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重复外周磁神经刺激(rPMS)作为辅助治疗可降低骨骼肌反射活动。

Repetitive Peripheral Magnetic Nerve Stimulation (rPMS) as Adjuvant Therapy Reduces Skeletal Muscle Reflex Activity.

作者信息

Zschorlich Volker R, Hillebrecht Martin, Tanjour Tammam, Qi Fengxue, Behrendt Frank, Kirschstein Timo, Köhling Rüdiger

机构信息

Faculty of Philosophy, Institute of Sports Science, University of Rostock, Rostock, Germany.

Department of Ageing of Individuals and Society, Faculty of Interdisciplinary Research, University of Rostock, Rostock, Germany.

出版信息

Front Neurol. 2019 Aug 27;10:930. doi: 10.3389/fneur.2019.00930. eCollection 2019.

Abstract

The reduction of muscle hypertonia and spasticity, as well as an increase in mobility, is an essential prerequisite for the amelioration of physiotherapeutical treatments. Repetitive peripheral magnetic nerve stimulation (rPMS) is a putative adjuvant therapy that improves the mobility of patients, but the underlying mechanism is not entirely clear. Thirty-eight participants underwent either an rPMS treatment ( = 19) with a 5 Hz stimulation protocol in the posterior tibial nerve or sham stimulation ( = 19). The stimulation took place over 5 min. The study was conducted in a pre-test post-test design with matched groups. Outcome measures were taken at the baseline and after following intervention. The primary outcome was a significant reduction of the reflex activity of the soleus muscle, triggered by a computer-aided tendon-reflex impact. The pre-post differences of the tendon reflex response activity were -23.7% ( < 0.001) for the treatment group. No significant effects showed in the sham stimulation group. Low-frequency magnetic stimulation (5 Hz rPMS) shows a substantial reduction of the tendon reflex amplitude. It seems to be an effective procedure to reduce muscular stiffness, increase mobility, and thus, makes the therapeutic effect of neuro-rehabilitation more effective. For this reason, the 5 Hz rPMS treatment might have the potential to be used as an adjuvant therapy in the rehabilitation of gait and posture control in patients suffering from limited mobility due to spasticity. The effect observed in this study should be investigated conjoined with the presented method in patients with impaired mobility due to spasticity.

摘要

降低肌肉张力亢进和痉挛,以及提高活动能力,是改善物理治疗效果的重要前提。重复外周磁神经刺激(rPMS)是一种公认的辅助治疗方法,可改善患者的活动能力,但其潜在机制尚不完全清楚。38名参与者接受了两种治疗之一,19名接受了后胫神经5Hz刺激方案的rPMS治疗,另外19名接受了假刺激。刺激持续5分钟。该研究采用配对组的前后测试设计。在基线和干预后进行结果测量。主要结果是通过计算机辅助肌腱反射冲击触发的比目鱼肌反射活动显著降低。治疗组肌腱反射反应活动的前后差异为-23.7%(P<0.001)。假刺激组未显示出显著效果。低频磁刺激(5Hz rPMS)显示肌腱反射幅度大幅降低。它似乎是一种有效的方法,可以降低肌肉僵硬程度,增加活动能力,从而使神经康复治疗效果更显著。因此,5Hz rPMS治疗可能有潜力作为辅助治疗方法,用于因痉挛导致活动受限的患者的步态和姿势控制康复。本研究中观察到的效果应与所提出的方法相结合,在因痉挛导致活动能力受损的患者中进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3530/6718706/0459d906f2ec/fneur-10-00930-g0001.jpg

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