{"title":"基于三维步态分析和sEMG的rTM与增强现实步态适应性训练相结合对脑卒中患者行走功能的影响：随机对照试验。","authors":"Linjie Fang, Wanying Zhang, Jianing Wu, Hong Yu, Huihuang Zhang, Shishi Chen, Beisi Zheng, Manting Cao, Yujia Zhang, Lei Dai, Jianer Chen","doi":"10.1080/09593985.2024.2378905","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Augmented reality gait adaptive training (ARGAT) and repetitive transcranial magnetic stimulation (rTMS) have both demonstrated efficacy in improving lower limb motor function in survivors of stroke.</p><p><strong>Purpose: </strong>To investigate the effects of combining rTMS and ARGAT on motor function in survivors of stroke.</p><p><strong>Methods: </strong>The experimental group received a combination of rTMS and ARGAT, while the control group received ARGAT alone. The interventions comprised a total of 20 sessions, conducted over four weeks with five consecutive daily sessions. Outcome measures included three-dimensional gait analysis (3DGA), surface electromyography (sEMG), Fugl-Meyer assessment for the lower extremity (FMA-LE), and the Berg Balance Scale (BBS).</p><p><strong>Results: </strong>Following the intervention, both groups showed significant improvements in walking speed, symmetry index, affected step length, affected stride length, FMA-LE, and BBS scores (<i>p</i> < .05). Furthermore, the experimental group demonstrated greater improvements in walking speed (F = 4.58, <i>p</i> = .040), cadence (F = 5.67, <i>p</i> = .023), affected step length (F = 5.79, <i>p</i> = .022), affected stride length (F = 4.84, <i>p</i> = .035), FMA-LE (Z = 2.43, <i>p</i> = .019), and BBS (F = 4.76, <i>p</i> = .036) compared to the control group. The experimental group demonstrated a significant improvement in the co-contraction index (CCI) of the knee joint (F = 14.88, <i>p</i> < .001), a change not observed in the control group (F = 2.16, <i>p</i> = .151). However, neither group showed significant alterations in CCI of the ankle joint (F = 1.58, <i>p</i> = .218), step width (F = 0.24, <i>p</i> = .630), unaffected step length (F = 0.22, <i>p</i> = .641), or unaffected stride length (F = 2.99, <i>p</i> = .093).</p><p><strong>Conclusion: </strong>The combination of low-frequency rTMS and ARGAT demonstrated superior effects on motor function recovery compared to ARGAT alone in survivors of stroke.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of combining rTMs and augmented reality gait adaptive training on walking function of patients with stroke based on three-dimensional gait analysis and sEMG: a randomized controlled trial.\",\"authors\":\"Linjie Fang, Wanying Zhang, Jianing Wu, Hong Yu, Huihuang Zhang, Shishi Chen, Beisi Zheng, Manting Cao, Yujia Zhang, Lei Dai, Jianer Chen\",\"doi\":\"10.1080/09593985.2024.2378905\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Augmented reality gait adaptive training (ARGAT) and repetitive transcranial magnetic stimulation (rTMS) have both demonstrated efficacy in improving lower limb motor function in survivors of stroke.</p><p><strong>Purpose: </strong>To investigate the effects of combining rTMS and ARGAT on motor function in survivors of stroke.</p><p><strong>Methods: </strong>The experimental group received a combination of rTMS and ARGAT, while the control group received ARGAT alone. The interventions comprised a total of 20 sessions, conducted over four weeks with five consecutive daily sessions. Outcome measures included three-dimensional gait analysis (3DGA), surface electromyography (sEMG), Fugl-Meyer assessment for the lower extremity (FMA-LE), and the Berg Balance Scale (BBS).</p><p><strong>Results: </strong>Following the intervention, both groups showed significant improvements in walking speed, symmetry index, affected step length, affected stride length, FMA-LE, and BBS scores (<i>p</i> < .05). Furthermore, the experimental group demonstrated greater improvements in walking speed (F = 4.58, <i>p</i> = .040), cadence (F = 5.67, <i>p</i> = .023), affected step length (F = 5.79, <i>p</i> = .022), affected stride length (F = 4.84, <i>p</i> = .035), FMA-LE (Z = 2.43, <i>p</i> = .019), and BBS (F = 4.76, <i>p</i> = .036) compared to the control group. The experimental group demonstrated a significant improvement in the co-contraction index (CCI) of the knee joint (F = 14.88, <i>p</i> < .001), a change not observed in the control group (F = 2.16, <i>p</i> = .151). However, neither group showed significant alterations in CCI of the ankle joint (F = 1.58, <i>p</i> = .218), step width (F = 0.24, <i>p</i> = .630), unaffected step length (F = 0.22, <i>p</i> = .641), or unaffected stride length (F = 2.99, <i>p</i> = .093).</p><p><strong>Conclusion: </strong>The combination of low-frequency rTMS and ARGAT demonstrated superior effects on motor function recovery compared to ARGAT alone in survivors of stroke.</p>\",\"PeriodicalId\":48699,\"journal\":{\"name\":\"Physiotherapy Theory and Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physiotherapy Theory and Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/09593985.2024.2378905\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy Theory and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09593985.2024.2378905","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
Effects of combining rTMs and augmented reality gait adaptive training on walking function of patients with stroke based on three-dimensional gait analysis and sEMG: a randomized controlled trial.
Background: Augmented reality gait adaptive training (ARGAT) and repetitive transcranial magnetic stimulation (rTMS) have both demonstrated efficacy in improving lower limb motor function in survivors of stroke.
Purpose: To investigate the effects of combining rTMS and ARGAT on motor function in survivors of stroke.
Methods: The experimental group received a combination of rTMS and ARGAT, while the control group received ARGAT alone. The interventions comprised a total of 20 sessions, conducted over four weeks with five consecutive daily sessions. Outcome measures included three-dimensional gait analysis (3DGA), surface electromyography (sEMG), Fugl-Meyer assessment for the lower extremity (FMA-LE), and the Berg Balance Scale (BBS).
Results: Following the intervention, both groups showed significant improvements in walking speed, symmetry index, affected step length, affected stride length, FMA-LE, and BBS scores (p < .05). Furthermore, the experimental group demonstrated greater improvements in walking speed (F = 4.58, p = .040), cadence (F = 5.67, p = .023), affected step length (F = 5.79, p = .022), affected stride length (F = 4.84, p = .035), FMA-LE (Z = 2.43, p = .019), and BBS (F = 4.76, p = .036) compared to the control group. The experimental group demonstrated a significant improvement in the co-contraction index (CCI) of the knee joint (F = 14.88, p < .001), a change not observed in the control group (F = 2.16, p = .151). However, neither group showed significant alterations in CCI of the ankle joint (F = 1.58, p = .218), step width (F = 0.24, p = .630), unaffected step length (F = 0.22, p = .641), or unaffected stride length (F = 2.99, p = .093).
Conclusion: The combination of low-frequency rTMS and ARGAT demonstrated superior effects on motor function recovery compared to ARGAT alone in survivors of stroke.
期刊介绍：
The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.
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