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高频重复经颅磁刺激对慢性不完全性脊髓损伤患者运动恢复和步态参数的影响:一项随机对照研究。

The effect of high-frequency repetitive transcranial magnetic stimulation on motor recovery and gait parameters in chronic incomplete spinal cord injury: A randomized-controlled study.

作者信息

Kesikburun Serdar, Uran Şan Ayça, Yaşar Evren, Yılmaz Bilge

机构信息

Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane Medical School, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Türkiye.

Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Türkiye.

出版信息

Turk J Phys Med Rehabil. 2023 Jun 6;69(3):275-285. doi: 10.5606/tftrd.2023.11585. eCollection 2023 Sep.

Abstract

OBJECTIVES

This study aims to examine the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on gait parameters and lower extremity motor recovery in a more specific sample of individuals with chronic and traumatic incomplete spinal cord injury (iSCI).

PATIENTS AND METHODS

This double-blind, sham-controlled, randomized study included a total of 28 individuals (20 males, 8 females; mean age: 35.7±12.1 years; range, 18 to 45 years) with chronic (>1 year) traumatic iSCI. The participants were randomly allocated to either sham rTMS group (n=14) or real rTMS group (n=14). We compared the groups based on the lower extremity motor scores (LEMS), the temporal-spatial gait measurements using three-dimensional gait analysis, the Walking Index for SCI-II (WISCI-II), and 10-m walking test at baseline, three weeks (post-treatment) and five weeks (follow-up) after the treatment.

RESULTS

The real rTMS group revealed a significant improvement in walking speed, LEMS score, and 10-m walking test after the treatment compared to baseline (p=0.001, p=0.002, and p=0.023, respectively). Changes in the LEMS score were significantly increased in the real rTMS group compared to the sham group at both three and five weeks (p=0.001 and p=0.001, respectively). No significant difference was observed in the other variables between the groups (p>0.05).

CONCLUSION

Our study findings support the therapeutic effectiveness of rTMS on motor recovery in chronic iSCI. The rTMS can be used as an adjuvant therapy to conventional physiotherapy in the rehabilitation of patients with iSCI.

摘要

目的

本研究旨在探讨高频重复经颅磁刺激(rTMS)对慢性创伤性不完全脊髓损伤(iSCI)个体更具针对性样本的步态参数和下肢运动恢复的影响。

患者与方法

本双盲、假对照、随机研究共纳入28例慢性(>1年)创伤性iSCI患者(20例男性,8例女性;平均年龄:35.7±12.1岁;范围18至45岁)。参与者被随机分为假rTMS组(n = 14)或真rTMS组(n = 14)。我们在基线、治疗后三周(治疗后)和五周(随访)时,基于下肢运动评分(LEMS)、使用三维步态分析的时空步态测量、脊髓损伤步行指数-II(WISCI-II)和10米步行测试对两组进行比较。

结果

与基线相比,真rTMS组在治疗后步行速度、LEMS评分和10米步行测试方面有显著改善(分别为p = 0.001、p = 0.0,02和p = 0.023)。在三周和五周时,真rTMS组的LEMS评分变化与假刺激组相比均显著增加(分别为p = 0.001和p = 0.001)。两组之间在其他变量上未观察到显著差异(p>0.05)。

结论

我们的研究结果支持rTMS对慢性iSCI运动恢复的治疗效果。rTMS可作为iSCI患者康复中传统物理治疗的辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227f/10478546/e1b041d94a20/TJPMR-2023-69-3-275-285-F1.jpg

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