Department of Physical Therapy, The Graduate School, Sahmyook University, Seoul, South Korea.
Med Sci Monit. 2018 Feb 6;24:743-750. doi: 10.12659/msm.905636.
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.
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。
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。
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)。
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。