Flamand Véronique H, Schneider Cyril
Neuroscience Division, CHU de Québec Research Center, Québec, QC, Canada; Faculty of Medicine, Université Laval, Québec, QC, Canada.
Neuroscience Division, CHU de Québec Research Center, Québec, QC, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, QC, Canada.
Arch Phys Med Rehabil. 2014 Oct;95(10):1984-90. doi: 10.1016/j.apmr.2014.05.014. Epub 2014 Jun 4.
Motor deficits in cerebral palsy disturb functional independence. This study tested whether noninvasive and painless repetitive peripheral magnetic stimulation could improve motor function in a 7-year-old boy with spastic hemiparetic cerebral palsy. Stimulation was applied over different nerves of the lower limbs for 5 sessions. We measured the concurrent aftereffects of this intervention on ankle motor control, gait (walking velocity, stride length, cadence, cycle duration), and function of brain motor pathways. We observed a decrease of ankle plantar flexors resistance to stretch, an increase of active dorsiflexion range of movement, and improvements of corticospinal control of ankle dorsiflexors. Joint mobility changes were still present 15 days after the end of stimulation, when all gait parameters were also improved. Resistance to stretch was still lower than prestimulation values 45 days after the end of stimulation. This case illustrates the sustained effects of repetitive peripheral magnetic stimulation on brain plasticity, motor function, and gait. It suggests a potential impact for physical rehabilitation in cerebral palsy.
脑瘫中的运动功能障碍会干扰功能独立性。本研究测试了无创且无痛的重复外周磁刺激是否能改善一名7岁痉挛性偏瘫型脑瘫男孩的运动功能。对下肢的不同神经进行了5次刺激。我们测量了该干预对踝关节运动控制、步态(步行速度、步幅长度、步频、周期时长)以及脑运动通路功能的即时后效应。我们观察到踝关节跖屈肌的伸展阻力降低,主动背屈运动范围增加,以及踝关节背屈肌的皮质脊髓控制得到改善。刺激结束15天后,关节活动度变化仍然存在,此时所有步态参数也都得到了改善。刺激结束45天后,伸展阻力仍低于刺激前值。该病例说明了重复外周磁刺激对脑可塑性、运动功能和步态的持续影响。它提示了对脑瘫物理康复的潜在影响。