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对侧肢体交叉训练和高频重复经颅磁刺激对中风亚急性期患侧上肢功能指标的评估

Evaluation of Contralateral Limb Cross Education and High-Frequency Repetitive Transcranial Magnetic Stimulation on Functional Indices of the Affected Upper Limb in Subacute Phase of Stroke.

作者信息

Rezaei Katayoon, Kordi Yoosefinejad Amin, Moslemi Haghighi Farzaneh, Razeghi Mohsen

机构信息

Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Stroke Res Treat. 2023 Dec 19;2023:4387667. doi: 10.1155/2023/4387667. eCollection 2023.

Abstract

BACKGROUND

Stroke is one of the causes of long-term morbidity. Despite rehabilitation strategies, most survivors live with motor deficits in the upper limbs.

OBJECTIVES

The aim of the study was to compare the effect of contralateral cross education (CE) and high-frequency repetitive magnetic stimulation (HF-rTMS) on the function of upper extremity in subacute phase of stroke.

METHODS

Forty patients were randomly assigned into 4 groups. Group "A" received physical therapy (PT) for 10 sessions, 3 times per week. Group "B" received PT and HF-rTMS as follows: stimulation of 20 Hz for 5 s, intertrain interval for 50 s, 20 trains, 2000 pulses at 90% resting motor threshold, and conventional PT. Group "C" was treated with CE and PT. In group "D," HF-rTMS, CE, and PT were administered.

RESULTS

Significant differences were found in the Fugl-Meyer scale between "A" and "C" ( = 0.01), "A" and "D" ( = 0.02), and "B" and "C" groups ( = 0.01). In the box-block test, there were significant differences between "A" and "B" ( = 0.01), "A" and "C" ( < 0.001), "B" and "D" ( = 0.001), and "B" and "C" groups ( = 0.01). Statistical differences were observed in grip strength between "A" and "B" ( = 0.01) and "A" and "C" groups ( = 0.02).

CONCLUSIONS

It is suggested that clinicians select the therapeutic methods in line with their expected goal. When the goal is to improve upper extremity function, CE+PT could be more effective than HF-rTMS+PT. Also, CE+PT and HF-rTMS+PT were more effective than CE+HF-rTMS+PT at improving grip strength. Therefore, combining several methods would not always lead to better results.

摘要

背景

中风是长期致残的原因之一。尽管有康复策略,但大多数幸存者仍存在上肢运动功能障碍。

目的

本研究旨在比较对侧交叉训练(CE)和高频重复磁刺激(HF-rTMS)对中风亚急性期上肢功能的影响。

方法

40例患者随机分为4组。A组接受10次物理治疗(PT),每周3次。B组接受PT和HF-rTMS如下:以20Hz刺激5秒,组间间隔50秒,共20组,在静息运动阈值的90%下给予2000个脉冲,并进行常规PT。C组采用CE和PT治疗。D组给予HF-rTMS、CE和PT。

结果

Fugl-Meyer量表显示,A组与C组(P = 0.01)、A组与D组(P = 0.02)以及B组与C组(P = 0.01)之间存在显著差异。在方块积木测试中,A组与B组(P = 0.01)、A组与C组(P < 0.001)、B组与D组(P = 0.001)以及B组与C组(P = 0.01)之间存在显著差异。握力方面,A组与B组(P = 0.01)以及A组与C组(P = 0.02)之间观察到统计学差异。

结论

建议临床医生根据预期目标选择治疗方法。当目标是改善上肢功能时,CE + PT可能比HF-rTMS + PT更有效。此外,在提高握力方面,CE + PT和HF-rTMS + PT比CE + HF-rTMS + PT更有效。因此,联合多种方法并不总是能带来更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3567/10751172/65e43ad4132d/SRT2023-4387667.001.jpg

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