摘要
目的:探讨低频重复经颅磁刺激(rTMS)联合互动达标模式康复训练对脑卒中偏瘫患者的影响。方法:选取150例脑卒中偏瘫患者为研究对象,根据康复训练方式不同分为A组(n=51)、B组(n=50)及C组(n=49)。A组患者采用低频rTMS联合互动达标模式康复训练;B组患者采用互动达标模式康复训练;C组患者采用常规康复训练,均持续干预8周。比较各组患者上下肢运动功能[简式Fugl-Meyer运动功能评测表(FMA)评分]、平衡功能[Berg平衡量表(BBS)评分、脑卒中姿势评定量表(PASS)评分]、步行能力[计时起立行走实验(TUGT)、6 min步行试验(6MWT)]、功能独立性与日常生活能力[功能独立性评定量表(FIM)评分、改良Barthel指数(MBI)]、表面肌电图[表面肌电积分值(iEMG)、表面肌电均方根(RMS)值]、运动皮质兴奋性[静息运动阈值(RMT)、MEP波幅]。结果:干预后,各组患者上肢FMA-UE评分、下肢FMA-LE评分、FIM评分、MBI比较:A组>B组>C组(P<0.05)。各组患者6MWT、TUGT比较:A组>B组>C组(P<0.05);TUGT时间比较:A组<B组<C组(P<0.05)。A组患者胫骨前肌、股四头肌iEMG水平、MEP波幅高于B组、C组(P<0.05),RMS、RMT值低于B组、C组(P<0.05)。结论:低频rTMS联合互动达标模式康复训练可促进脑卒中偏瘫患者上、下肢功能恢复,提高患者平衡功能、步行能力及日常生活能力,促使表面肌电图改善,增加患侧运动皮质兴奋性。
Objective:To explore the effect of low frequency repetitive transcranial magnetic stimulation(rTMS)combined with interactive standard mode rehabilitation training on stroke patients with hemiplegia.Methods:150 stroke patients with hemiplegia were selected as the research subjects.According to the rehabilitation methods,they were divided into three groups,51 patients with low-frequency rTMS combined with interactive standard mode rehabilitation training were included in group A,50 patients with interactive standard mode rehabilitation training were included in group B,and 49 patients with conventional rehabilitation training were included in group C.The intervention lasted for 8 weeks.The differences of upper and lower limb motor function[simplified Fugl-Meyer motor function assessment(FMA)],balance function[Berg balance scale(BBS)score,stroke postural assessment scale(PASS)],walking ability[timed up and go test(TUGT),6-minute walking test(6MWT)],functional independence and daily living ability[functional independence measure(FIM),modified Barthel index(MBI)],surface electromyography[surface electromyography integral(iEMG),surface electromyography root mean square(RMS)],motor cortex excitability[resting motor threshold(RMT),MEP amplitude]were compared among the groups.Results:After intervention,the upper limb FMA-UE score,lower limb FMA-LE score,FIM score,and MBI among patients in each group were compared,group A was higher than group B,and group B was higher than group.The 6MWT and TUGT among patients in each group were compared,the 6 MWT distance in group A was greater than that in group B,and that in group B was greater than that in group C(P<0.05).The TUGT time in group A was shorter than that in group B,and that in group B was shorter than that in group C(P<0.05).The iEMG level of tibialis anterior muscle and quadriceps femoris,and MEP in group A were higher than those in group B and group C,and the RMS and RMT levels were lower than those in group B and group C(P<0.05).Conclusion:Low frequency rTMS combined
作者
孙艺淼
王京芳
陈思洁
刘索志
郗海涛
SUN Yi-miao;WANF Jing-fang;CHEN Si-jie;LIU Suo-zhi;XI Hai-tao(Community Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)
出处
《川北医学院学报》
CAS
2023年第11期1538-1542,共5页
Journal of North Sichuan Medical College
基金
北京市医院管理中心青年人才培养“青苗”计划(QML202100404)。
关键词
脑卒中偏瘫
互动达标模式康复训练
低频重复经颅磁刺激
肢体功能
肌电图
运动皮质兴奋性
Stroke hemiplegia
Interactive standard mode rehabilitation training
Low-frequency repetitive transcranial magnetic stimulation
Limb function
Electromyography
Motor cortex excitability