患者患肢对侧旁中央小叶（PCL）激活强度较训练前增大较明显;患肢运动激活辅助运动区（SMA）的LI值训练后3周多数为负值;跑台组6名患者中有4名训练后3周患肢运动时出现双侧前额叶皮层多发激活区.结论：VR＋BWSTT对脑卒中患者步行功能的改善作用优于常规步态训练;下肢功能恢复的中枢神经机制与上肢不完全相同;VR的作用机制可能与双侧前额叶皮质有关.

英文摘要：

Purpose：To investigate the effect and mechanism of virtual reality-enhanced partial body weight-supported treadmill （VR＋BWSTT） on early gait recovery of acute ischemic stroke by BOLD-fMRI.Methods：Treadmill group consisting of 6 cases of acute ischemic patients was compared with control group consisting of 5 cases of acute ischemic patients with different rehabilitation schemes.The patients in both groups underwent 4 series of fMRI examinations and lower limb motor function evaluations at four certain time points,which were before rehabilitation training,3 weeks after training,3 months after training and 6 months after training.Results：Patients in treadmill group had greater improvement of walking velocities and Fugl-Meyer scores than those in control group.Most lateral indexes （LI） of supplementary motor areas （SMA） activated by the motor of affected lower limbs were negative at 3 weeks after training.Four out of 6 patients of treadmill group manifested multiple activations in the prefrontal cortex of both hemispheres.Conclusion：VR＋BWSTT is more effective in gait improvement of acute ischemic patients than common gait rehabilitation therapy.The effect of virtual reality technique is probably induced by prefrontal cortex of both hemispheres.