多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激对脑卒中患者手部运动和触压觉的效果

doi:10.3969/j.issn.1006-9771.2025.04.011

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (4): 458-465.doi: 10.3969/j.issn.1006-9771.2025.04.011

多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激对脑卒中患者手部运动和触压觉的效果

刘鹏程^1a^,^1b^,^1c, 屈萌艰^1a^,^1b^,^1c, 龙黎萍^1a^,^1b^,^1c, 王亚琳^1a^,^1b^,^1c, 阳明珠^1a^,^1b^,^1c, 刘培勇^1a^,^1b^,^1c, 周君^1a^,^1b^,^1c(), 刘静^1a^,^1b^,^1c()

1.南华大学附属第一医院，a.康复医学中心;b.康复医学科;c.康复医学实验室，湖南衡阳市 421001

收稿日期:2024-12-06 修回日期:2025-03-05 出版日期:2025-04-25 发布日期:2025-04-25
通讯作者: 周君(1980-)，男，汉族，湖南衡阳市人，博士，主任医师，主要研究方向：神经康复、骨科康复，E-mail: zhoujun8005@163.com；刘静(1986-)，女，汉族，湖南衡阳市人，硕士，副主任医师，主要研究方向：神经康复、重症康复、呼吸康复。E-mail: liujing724@163.com
作者简介:刘鹏程(1990-)，男，汉族，湖南衡阳市人，硕士，主管技师，主要研究方向：脑卒中康复及神经调控技术相关研究。
基金资助:
1.南华大学临床医学4310项目(20214310NHYCG07);2.湖南省临床医疗技术创新引导项目(2021SK51805);3.南华大学附属第一医院新技术新项目培育项目(2022PY016)

Effect of pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke

LIU Pengcheng^1a^,^1b^,^1c, QU Mengjian^1a^,^1b^,^1c, LONG Liping^1a^,^1b^,^1c, WANG Yalin^1a^,^1b^,^1c, YANG Mingzhu^1a^,^1b^,^1c, LIU Peiyong^1a^,^1b^,^1c, ZHOU Jun^1a^,^1b^,^1c(), LIU Jing^1a^,^1b^,^1c()

1a. Rehabilitation Medicine Center, b. Department of Rehabilitation, c. Rehabilitation Laboratory, the First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China

Received:2024-12-06 Revised:2025-03-05 Published:2025-04-25 Online:2025-04-25
Contact: ZHOU Jun, E-mail: zhoujun8005@163.com; LIU Jing, E-mail: liujing724@163.com
Supported by:
University of South China 4310 Project of Clinical Medicine(20214310NHYCG07);Hunan Provincial Clinical Medical Technology Innovation Guidance Project(2021SK51805);Cultivation Project of New Technology and New Projects of the First Affiliated Hospital of University of South China(2022PY016)

摘要/Abstract

摘要：

目的探讨多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激对脑卒中患者手部运动和触压觉的效果。
方法 2023年5月至2024年10月，南华大学附属第一医院62例脑卒中患者，随机分为对照组(n = 31)和试验组(n = 31)。两组均接受常规康复治疗，并接受健侧大脑初级运动皮质区1 Hz低频重复经颅磁刺激，试验组接受多重感觉刺激模态的气电手训练系统训练，共4周。治疗前后，采用Fugl-Meyer评定量表上肢部分(FMA-UE)、运动功能评估量表(MAS)、单丝测试(SWMT)和改良Barthel指数(MBI)进行评估。
结果对照组和试验组各脱落1例。治疗后，两组FMA-UE、MAS和MBI评分，试验组SWMT评分均显著提高(|t| > 5.464, P < 0.001)，且各项指标试验组均优于对照组(|t| > 2.195, P < 0.05)。
结论多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激可以改善脑卒中患者手部的运动和触压觉功能，提高日常生活活动能力。

关键词: 脑卒中, 手功能, 气电手训练系统, 多感觉刺激, 低频重复经颅磁刺激

Abstract:

Objective To explore the effect of the pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke.
Methods From May, 2023 to October, 2024, 62 stroke patients from the First Affiliated Hospital of University of South China were randomly divided into control group (n = 31) and experimental group (n = 31). Both groups received conventional rehabilitation, and 1 Hz low-frequency repetitive transcranial magnetic stimulation in the primary cerebral motor cortex on the unaffected side, while the experimental group received the pneumatic and electric hand training system with multiple sensory stimulation modalities in addition, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Motor Assessment Scale (MAS), Semmes Weinstein Monofilament Test (SWMT) and modified Barthel index (MBI) before and after treatment.
Results One case dropped out in control group and one in the experimental group. After treatment, the scores of FMA-UE, MAS, SWMT and MBI increased in both groups (|t| > 5.464, P < 0.001), expect the score of SWMT in the control group (P > 0.05), and all scores were better in the experimental group than in the control group (|t| > 2.195, P < 0.05).
Conclusion The pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation can improve the motor and tactile pressure function of stroke patients, and improve their activity of daily living.

Key words: stroke, hand function, pneumatic and electric hand training system, multisensory stimulation, low-frequency repetitive transcranial magnetic stimulation

中图分类号:

R743.3

刘鹏程, 屈萌艰, 龙黎萍, 王亚琳, 阳明珠, 刘培勇, 周君, 刘静. 多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激对脑卒中患者手部运动和触压觉的效果[J]. 《中国康复理论与实践》, 2025, 31(4): 458-465.

LIU Pengcheng, QU Mengjian, LONG Liping, WANG Yalin, YANG Mingzhu, LIU Peiyong, ZHOU Jun, LIU Jing. Effect of pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 458-465.

图/表 5

表1

表2

两组治疗前后FMA-UE评分比较"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	13.93±13.01	-8.740	< 0.001
		后测	19.93±15.38
试验组	30	前测	15.40±13.48	-8.887	< 0.001
		后测	23.83±13.39
治疗前两组均值差			-1.47±3.42	-0.304	0.557
治疗后两组均值差			-3.90±3.72	-2.078	0.043

表2

表3

两组治疗前后MAS评分比较"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	14.20±10.94	-5.464	< 0.001
		后测	17.07±10.93
试验组	30	前测	16.50±10.55	-8.523	< 0.001
		后测	21.90±9.95
治疗前两组均值差			-2.30±2.77	-0.829	0.411
治疗后两组均值差			-4.83±2.70	-3.080	0.003

表3

表4

表5

两组治疗前后MBI评分比较"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	46.03±18.48	-7.387	< 0.001
		后测	61.00±19.40
试验组	30	前测	52.00±19.81	-7.460	< 0.001
		后测	71.67±18.21
治疗前两组均值差			-5.97±4.95	-1.206	0.233
治疗后两组均值差			-10.67±4.86	-2.195	0.032

表5

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组别	n	性别(男/女)/n	年龄/岁	病程/d	卒中类型(出血/梗死)/n	偏瘫侧(左/右)/n
对照组	30	24/6	57.97±10.07	27.9(10,39.2)	6/24	17/13
试验组	30	21/9	56.10±11.46	28.6(14,40.0)	9/21	16/14
χ²/t/Z值		0.800	0.670	-0.592	0.800	0.067
P值		0.371	0.506	0.554	0.371	0.795

多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激对脑卒中患者手部运动和触压觉的效果

Effect of pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke

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