Ke Jiaqia, Wei Jiana, Zheng Bofang, Tan Tian, Zhou Wenbin, Zou Xiaopei, Zou Huihui, Zeng Haoxuan, Zhou Guoping, Chen Lukui, Zhou Xianju
Department of Neurology, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shi Liu Gang Road, Haizhu District, Guangzhou, Guangdong, China 510315.
Department of Neurology, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No.13, Shi Liu Gang Road, Haizhu District, Guangzhou, Guangdong, China 510315; Department of Neurology, The second affiliated hospital of Guangzhou Medical University, No.250, Chan Gang East Road, Haizhu District, Guangzhou, Guangdong, China 510315.
J Stroke Cerebrovasc Dis. 2022 Jul;31(7):106446. doi: 10.1016/j.jstrokecerebrovasdis.2022.106446. Epub 2022 May 2.
The aim of the randomized, double-blind, sham-controlled trial was to explore the efficacy and safety of HF-rPMS synchronosly applied to the axilla (stimulating the brachial plexus) and the popliteal fossa (stimulating the tibial nerve and common peroneal nerve) in patients with intracerebral hemorrhage on rehabilitation of motor functions.
Patients with intracerebral haemorrhage in the early period were recruited and randomly assigned to the HF-rPMS group or the sham rPMS group. The two synchrous coils of magnetic stimulation in the two groups were respectively applied to the axilla and the popliteal fossa of the affected limb. But the sham group received the ineffective rPMS and only heard the sound as occured in the HF-rPMS group. Clinical outcomes included the change of Fugl-Meyer Assessment (FMA) scale and Medical Research Council (MRC) scale before and after HF-rPMS.
Of 76 eligible patients, 30 were included and only 26 patients completed this study. The diferences on the improvement of the upper extremity FMA (P=0.012), the lower extremity FMA (P=0.001), the proximal MRC of upper extremity (p = 0.043), the proximal MRC of lower extremity (p= 0.004) and the distal MRC scores of lower extremity (p= 0.008) between the the HF-rPMS group and sham rPMS group were statistically signifcant.
Synchrous HF-rPMS intervention at the axilla and the popliteal fossa significantly improved motor function and proximal muscle strength of upper and lower limb of patients in acute or early subacute phase of intracerebral hemorrhage.
这项随机、双盲、假对照试验的目的是探讨高频重复经颅磁刺激（HF-rPMS）同步应用于腋窝（刺激臂丛神经）和腘窝（刺激胫神经和腓总神经）对脑出血患者运动功能康复的疗效和安全性。
招募早期脑出血患者并随机分为HF-rPMS组或假rPMS组。两组的两个同步磁刺激线圈分别应用于患侧肢体的腋窝和腘窝。但假刺激组接受无效的rPMS，仅听到与HF-rPMS组相同的声音。临床结局包括HF-rPMS前后Fugl-Meyer评估（FMA）量表和医学研究委员会（MRC）量表的变化。
76例符合条件的患者中，30例被纳入研究，仅26例患者完成了本研究。HF-rPMS组与假rPMS组在上肢FMA改善（P=0.012）、下肢FMA改善（P=0.001）、上肢近端MRC（P=0.043）、下肢近端MRC（P=0.004）和下肢远端MRC评分（P=0.008）方面的差异具有统计学意义。
在腋窝和腘窝同步进行HF-rPMS干预可显著改善脑出血急性期或早期亚急性期患者上下肢的运动功能和近端肌肉力量。
