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重复经颅磁刺激联合强化物理治疗对出血性中风后步态障碍的影响:一项开放标签病例系列研究

Repetitive peripheral magnetic stimulation combined with intensive physical therapy for gait disturbance after hemorrhagic stroke: an open-label case series.

作者信息

Kinoshita Shoji, Ikeda Kumi, Hama Midori, Suzuki Shin, Abo Masahiro

机构信息

Department of Rehabilitation Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo.

Department of Rehabilitation Medicine, Aomori Shintoshi Hospital, Aomori, Aomori, Japan.

出版信息

Int J Rehabil Res. 2020 Sep;43(3):235-239. doi: 10.1097/MRR.0000000000000416.

DOI:10.1097/MRR.0000000000000416
PMID:32776765
Abstract

In this pilot study, we aimed to determine the safety and feasibility of a 15-day protocol consisting of in-hospital repetitive peripheral magnetic stimulation (rPMS) combined with intensive physical therapy for the recovery of the gait disturbance in chronic stroke patients with lower limb hemiparesis. Seven hemorrhagic stroke patients with lower limb hemiparesis and gait disturbance (age: 50-78; time from onset of stroke: 7-107 months) were enrolled. rPMS was applied to the muscles of the paretic lower limb with a parabolic coil. A train of stimuli at a frequency of 20 Hz was applied for 3 s followed by a 27-s rest interval. Therapy with rPMS was performed with eighty such trains of stimuli (total 4800 pulses). Following rPMS therapy, 120 min of physical therapy was administrated daily. Each patient received this combination treatment over fifteen consecutive days, with the walking function of all participants assessed before and after the intervention. The proposed treatment protocol resulted in significant improvements in the walking speed, ambulation ability, and balance ability, but showed no significant effects on the endurance capacity, step length, and spasticity. No rPMS-related side effects were noted. Our protocol consisting of rPMS and intensive physical therapy appears well tolerated and feasible for therapy in hemorrhagic stroke patients with gait disturbance. Further large-scale studies are required to confirm its efficacy.

摘要

在这项初步研究中,我们旨在确定一项为期15天的方案的安全性和可行性,该方案包括住院期间重复外周磁刺激(rPMS)联合强化物理治疗,用于改善慢性下肢偏瘫中风患者的步态障碍。纳入了7例患有下肢偏瘫和步态障碍的出血性中风患者(年龄:50 - 78岁;中风发病时间:7 - 107个月)。使用抛物线线圈对偏瘫下肢的肌肉进行rPMS治疗。以20赫兹的频率施加一系列刺激,持续3秒,随后是27秒的休息间隔。rPMS治疗采用八十组这样的刺激(共4800个脉冲)。rPMS治疗后,每天进行120分钟的物理治疗。每位患者连续15天接受这种联合治疗,并在干预前后评估所有参与者的步行功能。所提出的治疗方案使步行速度、行走能力和平衡能力有显著改善,但对耐力、步长和痉挛没有显著影响。未观察到与rPMS相关的副作用。我们的rPMS联合强化物理治疗方案似乎耐受性良好,对有步态障碍的出血性中风患者的治疗是可行的。需要进一步的大规模研究来证实其疗效。

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