《中国康复理论与实践》

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (11): 1247-1251.doi: 10.3969/j.issn.1006-9771.2022.11.002

• 专题 脑卒中上肢功能康复 • 上一篇    下一篇

阳极经颅直流电刺激联合镜像疗法对脑卒中患者上肢功能的效果

朱琳,曲斯伟,刘霖,宋为群()   

  1. 首都医科大学宣武医院康复医学科，北京市 100053
  • 收稿日期:2022-08-24 修回日期:2022-11-08 出版日期:2022-11-25 发布日期:2022-12-20
  • 通讯作者: 宋为群 E-mail:songwq66@163.com
  • 作者简介:朱琳(1981-)，女，汉族，北京市人，硕士，副主任治疗师，主要研究方向：神经康复。|宋为群，女，博士，主任医师、教授。
  • 基金资助:
    首都医科大学宣武医院国自然青年培育项目(QNPY2020017)

Effect of combination of anodal transcranial direct current stimulation and mirror therapy on upper limb function for stroke patients

ZHU Lin,QU Siwei,LIU Lin,SONG Weiqun()   

  1. Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2022-08-24 Revised:2022-11-08 Published:2022-11-25 Online:2022-12-20
  • Contact: SONG Weiqun E-mail:songwq66@163.com
  • Supported by:
    National Nature Youth Cultivation Program of Xuanwu Hospital, Capital Medical University(QNPY2020017)

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摘要：

目的 研究阳极经颅直流电刺激(atDCS)联合镜像疗法(MT)对脑卒中患者上肢功能恢复的影响。

方法 2018年7月至2019年6月，在首都医科大学宣武医院康复医学科康复的脑卒中患者54例，随机数字表法分为A、B、C三组，每组18例。三组均接受神经内科常规药物治疗和康复训练。此外，A组接受MT 60 min；B组先行atDCS 20 min，再予MT 40 min；C组患者先行MT 40 min，再予atDCS 20 min；共4周。训练前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、上肢动作研究量表(ARAT)、运动功能评定量表(MAS)和改良Barthel指数(MBI)进行评定。

结果 时间对FMA-UE评分(F = 159.811, P < 0.001)、ARAT评分(F = 353.227, P < 0.001)、MAS评分(F = 513.494, P < 0.001)和MBI评分(F = 85.982, P < 0.001)的主效应非常显著，治疗后3组各项评分均改善；组别对FMA-UE评分(F = 12.502, P < 0.001)、ARAT评分(F = 20.095, P < 0.001)、MAS评分(F = 16.371, P < 0.001)和MBI评分(F = 11.882, P < 0.001)的主效应非常显著；时间与组别对FMA-UE评分(F = 37.659, P < 0.001)、ARAT评分(F = 78.681, P < 0.001)、MAS评分(F = 97.997, P < 0.001)和MBI评分(F = 48.015, P < 0.001)的交互效应非常显著，B组明显优于A组和C组(P < 0.01)，A组和C组无显著性差异(P > 0.05)。

结论 先行atDCS干预再予MT，对脑卒中患者上肢功能恢复更为有利。

关键词: 脑卒中, 经颅直流电刺激, 镜像疗法, 上肢, 运动功能

Abstract:

Objective To study the effect of anodal transcranial direct current stimulation (atDCS) combined with mirror therapy (MT) on upper limb function for stroke patients.

Methods From July, 2018 to June, 2019, 54 stroke patients from the Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, were randomly divided into groups A, B and C, with 18 cases in each group. All the patients received routine medication and rehabilitation training, while group A accepted 60 minutes of MT, group B accepted 20 minuts of atDCS first and then 40 minuts of MT, and group C accepted 40 minutes of MT first and then 20 minuts of atDCS in addittion; for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), Motor Assessment Scale (MAS) and modified Barthel Index (MBI) before and after treatment.

Results The main effect of time was significant in scores of FMA-UE (F = 159.811, P < 0.001), ARAT (F = 353.227, P < 0.001), MAS (F = 513.494, P < 0.001) and MBI (F = 85.982, P < 0.001), and all of them improved after treatment. The main effect of groups was significant in scores of FMA-UE (F = 12.502, P < 0.001), ARAT (F = 20.095, P < 0.001), MAS (F = 16.371, P < 0.001) and MBI (F = 11.882, P < 0.001). The interacted-effect between time and groups was significant in scores of FMA-UE (F = 37.659, P < 0.001), ARAT (F = 78.681, P < 0.001), MAS (F = 97.997, P < 0.001) and MBI (F = 48.015, P < 0.001); while all the scores were the best in group B (P < 0.01), and there was no significant difference between groups A and C (P > 0.05).

Conclusion The combination of atDCS first and then MT can promote the recovery of motor function of the affected limbs for stroke patients.

Key words: stroke, transcranial direct current stimulation, mirror therapy, upper limb, motor function

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