摘要
目的观察1 Hz重复经颅磁刺激(rTMS)对于脑卒中偏瘫病人上肢功能康复的疗效。方法将2017年9月至2019年6月安徽医科大学第二附属医院康复医学科住院的41例脑卒中偏瘫病人按随机数字表法分为试验组(n=20)和对照组(n=21),两组均给予常规康复治疗。于健侧大脑皮质M1区,试验组给予1 Hz的rTMS刺激,对照组施以伪刺激,均每天1次,每周6次,共2周。治疗前、后采用Fugl⁃Meyer评分上肢部分(u⁃FMA)评估病侧上肢功能,改良巴氏指数(MBI)评估病人日常生活活动能力;并采集病侧肱二、三头肌最大等长收缩(MIVC)时表面肌电信号均方根值(RMS)。结果治疗前两组病人u⁃FMA、MBI评分、RMS值比较均差异无统计学意义(P>0.05)。治疗后:两组病人u⁃FMA、MBI评分均较治疗前明显提高(P<0.05),但试验组较对照组提高更显著(P<0.05);两组病人MIVC屈肘时肱二头肌和伸肘时肱三头肌RMS值较治疗前均明显提高(P<0.05),治疗后屈肘时肱二头肌RMS值试验组(9.65±11.37)与对照组(4.08±3.04)差异有统计学意义(P<0.05),伸肘时肱三头肌RMS值试验组(6.21±5.04)与对照组(3.64±2.49)差异有统计学意义(P<0.05)。结论1 Hz rTMS作用于脑卒中病人健侧大脑皮质M1区能促进偏瘫侧上肢运动功能及病人日常生活活动能力的恢复。
Objective To observe the effect of 1 Hz repetitive transcranial magnetic stimulation(rTMS)on upper limb function in stroke patients with hemiplegia.Methods Forty⁃one patients with hemiplegia who were hospitalized in the Department of Rehabili⁃tation Medicine,Second Affiliated Hospital of Anhui Medical University from September 2017 to June 2019 were selected and ran⁃domly assigned into experimental group(n=20)and control group(n=21)by random number table.Routine rehabilitation treat⁃ment was given to both groups,the experimental group received 2 weeks(once per day,6 days per week)of 1 Hz rTMS over the contralesional cortex M1 area,while the control group received sham rTMS stimulation.Before and after treatment,the upper limb function of the affected side was evaluated by the upper limb part of the Fugl⁃Meyer scale(u⁃FMA),the Barthel index(MBI)was used to evaluate the activity of daily living of the patients,and surface electromyography signals(RMS values)were recorded dur⁃ing maximum isometric voluntary contraction(MIVC)of biceps brachii and triceps brachii on the affected side.Results There were no significant differences in u⁃FMA,MBI scoresand the RMS values of biceps/triceps between the two groups before treatment(P>0.05).After treatment,the scores of u⁃FMA and MBI increased in both groups(P<0.05),and the added values of the experi⁃mental group were significantly greater than those of the control group(P<0.05);When the elbow flexed in MIVC,the RMS values of the biceps muscles were significantly higher than those before treatment in both groups,and there was a statistically significant difference between the experimental group(9.65±11.37)and the control group(4.08±3.04)(P<0.05).When the elbow extended in MIVC,the RMS values of the triceps were significantly higher than those before treatment in both groups,and there were statisti⁃cal differences in the experimental group(6.21±5.04)and control group(3.64±2.49)(P<0.05).Conclusion 1 Hz rTMS over the contralesional cortex M1 area can prom
作者
干峥
缪永娟
沈显山
阚秀丽
卢茜
唐晓晓
洪永锋
GAN Zheng;MIAO Yongjuan;SHEN Xianshan;KAN Xiuli;LU Qian;TANG Xiaoxiao;HONG Yongfeng(Department of Rehabilitation Medicine,Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)
出处
《安徽医药》
CAS
2020年第12期2377-2382,共6页
Anhui Medical and Pharmaceutical Journal
基金
安徽医科大学校级质量工程项目(2017045)。
关键词
卒中
经颅磁刺激
运动活动
上肢
肌电描记术
Stroke
Transcranial magnetic stimulation
Motor activity
Upper extremity
Electromyography
