本体感觉神经肌肉促进绳带训练联合重复经颅磁刺激对脑卒中偏瘫患者上肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2023.03.003

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (3): 262-268.doi: 10.3969/j.issn.1006-9771.2023.03.003

• 专题非侵入式神经调控技术在康复中的应用 • 上一篇下一篇

本体感觉神经肌肉促进绳带训练联合重复经颅磁刺激对脑卒中偏瘫患者上肢运动功能的效果

梁天佳, 龙耀斌(), 陆丽燕, 周金英, 黄福才, 邬映超, 龙耀翔, 韦小翠

广西医科大学第二附属医院康复医学科，广西南宁市 530007

收稿日期:2022-09-26 修回日期:2022-12-16 出版日期:2023-03-25 发布日期:2023-04-14
通讯作者: 龙耀斌 E-mail:ltj668@163.com
作者简介:梁天佳(1975-)，男，壮族，广西南宁市人，硕士，主任医师，主要研究方向：康复医学。
基金资助:
1. 广西医疗卫生适宜技术开发与推广应用项目(S2019010);广西医疗卫生适宜技术开发与推广应用项目(S2019010);2. 广西医疗卫生重点学科建设项目(桂卫科教发〔2022〕4号)

Effect of proprioceptive neuromuscular facilitation rope training and repetitive transcranial magnetic stimulation on upper limb motor function of stroke patients with hemiplegia

LIANG Tianjia, LONG Yaobin(), LU Liyan, ZHOU Jinying, HUANG Fucai, WU Yingchao, LONG Yaoxiang, WEI Xiaocui

Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China

Received:2022-09-26 Revised:2022-12-16 Published:2023-03-25 Online:2023-04-14
Contact: LONG Yaobin E-mail:ltj668@163.com
Supported by:
Guangxi Medical and Health Appropriate Technology Development, Promotion and Application(S2019010);Guangxi Medical and Health Appropriate Technology Development, Promotion and Application(S2019010);Guangxi Medical and Health Key Discipline Construction ([2022]4)

摘要/Abstract

摘要：

目的探讨本体感觉神经肌肉促进(PNF)绳带训练联合重复经颅磁刺激(rTMS)对脑卒中偏瘫患者上肢运动功能的效果。

方法 2021年3月至2022年2月，广西医科大学第二附属医院康复医学科的脑卒中偏瘫住院患者90例随机分为对照组、绳带组和联合组，每组各30例。3组均接受常规康复治疗，对照组接受PNF训练，绳带组接受PNF绳带训练，联合组接受PNF绳带训练和rTMS，共4周。治疗前后，采用偏瘫上肢功能测试(香港版)(FTHUE-HK)、Fugl-Meyer评定量表上肢部分(FMA-UE)和改良Barther指数(MBI)进行评定。

结果治疗后，3组FTHUE-HK、FMA-UE和MBI评分均提高(t > 2.167, P < 0.05)，联合组优于绳带组(P < 0.05)，绳带组优于对照组(P < 0.05)。

结论 PNF绳带训练联合rTMS改善脑卒中偏瘫患者上肢运动功能的效果优于单纯PNF训练。

关键词: 脑卒中, 上肢, 运动功能, 绳带疗法, 本体感觉神经肌肉促进技术, 重复经颅磁刺激

Abstract:

Objective To investigate the effect of combination of proprioceptive neuromuscular facilitation (PNF) rope training and repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function of stroke patients with hemiplegia.

Methods From March, 2021 to February, 2022, 90 stroke inpatients with hemiplegia in the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangxi Medical University were divided into control group (n = 30), rope group (n = 30) and combination group (n = 30) randomly. All the groups received routine rehabilitation, while the control group received routine PNF training, the rope group received PNF rope training, and the combination group received PNF rope training and rTMS, for four weeks. They were assessed with Functional Test for the Hemiplegic Upper Extremity-Hong Kong version (FTHUE-HK), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment.

Results The scores of FTHUE-HK, FMA-UE and MBI increased in all the three groups after treatment (t > 2.167, P < 0.05), and they were more in the combination group than in the rope group (P < 0.05), and in the rope group than in the control group (P < 0.05).

Conclusion The combination of PNF rope training and rTMS is more effective on motor function of upper limbs of stroke patients with hemiplegia than PNF training alone.

Key words: stroke, upper extremity, motor function, rope therapy, proprioceptive neuromuscular facilitation, repetitive transcranial magnetic stimulation

中图分类号:

R743.3

梁天佳, 龙耀斌, 陆丽燕, 周金英, 黄福才, 邬映超, 龙耀翔, 韦小翠. 本体感觉神经肌肉促进绳带训练联合重复经颅磁刺激对脑卒中偏瘫患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(3): 262-268.

LIANG Tianjia, LONG Yaobin, LU Liyan, ZHOU Jinying, HUANG Fucai, WU Yingchao, LONG Yaoxiang, WEI Xiaocui. Effect of proprioceptive neuromuscular facilitation rope training and repetitive transcranial magnetic stimulation on upper limb motor function of stroke patients with hemiplegia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(3): 262-268.

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(梗死/出血)/n	偏瘫侧(左/右)/n
对照组	30	18/12	56.02±6.94	116.57±15.21	19/11	14/16
绳带组	30	19/11	54.57±7.83	118.42±16.19	20/10	11/19
联合组	30	17/13	55.16±7.19	115.32±15.81	18/12	12/18
χ²/F值		0.278	0.297	0.295	0.287	0.643
P值		0.870	0.744	0.746	0.866	0.725

组别	n	治疗前	治疗后	t值	P值
对照组	30	2.48±1.02	3.13±1.07	2.408	0.019
绳带组	30	2.55±1.06	3.71±1.08^a	4.199	< 0.001
联合组	30	2.62±1.05	4.29±1.12^a,b	5.958	< 0.001
F值		0.135	8.491
P值		0.874	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	29.85±5.26	33.24±5.47	2.447	0.018
绳带组	30	28.58±5.06	36.75±5.56^a	2.465	0.017
联合组	30	27.67±5.18	39.87±5.71^a,b	8.668	< 0.001
F值		1.347	10.597
P值		0.265	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	44.85±9.32	50.13±9.55	2.167	0.034
绳带组	30	43.18±8.15	55.38±9.46^a	5.352	< 0.001
联合组	30	45.27±9.18	60.98±9.87^a,b	6.384	< 0.001
F值		0.463	9.527
P值		0.631	< 0.001

本体感觉神经肌肉促进绳带训练联合重复经颅磁刺激对脑卒中偏瘫患者上肢运动功能的效果

Effect of proprioceptive neuromuscular facilitation rope training and repetitive transcranial magnetic stimulation on upper limb motor function of stroke patients with hemiplegia

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