阴极经颅直流电刺激对右侧脑损伤患者上肢及手指运动功能的影响

doi:10.3969/j.issn.1006-9771.2023.01.012

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (1): 82-87.doi: 10.3969/j.issn.1006-9771.2023.01.012

阴极经颅直流电刺激对右侧脑损伤患者上肢及手指运动功能的影响

刘俊明¹^,², 黄富表¹^,²(), 刘静娅¹^,², 杨絮¹^,²

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院作业疗法科，北京市 100068

收稿日期:2022-09-23 修回日期:2022-12-08 出版日期:2023-01-25 发布日期:2023-02-17
通讯作者: 黄富表(1983-)，男，汉族，浙江绍兴市人，博士，副主任治疗师，主要研究方向：作业治疗策略的循证研究，E-mail： huangfubiao123@126.com。
作者简介:刘俊明(1972-)，女，汉族，北京市人，主管治疗师，主要研究方向：偏瘫、截瘫的作业治疗。
基金资助:
1.中国康复研究中心项目(2022ZX-23);2.国家自然科学基金重点支持项目(U1913209)

Effects of cathodic transcranial direct current stimulation on motor function of upper limbs and fingers in patients with right brain injury

LIU Junming¹^,², HUANG Fubiao¹^,²(), LIU Jingya¹^,², YANG Xu¹^,²

1. Capital Medical University School of Rehabilitation Medicine, Beijing, 100068, China
2. Department of Occupational Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2022-09-23 Revised:2022-12-08 Published:2023-01-25 Online:2023-02-17
Contact: HUANG Fubiao, E-mail: huangfubiao123@126.com
Supported by:
China Rehabilitation Research Center Project(2022ZX-23);National Natural Science Foundation of China (Key)(U1913209)

摘要/Abstract

摘要：

目的探讨阴极经颅直流电刺激(ctDCS)对右侧脑损伤(RBI)上肢及手指运动功能障碍的影响。

方法 2020年10月至2022年5月，北京博爱医院住院RBI患者40例，随机分为对照组和试验组，各20例。两组均接受常规药物治疗、常规康复治疗和功能性作业治疗。阴极电极片置于未受损大脑半球M1区，对照组伪刺激，试验组真刺激，共治疗4周。治疗前后，采用Fugl-Meyer评定量表上肢部分(FMA-UE)、Fugl-Meyer评定量表手指部分、改良Barthel指数(MBI)进行评定。

结果治疗后，两组FMA-UE、FMA手指和MBI评分显著提高(t > 5.627, P < 0.001)，且试验组高于对照组(t > 2.161, P < 0.05)。

结论 ctDCS可有效提高RBI患者上肢及手指的运动功能，提高日常生活活动能力。

关键词: 右侧脑损伤, 阴极经颅直流电刺激, 功能性作业治疗, 运动功能, 上肢, 手指

Abstract:

Objective To investigate the effects of cathodic transcranial direct current stimulation (ctDCS) on upper limb and finger dysfunction after right brain injury (RBI).

Methods From October, 2020 to May, 2022, 40 RBI patients in Beijing Bo'ai Hospital were randomly divided into control group and experimental group, with 20 patients in each group. All the patients accepted conventional drug treatment, conventional rehabilitation treatment and functional occupational therapy. The cathode electrode was placed in the M1 area of the uninjured side of brain, then the control group received sham stimulation and the experimental group received stimulation, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and -Finger, and the modified Barthel Index (MBI) before and after treatment.

Results After treatment, the scores of FMA-UE, FMA-Finger and MBI improved in the two groups (t > 5.627, P < 0.001), and improved more in the experimental group than in the control group (t > 2.161, P < 0.05).

Conclusion ctDCS can effectively improve the motor function of upper limbs and fingers of RBI patients, and improve the ability of activities of daily living.

Key words: right brain injury, cathode transcranial direct current, functional occupational therapy, motor function, upper limb, finger

中图分类号:

刘俊明, 黄富表, 刘静娅, 杨絮. 阴极经颅直流电刺激对右侧脑损伤患者上肢及手指运动功能的影响[J]. 《中国康复理论与实践》, 2023, 29(1): 82-87.

LIU Junming, HUANG Fubiao, LIU Jingya, YANG Xu. Effects of cathodic transcranial direct current stimulation on motor function of upper limbs and fingers in patients with right brain injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 82-87.

图/表 4

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组别	n	性别/n		年龄/岁	病程/d
组别	n	男	女	年龄/岁	病程/d
对照组	20	12	8	61.09±6.96	36.95±22.25
试验组	20	13	7	58.32±10.28	36.59±23.68
χ²/t值		0.107		-1.048	-0.052
P值		0.704		0.301	0.958

组别	n	治疗前	治疗后	t值	P值
对照组	20	15.75±18.90	27.65±20.54	7.794	< 0.001
试验组	20	22.65±18.18	38.40±19.91	5.813	< 0.001
t值		1.906	2.612
P值		0.064	0.013

组别	n	治疗前	治疗后	t值	P值
对照组	20	4.70±9.60	8.75±8.61	5.627	< 0.001
试验组	20	5.70±9.40	12.35±10.05	5.837	< 0.001
t值		1.404	2.161
P值		0.168	0.037

组别	n	治疗前	治疗后	t值	P值
对照组	20	47.65±21.56	59.15±20.79	11.607	< 0.001
试验组	20	51.00±19.97	72.50±16.10	8.212	< 0.001
t值		0.510	2.271
P值		0.613	0.029

阴极经颅直流电刺激对右侧脑损伤患者上肢及手指运动功能的影响

Effects of cathodic transcranial direct current stimulation on motor function of upper limbs and fingers in patients with right brain injury

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