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中枢间歇性 theta 爆发刺激联合重复外周磁刺激对脑卒中患者上肢功能的影响。

Effects of central intermittent theta-burst stimulation combined with repetitive peripheral magnetic stimulation on upper limb function in stroke patients.

机构信息

Gansu Provincial Hospital, Second Ward of Neurology Department, Lanzhou, China.

出版信息

Colomb Med (Cali). 2023 Dec 30;54(4):e2005766. doi: 10.25100/cm.v54i4.5766. eCollection 2023 Oct-Dec.

Abstract

BACKGROUND

Intermittent theta-burst stimulation and repetitive peripheral magnetic stimulation can improve motor function in poststroke patients, but the therapeutic effect of this combination remains unclear.

OBJECTIVE

To determine the effects of central intermittent theta-burst stimulation and repetitive peripheral magnetic stimulation on upper limb function.

METHODS

Fifty-six subacute stroke patients were randomly assigned to three groups: the CMS (n = 18), peripheral magnetic stimulation (PMS) (n = 19) and CPS (n = 19) groups. The CMS group received intermittent theta-burst stimulation and peripheral false stimulation, while the PMS group received repetitive peripheral magnetic stimulation and central false stimulation once a day for five days a week over four weeks. The CPS group received intermittent theta-burst stimulation and repetitive peripheral magnetic stimulation simultaneously once daily for four weeks. The Fugl-Meyer Assessment, Action Research Arm Test, Modified Barthel Index and Modified Ashworth Scale evaluated outcomes before and after four weeks of treatment.

RESULTS

The motor function scores of all groups were significantly increased after treatment compared with before treatment, while the Modified Ashworth Scale score showed no significant change. There was a significant difference in the motor function score of the CPS group compared with that of the CMS and PMS groups, but there was no significant improvement in the Modified Ashworth Scale score.

CONCLUSION

Combining the two treatment methods can improve patients' motor function and daily living abilities but cannot improve muscle tone.

摘要

背景

间歇性 theta 爆发刺激和重复外周磁刺激均可改善脑卒中后患者的运动功能,但联合治疗的疗效尚不清楚。

目的

确定中枢间歇性 theta 爆发刺激和重复外周磁刺激对上肢功能的影响。

方法

将 56 例亚急性期脑卒中患者随机分为三组:CMS 组(n=18)、外周磁刺激(PMS)组(n=19)和 CPS 组(n=19)。CMS 组接受间歇性 theta 爆发刺激和外周假刺激,PMS 组接受重复外周磁刺激和中枢假刺激,每周 5 天,每天 1 次,共 4 周。CPS 组接受间歇性 theta 爆发刺激和重复外周磁刺激,每天 1 次,共 4 周。在治疗前和治疗 4 周后,采用 Fugl-Meyer 评估、动作研究上肢测试、改良巴氏指数和改良 Ashworth 量表评估疗效。

结果

与治疗前相比,所有组治疗后运动功能评分均显著升高,而改良 Ashworth 量表评分无显著变化。与 CMS 组和 PMS 组相比,CPS 组的运动功能评分有显著差异,但改良 Ashworth 量表评分无显著改善。

结论

联合两种治疗方法可改善患者的运动功能和日常生活能力,但不能改善肌肉张力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e4/11341120/a499f8c3d6b8/1657-9534-cm-54-04-e2005766-gf1.jpg

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