中枢间歇θ-脉冲刺激结合重复外周磁刺激对中风患者上肢功能的影响。

Pub Date : 2023-12-30 eCollection Date: 2023-10-01 DOI:10.25100/cm.v54i4.5766
Shangrong Jiang, Tingtin Han, Zhijie Zhang, Mingming Wen, Yongping Li
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引用次数: 0

摘要

背景:间歇性θ-脉冲刺激和重复性外周磁刺激可以改善卒中后患者的运动功能,但这种组合的治疗效果仍不明确:目的:确定中枢间歇θ-脉冲刺激和重复外周磁刺激对上肢功能的影响:将 56 名亚急性中风患者随机分配到三组:CMS 组(18 人)、外周磁刺激组(19 人)和 CPS 组(19 人)。CMS组接受间歇性θ-脉冲刺激和外周假刺激,而PMS组接受重复性外周磁刺激和中枢假刺激,每天一次,每周五天,持续四周。CPS 组接受间歇性θ-脉冲刺激和重复性外周磁刺激,每天一次,持续四周。Fugl-Meyer 评估、行动研究手臂测试、改良 Barthel 指数和改良 Ashworth 量表对治疗四周前后的结果进行了评估:结果:与治疗前相比,治疗后各组的运动功能评分均有明显提高,而改良阿什沃斯量表评分则无明显变化。CPS组的运动功能评分与CMS组和PMS组相比有明显差异,但改良阿什沃斯量表评分没有明显改善:结论:两种治疗方法联合使用可改善患者的运动功能和日常生活能力,但不能改善肌张力。
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Effects of central intermittent theta-burst stimulation combined with repetitive peripheral magnetic stimulation on upper limb function in stroke patients.

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.

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