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附加电刺激联合重复经颅磁刺激和运动想象对脑卒中后亚急性期上肢运动功能恢复的影响:一项初步研究。

The effects of additional electrical stimulation combined with repetitive transcranial magnetic stimulation and motor imagery on upper extremity motor recovery in the subacute period after stroke: A preliminary study.

机构信息

Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Occupational Therapy, Incheon St. Mary's Hospital, Republic of Korea.

出版信息

Medicine (Baltimore). 2021 Sep 3;100(35):e27170. doi: 10.1097/MD.0000000000027170.

Abstract

BACKGROUND

To evaluate the therapeutic effects of additional electrical stimulation (ES) combined with low frequency (LF)-repetitive transcranial magnetic stimulation (rTMS) and motor imagery (MI) training on upper extremity (UE) motor function following stroke.

METHODS

The participants with subacute stroke in the experimental group (n = 8) received LF rTMS + MI + active ES interventions, and those in control group (n = 9) received LF rTMS + MI + sham ES interventions. Interventions were performed 5 days a week for 2 weeks, for a total of 10 sessions. All participants were given the same dosage of conventional rehabilitation during the study period. The primary outcome measure was the UE Fugl-Meyer Assessment (FMA). The secondary outcome measures were the shoulder abduction and finger extension scores, modified Barthel Index, Purdue Pegboard Test, and finger tapping test. All scores were measured before and just after the intervention.

RESULTS

After the 2-week intervention period, the FMA and modified Barthel Index scores were improved in both groups compared to baseline assessment (P < .001 in the experimental group and P = .008 in the control group). Of note, the change in FMA scores was significantly higher in the experimental group compared with that of the control group (P = .04).

CONCLUSION

These results suggest that the use of LF rTMS + MI combined with additional ES lead to greater improvement of UE motor function after stroke. As such, this intervention may be a promising adjuvant therapy in UE motor training.

摘要

背景

评估附加电刺激(ES)联合低频(LF)重复经颅磁刺激(rTMS)和运动想象(MI)训练对脑卒中后上肢(UE)运动功能的治疗效果。

方法

实验组(n = 8)的参与者接受 LF rTMS + MI + 主动 ES 干预,对照组(n = 9)接受 LF rTMS + MI + 假 ES 干预。干预每周进行 5 天,共进行 10 次。研究期间,所有参与者均接受相同剂量的常规康复治疗。主要结局指标为 UE Fugl-Meyer 评估(FMA)。次要结局指标为肩外展和手指伸展评分、改良巴氏指数、普渡钉板测试和手指叩诊测试。所有评分均在干预前和干预后即刻进行测量。

结果

经过 2 周的干预期后,与基线评估相比,两组的 FMA 和改良巴氏指数评分均有所改善(实验组 P < .001,对照组 P = .008)。值得注意的是,实验组的 FMA 评分变化明显高于对照组(P = .04)。

结论

这些结果表明,LF rTMS + MI 联合附加 ES 可导致脑卒中后 UE 运动功能的显著改善。因此,这种干预可能是 UE 运动训练中一种有前途的辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e384/8416012/5018d7981e67/medi-100-e27170-g001.jpg

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