运动前区高频重复经颅磁刺激对脑卒中上肢功能康复的疗效

doi:10.3969/j.issn.1006-9771.2020.06.014

Abstract

Abstract:

Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in hemiplegic patients after stroke.Methods From August, 2018 to July, 2019, 60 patients with hemiplegia after stroke were randomly divided into control group (n = 30) and observation group (n = 30). Both groups received conventional treatment. The observation group accepted 5 Hz rTMS to ipsilesional hemisphere premotor areas for three weeks. The control group received sham stimulation. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Brunnstrom stages, modified Ashworth Scale (MAS), modified Barthel Index (MBI) and Wolf Motor Function Test before and after treatment.Results Two patients dropped in the control group. After treatment, the scores of FMA-UE, MBI and Wolf Motor Function Test improved in both groups (|t| > 3.686, P< 0.01), and the difference values of FMA-UE and Wolf Motor Function Test before and after treatment were more in the observation group than in the control group (|t| > 2.119, P< 0.05).Conclusion High-frequency rTMS to ipsilesional hemisphere premotor areas could improve the recovery of upper limb and hand motor function in hemiplegic patients after stroke.

Key words: stroke, repetitive transcranial magnetic stimulation, premotor areas, upper limb, hand function, rehabilitation

CLC Number:

R743.3

ZHOU Zhe,SHEN Xia-feng,XIONG Li,ZHANG Wen,HUANG Hong-yan,ZHANG Ping,WU Yi,RONG Ji-feng. Effects of High-frequency Repetitive Transcranial Magnetic Stimulation to Premotor Areas on Upper Limb Motor Dysfunction after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(6): 697-702.

Figures/Tables 7

References 30

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组别	n	性别(n)		年龄(岁)	病程(月)	偏瘫侧(n)		病变性质(n)
组别	n	男	女	年龄(岁)	病程(月)	左	右	脑梗死	脑出血
对照组	28	19	9	61.75±11.43	10.50±7.38	12	16	16	12
观察组	30	22	8	59.73±10.41	10.70±7.57	16	14	20	10
χ²/t值		0.210		-0.703	0.102	0.637		0.558
P值		0.647		0.485	0.919	0.425		0.455

组别	n	治疗前	治疗后	差值	t值	P值
对照组	28	30.04±18.33	32.21±19.19	2.18±2.42	-4.764	< 0.001
观察组	30	26.73±15.48	32.20±16.66	5.47±8.12	-3.686	0.001
t值		-0.743	-0.003	2.119
P值		0.461	0.998	0.041

组别	n	治疗前						治疗后						Z值	P值
组别	n	Ⅰ	Ⅱ	Ⅲ	Ⅳ	Ⅴ	Ⅵ	Ⅰ	Ⅱ	Ⅲ	Ⅳ	Ⅴ	Ⅵ	Z值	P值
对照组	28	6	4	5	6	7	0	5	5	4	5	6	3	-0.067	0.946
观察组	30	6	8	5	6	5	0	2	8	9	2	8	1	-0.541	0.589
Z值		-1.617						-0.886
P值		0.106						0.376

组别	n	治疗前						治疗后						Z值	P值
组别	n	Ⅰ	Ⅱ	Ⅲ	Ⅳ	Ⅴ	Ⅵ	Ⅰ	Ⅱ	Ⅲ	Ⅳ	Ⅴ	Ⅵ	Z值	P值
对照组	28	1	9	5	6	7	0	0	9	4	6	7	2	-0.036	0.971
观察组	30	8	10	3	3	3	3	4	9	5	5	3	4	-0.588	0.556
Z值		-0.919						-1.761
P值		0.358						0.078

组别	n	治疗前	治疗后	Z值	P值
对照组	28	0.37±0.57	0.34±0.56	-0.577	0.564
观察组	30	0.57±0.60	0.33±0.48	-1.950	0.051
Z值		-1.249	-0.096
P值		0.212	0.923

Effects of High-frequency Repetitive Transcranial Magnetic Stimulation to Premotor Areas on Upper Limb Motor Dysfunction after Stroke

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组别	n	治疗前	治疗后	差值	t值	P值
对照组	28	49.96±20.75	56.07±20.58	6.11±5.38	-6.010	< 0.001
观察组	30	49.50±22.82	57.33±23.68	7.83±9.64	-4.455	< 0.001
t值		-0.081	0.216	0.834
P值		0.936	0.830	0.408

组别	n	治疗前	治疗后	差值	t值	P值
对照组	28	39.54±25.31	42.15±25.78	2.61±2.94	-4.699	< 0.001
观察组	30	31.40±24.66	36.27±26.96	4.87±4.59	-5.805	< 0.001
t值		-1.240	-0.847	2.248
P值		0.220	0.401	0.029

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