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功能磁刺激对改善脑卒中后上肢功能的疗效:一项随机、单盲、对照研究。

Efficacy of functional magnetic stimulation in improving upper extremity function after stroke: a randomized, single-blind, controlled study.

机构信息

Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China.

School of Nursing, Jilin University, Changchun, Jilin, China.

出版信息

J Int Med Res. 2020 Jun;48(6):300060520927881. doi: 10.1177/0300060520927881.

Abstract

OBJECTIVE

To clarify the efficacy of functional magnetic stimulation (FMS) in improving hemiplegic upper extremity function in patients with sub-acute stroke.

METHODS

In this randomized controlled trial, 40 sub-acute stroke patients with hemiplegia were recruited from inpatient wards in the Department of Rehabilitation and randomly assigned to two groups. In the FMS group, magnetic stimulation was applied to extensor muscle groups of the affected upper extremity. In the low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) group, stimulation was applied to the contralesional primary motor cortex. All patients received occupational therapy. Hand and upper extremity motor function was evaluated using the Fugl-Meyer Assessment for upper extremity (FMA-UE), and the Barthel Index (BI) evaluated daily living abilities.

RESULTS

The FMA-UE and BI scores were significantly increased in both groups following stimulation. Furthermore, a significant between-group difference was observed in both FMA-UE and BI scores after 2 weeks of therapy. In the FMS group, 6 of 19 patients regained wrist and finger extension abilities, but only 2 patients regained equivalent motor skills in the LF-rTMS group.

CONCLUSIONS

FMS improves paretic upper extremity function and leads to better recovery of motor activity than LF-rTMS. FMS may be a novel modality to improve motor function.

摘要

目的

阐明功能性磁刺激(FMS)在改善亚急性脑卒中患者偏瘫上肢功能中的疗效。

方法

这是一项随机对照试验,共招募了 40 名来自康复科住院病房的亚急性脑卒中偏瘫患者,并将其随机分为两组。在 FMS 组中,磁刺激应用于患侧上肢伸肌肌群。在低频重复经颅磁刺激(LF-rTMS)组中,刺激应用于对侧初级运动皮层。所有患者均接受职业治疗。采用 Fugl-Meyer 上肢运动功能评估量表(FMA-UE)评估手和上肢运动功能,采用 Barthel 指数(BI)评估日常生活能力。

结果

两组患者在刺激后 FMA-UE 和 BI 评分均显著增加。此外,治疗 2 周后,FMA-UE 和 BI 评分在两组之间存在显著差异。在 FMS 组中,19 例患者中有 6 例恢复了腕部和手指伸展能力,但在 LF-rTMS 组中只有 2 例恢复了同等的运动技能。

结论

FMS 可改善瘫痪上肢功能,促进运动活动更好地恢复,优于 LF-rTMS。FMS 可能是改善运动功能的一种新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6a8/7273768/c1826fd89507/10.1177_0300060520927881-fig1.jpg

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