目的 研究改良五禽戏治疗老年脑卒中患者步态及平衡功能障碍的疗效及基于功能磁共 振的脑机制。方法 选择 2021 年 9 月至 2022 年 9 月在遵义医科大学附属医院接受治疗的 60 例脑卒中患 者为本次的研究对象，随机分组，分为 28 例对照组和 32 例观察组。对照组采用常规康复治疗，观察组在 对照组基础上通过视频练习改良五禽戏。采用 fMRI 扫描两组脑部激活区域，对两组脑血流动力学指标、 免疫功能指标、步态参数进行评估；Berg 量表评定（berg balance scale，BBS）对患者的平衡功能进行评定。 结果 治疗后，与对照组相比，观察组脑动脉血流平均流速（Vm）、平均血流量（Qm）、免疫球蛋白 G（IgG）、 免疫球蛋白 A（IgA）、免疫球蛋白 M（IgM）水平均提高，血管阻力指数（RI）水平下降，差异有统计学意义 （P < 0.05）；观察组 BBS 评分提高，差异有统计学意义（P < 0.05）；观察组步频、步幅、步速均提高，步态周 期下降，差异有统计学意义（P < 0.05）；观察组脑部激活区域的范围及脑功能大于对照组。结论 改良五 禽戏对老年脑卒中患者进行治疗，可以提高患者的免疫能力，改善患者的平衡能力，改善患者的步态。 

Objective To study the efficacy of modified Wuqinxi on gait and balance dysfunction in elder⁃ ly stroke patients and the brain mechanism based on fMRI. Methods The 60 stroke patients treated in our hospi⁃ tal from September 2021 to January 2023 were selected as the study subjects，and were randomly divided into 28 control groups and 32 experimental groups. The control group used conventional rehabilitation treatment，and the experimental group improved Wuqinxi by video practice based on the control group. The fMRI scan of two brain acti⁃ vation area was used to evaluate the cerebral hemodynamic index，immune function index and gait parameters，and the Berg Scale Assessment（berg balance scale，BBS）. Results After treatment，the average cerebral artery blood flow rate（Vm），the average blood flow rate（Qm），immunoglobulin G（lmmunoglobin G，IgG），and Immu⁃ noglobulin A（lmmunoglobin）in the experimental group compared with the control group. A，IgA），immunoglobu⁃ lin M（lmmunoglobin M，IgM）levels increase，vascular resistance index（RI）level decline，statistical difference （P < 0.05），the BBS score increase，statistical difference（P < 0.05），the step frequency，stride speed increase， gait cycle decline，statistical difference（P < 0.05）；the stride frequency，stride amplitude and stride speed of the experimental group decreased，with the statistical difference（P < 0.05）；the range of brain activation areas and brain function in the experimental group were greater than those in the control group. Conclusion The modified Wuqinxi treatment of elderly stroke patients can improve their immune ability，balance ability and gait.