Vongvaivanichakul Parinya, Tretriluxana Jarugool, Bovonsunthonchai Sunee, Pakaprot Narawut, Laksanakorn Wipawee
J Med Assoc Thai. 2014 Jul;97 Suppl 7:S45-9.
The present study investigated the immediate effects of low frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with reach-to-grasp (RTG) training of the paretic hand in individuals with chronic stroke.
Fourteen participants were randomly assigned to receive LF-rTMS or sham stimulation conditions. All participants underwent RTG training after the stimulation. Corticospinal excitability (CE) of the non-lesioned hemisphere, the total time of the wolf motor function test (WMFT) for dexterity tasks, maximum aperture, and movement time of RTG actions were evaluated at baseline, after the stimulation, and after RTG training.
Significant differences between interaction (group x time) were found in the total time of WMFT The CE of non-lesioned hemisphere diminished after LF-rTMS and showed moderate correlation with the reduction in time of RTG actions after the stimulation. The total time of WMFT and RTG actions reduced after motor training only in the LF-rTMS group. No change was observed in maximum aperture in either group.
The application of LF-rTMS combined with RTG training enhanced the training effect as evidenced by faster movement for the dexterity tasks of the paretic hand than RTG training alone. The findings suggested the benefit of LF-rTMS for enhancing the training effects in stroke rehabilitation.
本研究调查了低频重复经颅磁刺激(LF-rTMS)联合患侧手抓握训练(RTG)对慢性卒中患者的即时影响。
14名参与者被随机分配接受LF-rTMS或假刺激。所有参与者在刺激后均接受RTG训练。在基线、刺激后和RTG训练后,评估非损伤半球的皮质脊髓兴奋性(CE)、狼运动功能测试(WMFT)中灵巧任务的总时间、最大孔径以及RTG动作的运动时间。
在WMFT总时间上发现交互作用(组×时间)存在显著差异。LF-rTMS后非损伤半球的CE降低,且与刺激后RTG动作时间的减少呈中度相关。仅在LF-rTMS组中,运动训练后WMFT和RTG动作的总时间减少。两组的最大孔径均未观察到变化。
LF-rTMS联合RTG训练的应用增强了训练效果,表现为患侧手灵巧任务的运动速度比单独的RTG训练更快。研究结果表明LF-rTMS对增强卒中康复训练效果有益。