The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
NeuroRehabilitation. 2024;54(3):421-434. doi: 10.3233/NRE-230355.
The therapeutic effect and mechanism of robot-assisted upper limb training (RT) combined with intermittent theta burst stimulation (iTBS) for stroke patients are unclear.
The purpose of this study was to evaluate changes in brain activation after combination therapy and RT alone using functional near-infrared spectroscopy (fNIRS).
Patients were randomly assigned to two groups (iTBS + RT Group, n = 18, and RT Group, n = 18). Training was conducted five times a week for four weeks. fNIRS was used to measure changes in oxyhemoglobin in both the primary motor cortex (M1) and pre-motor and supplementary motor area (pSMA) during affected limb movement. Fugl-Meyer Assessment-Upper Extremity (FMA-UE) was employed for evaluating the function of upper limbs.
Thirty-two patients with subacute stroke completed the study. The cortex of both hemispheres was extensively activated prior to treatment in the RT group. After training, overactivation decreased. The brain activation of the combined treatment group transferred to the affected side after the treatment. There was a notable enhancement in the FMA-UE scores for both groups, with the combined group's progress significantly surpassing that of the RT group.
RT combined with iTBS can improve the motor function of stroke patients and promote the balance between cerebral hemispheres.
机器人辅助上肢训练（RT）联合间歇性经颅磁刺激（iTBS）治疗脑卒中患者的疗效和机制尚不清楚。
本研究旨在使用功能近红外光谱（fNIRS）评估联合治疗和单独 RT 后大脑激活的变化。
将患者随机分为两组（iTBS+RT 组，n=18，和 RT 组，n=18）。每周训练 5 次，共 4 周。fNIRS 用于测量在患侧肢体运动过程中，初级运动皮层（M1）和运动前区和辅助运动区（pSMA）中氧合血红蛋白的变化。采用 Fugl-Meyer 上肢评估量表（FMA-UE）评估上肢功能。
32 例亚急性期脑卒中患者完成了研究。在 RT 组治疗前，双侧大脑皮层广泛激活。治疗后，过度激活减少。联合治疗组治疗后大脑激活转移到患侧。两组的 FMA-UE 评分均显著提高，联合组的进展明显优于 RT 组。
RT 联合 iTBS 可改善脑卒中患者的运动功能，促进大脑半球间的平衡。
