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高频重复经颅磁刺激联合任务导向镜像治疗训练对急性脑卒中患者手部康复的影响。

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Task-Oriented Mirror Therapy Training on Hand Rehabilitation of Acute Stroke Patients.

机构信息

Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, South Korea.

出版信息

Med Sci Monit. 2018 Feb 6;24:743-750. doi: 10.12659/msm.905636.

DOI:10.12659/msm.905636
PMID:29402879
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5810366/
Abstract

BACKGROUND Impairments of hand function make it difficult to perform daily life activities and to return to work. The aim of this study was to investigate the effect of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) combined with task-oriented mirror therapy (TOMT) on hand rehabilitation in acute stroke patients. MATERIAL AND METHODS Twenty subacute stroke patients in the initial stages (<3 months) participated in the study. Subjects were allocated to 2 groups: the experimental group received HF-rTMS + TOMT and the control group received HF-rTMS. TOMT training was conducted in 10 sessions over 2 weeks for 30 min. rTMS was applied at a 20 Hz frequency over the hand motor area in the cortex of the affected hemisphere for 15 min. Outcomes, including motor-evoked potential (MEP), pinch grip, hand grip, and box and block test, were measured before and after training. RESULTS Significant improvements in the MEP and hand function variables were observed in both groups (p<0.05). In particular, hand functions (pinch grip and box and block test) were significantly different between the 2 groups (p<0.05). CONCLUSIONS HF-rTMS combined with TOMT had a positive effect on hand function and can be used for the rehabilitation of precise hand movements in acute stroke patients.

摘要

背景

手部功能障碍会导致日常生活活动困难和重返工作岗位困难。本研究旨在探讨高频重复经颅磁刺激(HF-rTMS)联合任务导向镜像疗法(TOMT)对急性脑卒中患者手部康复的影响。

材料和方法

20 名处于初始阶段(<3 个月)的亚急性脑卒中患者参与了本研究。受试者被分为 2 组:实验组接受 HF-rTMS+TOMT,对照组接受 HF-rTMS。TOMT 训练在 2 周内进行 10 次,每次 30 分钟。rTMS 以 20 Hz 的频率应用于受影响半球皮层的手部运动区,持续 15 分钟。在训练前后测量运动诱发电位(MEP)、捏力、手握力和方块-盒测试等结果。

结果

两组的 MEP 和手部功能变量均有显著改善(p<0.05)。特别是,两组之间手部功能(捏力和方块-盒测试)存在显著差异(p<0.05)。

结论

HF-rTMS 联合 TOMT 对手部功能有积极影响,可用于急性脑卒中患者精细手部运动的康复。

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Short- and Long-term Effects of Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function after Stroke: a Systematic Review and Meta-Analysis.重复经颅磁刺激对脑卒中后上肢运动功能的短期和长期影响:系统评价和荟萃分析。
Clin Rehabil. 2017 Sep;31(9):1137-1153. doi: 10.1177/0269215517692386. Epub 2017 Feb 17.
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Reference equations for handgrip strength: Normative values in young adult and middle-aged subjects.握力参考方程:青年和中年受试者的正常值。
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Neuroplastic Changes Following Brain Ischemia and their Contribution to Stroke Recovery: Novel Approaches in Neurorehabilitation.
经重复经颅磁刺激的运动过程相关启动对镜像视觉反馈期间具身感知的影响:一项初步研究。
Front Neurosci. 2024 Nov 26;18:1501169. doi: 10.3389/fnins.2024.1501169. eCollection 2024.
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Intermittent theta-burst stimulation combined with physical therapy as an optimal rehabilitation in Parkinson's disease: study protocol for a randomised, double-blind, controlled trial.经颅磁刺激联合物理治疗作为帕金森病优化康复的研究方案:一项随机、双盲、对照试验。
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Meta-analysis of repetitive transcranial magnetic stimulation combined with task-oriented training on upper limb function in stroke patients with hemiplegia.重复经颅磁刺激联合任务导向训练对偏瘫脑卒中患者上肢功能的Meta 分析。
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