摘要
目的观察反复促通疗法(repetitive facilitative exercise,RFE)结合低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对脑卒中后上肢功能障碍的影响。方法选取2016年1月～2017年12月在我院住院治疗的脑卒中后上肢运动功能障碍(Brunnstrom分期≥Ⅲ期,病程3～13周)的患者共30例,随机分为对照组、RFE组和联合组,每组10例。对照组给予常规康复治疗,RFE组在常规康复治疗基础上增加反复促通疗法治疗,联合组在RFE组基础上辅以rTMS治疗,刺激频率为1.0 Hz。于治疗前、治疗4周后采用简易Fugl-Meyer运动功能量表(FMA)、上肢动作研究量表(ARAT)、改良Ashworth痉挛评定量表(MAS)评分评价疗效。结果三组患者治疗前各项指标均无显著差异(P>0.05);RFE组和联合组治疗前后FMA评分均显著改善,组间对比发现,治疗后RFE组和联合组FMA评分明显优于对照组,且联合组明显优于RFE组(P<0.05);三组治疗前后ARAT评分均有显著改善,组间对比发现,联合组较对照组ARAT评分有明显提高(P<0.05)。治疗后三组MAS评分均无明显改善,组间比较也没有明显差异。结论反复促通疗法配合低频重复经颅磁刺激可改善卒中后患者上肢功能障碍,且两种方法联合效果更佳。
Objective To observe the effect of repetitive facilitative exercise（RFE） combined with repetitive transcranial magnetic stimulation（rTMS） on post-stroke upper extremity dysfunction. Methods A total of 30 patients with post-stroke upper extremity motor dysfunction（Brunnstrom stage≥stage Ⅲ, duration 3-13 weeks） who were hospitalized in Zhejiang Provincial People＇s Hospital from January 2016 to December 2017 were selected. They were randomly divided into control group, RFE group and combination group, with 10 cases in each group. The control group was given conventional rehabilitative treatment. The RFE group was further given RFE on the basis of the conventional rehabilitative treatment. The combination group was further given rTMS on the basis of the RFE group. The stimulation frequency was 1.0 Hz. Efficacy was evaluated by simple Fugl-Meyer motor function scale（FMA）, upper limb movement study scale （ARAT） and modified Ashworth spasm assessment（MAS） scores before treatment and 4 weeks after treatment. Results There was no significant difference in all indexes before treatment among the three groups（P〉0.05）; in the RFE group and the combined group, the FMA scores were significantly improved before and after treatment. It was found that after treatment, FMA scores in the RFE group and the combined group were significantly better than those in the control group. The combined group was significantly better than the RFE group（P〈0.05）; the ARAT scores in all the three groups were significantly improved before and after treatment. It was found that the ARAT score in the combined group was significantly higher than that in the control group（P〈0.05）. After treatment, there was no significant improvement in the MAS scores in the three groups, and there was no significant difference among the groups. Conclusion Repetitive facilitative exercise combined with low-frequency repetitive transcranial magnetic stimulation can improve upper extremity dysfunction in stroke patients, and
作者
李琦
程瑞动
闻万顺
叶祥明
LI Qi;CHENG Ruidong;WEN Wanshun;YE Xiangming(Department of Rehabilitative Medicine,Zhejiang Provincial People＇s Hospital,the People＇s Hospital Affiliated to Hangzhou Medical College,Hangzhou 310014,China)
出处
《中国现代医生》
2018年第26期1-5,10,共6页
China Modern Doctor
基金
浙江省医药卫生科技计划(2018KY255)
国家重点研发计划(2017YFC1308500)
关键词
反复促通疗法
重复经颅磁刺激
上肢功能障碍
脑卒中
康复
Repetitive facilitative exercise （RFE）
Repetitive transcranial magnetic stimulation （rTMS）
Upper extremity dysfunction
Cerebral stroke
Rehabilitation
