Gumarova L Sh, Bodrova R A, Khasanova D R, Yunusova E R, Nazipova A Ya
Kazan State Medical Academy - branch of Russian Medical Academy of Continuing Professional Education of the Ministry of Health of Russia, Kazan, Russia.
SAHI «City Clinical Hospital No. 7 of Kazan» of the Ministry of Health of Tatarstan, Kazan, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2020;97(5):39-44. doi: 10.17116/kurort20209705139.
As you know, complete successful recovery in stroke patients occurs only in 8% of cases, 20% need constant care. The use of innovative rehabilitation technologies, namely «thresholdless» low-frequency transcranial magnetic stimulation, will speed up the process of restoring impaired functions, increase independence in everyday life and, accordingly, the quality of life.
To evaluate the effectiveness of use of low-frequency «thresholdless» transcranial magnetic stimulation in the treatment of patients in acute period of ischemic stroke.
The study included 93 patients aged from 49 to 68 years on second-third days of ischemic stroke. The 1st (main) group (=48) received low-frequency «thresholdless» transcranial magnetic stimulation from the «Diamag» apparatus (AlMag-03) daily for 20 minutes, course - 8-10 procedures, with the background of drug treatment, and in addition to classes with an exercise therapy instructor and an occupational therapist. In the 2nd (control) group (=45), standard therapy was carried out in accordance with the Procedure for rendering medical care to patients with stroke, only with the exception of physiotherapy. Assessment methods: clinical and neurological examination, indicators of duplex scanning of brachiocephalic vessels, Rivermead mobility index, modified Rankin scale, FIM scale (Functional Independence Measure), Hospital anxiety and depression scale (HADS).
In patients of the 1st (main) group, an increase in the linear velocity of blood flow in the internal carotid artery on the side of lesion was revealed by 18.1% when compared with the 2nd (control) group (=0.042); mobility increased by 42.1%, functional independence in everyday life - by 38.1%, muscle strength - by 50%, compared with the 2nd (control) group (=0.0005). According to the HADS scale, in 29 (60.8%) patients of the main group, psychoemotional disorders were not detected, neither a single case of significantly expressed symptoms of depression (<0.0001).
The inclusion of low-frequency transcranial electromagnetic stimulation in complex rehabilitation leads to the regression of movement disorders, reduces the level of anxiety and depression, improves daily activity and, as a consequence, the quality of life.
如你所知，中风患者完全成功康复的情况仅占8%，20%需要长期护理。使用创新的康复技术，即“无阈值”低频经颅磁刺激，将加快受损功能的恢复进程，提高日常生活中的独立性，从而提高生活质量。
评估低频“无阈值”经颅磁刺激在缺血性中风急性期患者治疗中的有效性。
该研究纳入了93例年龄在49至68岁之间、处于缺血性中风第二至三天的患者。第一（主要）组（=48例）在药物治疗的基础上，每天接受来自“Diamag”仪器（AlMag - 03）的低频“无阈值”经颅磁刺激20分钟，疗程为8 - 10次，此外还接受运动疗法指导师和职业治疗师的课程。第二（对照）组（=45例）按照中风患者医疗护理程序进行标准治疗，仅不包括物理治疗。评估方法：临床和神经学检查、头臂血管双功扫描指标、Rivermead活动指数、改良Rankin量表、FIM量表（功能独立性测量）、医院焦虑抑郁量表（HADS）。
与第二（对照）组相比，第一（主要）组患者病变侧颈内动脉血流线性速度增加了18.1%（P = 0.042）；活动能力提高了42.1%，日常生活功能独立性提高了38.1%，肌肉力量提高了50%（P = 0.0005）。根据HADS量表，主要组的29例（60.8%）患者未检测到心理情绪障碍，也没有一例出现明显的抑郁症状（P < 0.0001）。
在综合康复中加入低频经颅电磁刺激可导致运动障碍的消退，降低焦虑和抑郁水平，改善日常活动能力，从而提高生活质量。
