一项关于使用颅神经非侵入性神经调节改善中风慢性期患者患侧手臂功能的可行性研究。

A feasibility study on the use of cranial nerve non-invasive neuromodulation to improve affected arm function in people in the chronic stage of a stroke.

作者信息

Ahiatsi Maureen, Léonard Guillaume, Riesco Eléonor, Girard Marie-Claude, Milot Marie-Hélène

机构信息

Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), 1036 Rue Belvédère Sud, Sherbrooke, Québec, J1H4C4, Canada.

Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H5N4, Canada.

出版信息

BMC Neurol. 2025 May 16;25(1):208. doi: 10.1186/s12883-025-04213-5.

DOI:10.1186/s12883-025-04213-5

PMID:40380081

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12082858/

Abstract

BACKGROUND

Chronic stroke survivors are often left with residual arm muscle weakness impeding arm function, daily life activities and quality of life. Exercise is one of the main post-stroke interventions to improve arm function, with cranial nerve non-invasive neuromodulation (CN-NINM) emerging as a potentially interesting complementary therapy to enhance its benefits. Only one study has evaluated the impact of CN-NINM combined with a lower-limb training program on improved balance in subacute stroke survivors. The aim of this study was to assess the feasibility and explore the effects on motor function of an arm strengthening program combined with CN-NINM in chronic stroke survivors (> 6 months).

METHODS

Twelve (12) participants (69 ± 11 years) took part in this feasibility study. Recruitment and drop-out rates, number of people who elected not to participate, adherence and adverse events were collected to assess feasibility. The effects of CN-NINM + exercise on motor function were evaluated by changes in arm motor function, measured using the Fugl-Meyer Assessment (FMA), and functional performance, evaluated through the Wolf Motor Function Test (WMFT), following a 4-week arm strengthening program (60 min, 3 sessions/week) combined with CN-NINM (tongue stimulation, 20 min at a comfortable intensity). Descriptive and non-parametric statistics (Wilcoxon signed-ranks test) were used to describe feasibility data and explore CN-NINM effects.

RESULTS

Feasibility was confirmed with a recruitment rate of 1.3 person/month, no dropout, a 100% adherence rate, and no serious adverse events. A significant gain in FMA (p = 0.003) with a trend for WMFT (P = 0.11) were noted post-intervention.

CONCLUSION

This study suggests that CN-NINM combined with an arm strengthening program is feasible and may improve arm function in chronic stroke survivors. Further research is needed to validate the results.

TRIAL REGISTRATION

This clinical trial was registered on ClinicalTrials.gov (NCT05370274) on April 27, 2022.

摘要

背景

慢性中风幸存者常常遗留手臂肌肉无力，这会妨碍手臂功能、日常生活活动及生活质量。运动是中风后改善手臂功能的主要干预措施之一，颅神经非侵入性神经调节（CN-NINM）作为一种可能有效的辅助疗法逐渐兴起，可增强运动疗法的效果。仅有一项研究评估了CN-NINM联合下肢训练计划对亚急性中风幸存者平衡能力改善的影响。本研究旨在评估在慢性中风幸存者（>6个月）中，手臂强化训练计划联合CN-NINM的可行性，并探讨其对运动功能的影响。

方法

12名参与者（69±11岁）参与了这项可行性研究。收集招募率、退出率、选择不参与的人数、依从性和不良事件，以评估可行性。通过4周的手臂强化训练计划（60分钟，每周3次）联合CN-NINM（舌刺激，舒适强度下20分钟）后，使用Fugl-Meyer评估量表（FMA）测量手臂运动功能的变化，以及通过Wolf运动功能测试（WMFT）评估功能表现，来评估CN-NINM+运动对运动功能的影响。采用描述性和非参数统计（Wilcoxon符号秩检验）来描述可行性数据并探讨CN-NINM的效果。