Cha Tae-Hyun, Hwang Ho-Sung
Department of Occupational Therapy, Konyang University of Occupational Therapy, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea.
Brain Sci. 2022 Jul 27;12(8):994. doi: 10.3390/brainsci12080994.
(1) Background: This systematic review aimed to focus on the effects of rehabilitation interventions combined with noninvasive brain stimulation on upper limb motor function in stroke patients. (2) Methods: PubMed, MEDLINE, and CINAHL were used for the literature research. Articles were searched using the following terms: "Stroke OR CVA OR cerebrovascular accident" AND "upper limb OR upper extremity" AND "NIBS OR Non-Invasive Brain Stimulation" OR "rTMS" OR "repetitive transcranial magnetic stimulation" OR "tDCS" OR "transcranial direct current stimulation" AND "RCT" OR randomized control trial." In total, 12 studies were included in the final analysis. (3) Results: Analysis using the Physiotherapy Evidence Database scale for qualitative evaluation of the literature rated eight articles as "excellent" and four as "good." Combined rehabilitation interventions included robotic therapy, motor imagery using brain-computer interaction, sensory control, occupational therapy, physiotherapy, task-oriented approach, task-oriented mirror therapy, neuromuscular electrical stimulation, and behavior observation therapy. (4) Conclusions: Although it is difficult to estimate the recovery of upper limb motor function in stroke patients treated with noninvasive brain stimulation alone, a combination of a task-oriented approach, occupational therapy, action observation, wrist robot-assisted rehabilitation, and physical therapy can be effective.
(1) 背景：本系统评价旨在聚焦康复干预联合非侵入性脑刺激对脑卒中患者上肢运动功能的影响。(2) 方法：使用PubMed、MEDLINE和CINAHL进行文献研究。通过以下检索词搜索文章：“Stroke OR CVA OR cerebrovascular accident”（中风或脑血管意外或脑血管事故）、“upper limb OR upper extremity”（上肢）、“NIBS OR Non-Invasive Brain Stimulation”（非侵入性脑刺激）、“rTMS”（重复经颅磁刺激）、“repetitive transcranial magnetic stimulation”（重复经颅磁刺激）、“tDCS”（经颅直流电刺激）、“transcranial direct current stimulation”（经颅直流电刺激）以及“RCT”（随机对照试验）或“randomized control trial”（随机对照试验）。最终分析共纳入12项研究。(3) 结果：使用物理治疗证据数据库量表对文献进行定性评估，8篇文章被评为“优秀”，4篇被评为“良好”。联合康复干预包括机器人治疗、基于脑机交互的运动想象、感觉控制、职业治疗、物理治疗、任务导向方法、任务导向镜像治疗、神经肌肉电刺激和行为观察治疗。(4) 结论：尽管单独使用非侵入性脑刺激治疗的脑卒中患者上肢运动功能恢复情况难以估计，但任务导向方法、职业治疗、动作观察、腕部机器人辅助康复和物理治疗相结合可能有效。
