Xu Lijuan, Ye Liang, Jia Jie, Chen Shugeng
Rehabilitation Department, Hangzhou Linping Hospital of Traditional Chinese and Western Medicine, Hangzhou 310000, P. R. China.
Rehabilitation Department, Huashan Hospital, Fudan University, Shanghai 200040, P. R. China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2025 Jun 25;42(3):628-634. doi: 10.7507/1001-5515.202411049.
Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients' activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency high-frequency), anatomical targeting (nerve trunk . motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity after stroke through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.
中风后痉挛是上运动神经元损伤的常见后遗症,会导致运动控制缺陷和病理性肌张力亢进,不仅会降低患者的日常生活活动能力,还可能导致适应性神经可塑性受损。重复外周磁刺激(rPMS)作为一种新型非侵入性神经调节技术,通过对外周神经肌肉系统中的电磁耦合效应进行靶向调节,展现出独特的临床潜力。尽管目前的国际研究已经证实了rPMS对痉挛的治疗潜力,但在阐明其作用机制、优化参数方案以及规范结果评估系统方面,仍存在显著的异质性。本综述创新性地综合了近期的随机对照试验(RCT)和机制证据,系统总结了rPMS介导的针对上肢和下肢痉挛的多维干预模式。它严格审查了刺激频率参数(低频、高频)、解剖定位(神经干、运动点)与包括痉挛严重程度、运动功能和生活质量在内的临床结果之间的相关性。至关重要的是,分析表明rPMS可能通过局部神经电生理调节和中枢感觉运动网络重组的双重机制改善中风后的痉挛,从而为制定个性化的rPMS临床方案和建立精准治疗策略提供理论基础。