经颅直流电刺激对脑卒中患者上肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2023.03.005

摘要/Abstract

摘要：

目的观察经颅直流电刺激(tDCS)对脑卒中偏瘫患者上肢运动功能的影响。

方法选取2020年10月至2021年10月武汉市第一医院收治的65例脑卒中偏瘫患者，随机分为对照组(n = 32)和观察组(n = 33)，两组均接受常规康复和镜像疗法，观察组增加tDCS，共4周。治疗前后，采用Fugl-Meyer评定量表上肢部分(FMA-UE)、上肢动作研究量表(ARAT)和改良Barthel指数(MBI)进行评定。

结果治疗后，两组FMA-UE、ARAT和MBI评分均显著改善(|t| > 10.455, Z = -2.793, P < 0.001)，观察组各项评分均高于对照组(|t| > 4.152, Z = -2.045, P < 0.05)。

结论联合应用tDCS可有效促进脑卒中患者上肢运动功能恢复。

关键词: 脑卒中, 偏瘫, 经颅直流电刺激, 上肢, 运动功能

Abstract:

Objective To observe the effect of transcranial direct current stimulation (tDCS) on motor function of upper limbs of stroke patients with hemiplegia.

Methods From October, 2020 to October, 2021, 65 patients from Wuhan No.1 Hospital were randomly divided into control group (n = 32) and observation group (n = 33). All the patients received routine rehabilitation and mirror therapy, and the observation group received tDCS in addition, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel index (MBI) before and after treatment.

Results The scores of FMA-UE, ARAT and MBI improved in the both groups after treatment (|t| > 10.455, Z = -2.793, P< 0.001), and all the scores were better in the observation group than in the control group (|t| > 4.152, Z = -2.045, P< 0.05).

Conclusion The combination of tDCS can effectively promote the recovery of upper limb motor function of stroke patients.

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

中图分类号:

R743.3

庞争争, 吕亚希, 高春华, 于利国, 张环. 经颅直流电刺激对脑卒中患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(3): 275-279.

PANG Zhengzheng, LÜ Yaxi, GAO Chunhua, YU Liguo, ZHANG Huan. Effect of transcranial direct current stimulation on upper limb motor function of patients with stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(3): 275-279.

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中性质(出血/梗死)/n	偏瘫侧(左/右)/n
对照组	32	17/15	64.52±5.21	27.62±4.17	14/18	17/15
观察组	33	19/14	63.93±4.98	28.23±4.78	13/20	16/17
χ²/t值		0.081	0.513	0.372	0.063	< 0.001
P值		0.793	0.682	0.716	0.834	0.974

组别	n	治疗前	治疗后	t值	P值
对照组	32	13.91±5.78	27.97±8.15	10.455	< 0.001
观察组	33	14.74±6.25	38.23±6.17	15.343	< 0.001
t值		0.963	4.152
P值		0.329	< 0.001

组别	n	治疗前	治疗后	Z值	P值
对照组	32	1.19±4.21	4.79±10.46	-2.793	< 0.001
观察组	33	1.28±4.32	10.21±14.58	-3.427	< 0.001
Z值		-0.867	-2.045
P值		0.390	0.030

组别	n	治疗前	治疗后	t值	P值
对照组	32	27.45±5.94	37.42±5.98	-11.676	< 0.001
观察组	33	29.23±7.54	62.81±13.41	-10.659	< 0.001
t值		2.894	-7.989
P值		0.057	< 0.001