耳迷走神经电刺激联合双任务训练对缺血性脑卒中患者上肢功能的效果

doi:10.3969/j.issn.1006-9771.2025.05.003

Abstract

Abstract:

Objective To explore the effect of transcutaneous auricular vagus nerve stimulation (taVNS) combined with dual-task training (DTT) on upper limb function recovery in patients with ischemic stroke.
Methods From January to October, 2024, 60 ischemic stroke patients with upper limb dysfunction admitted to Zhejiang Rehabilitation Medical Center were selected and randomly divided into control group (n = 30) and observation group (n = 30). Both groups received conventional rehabilitation training. The control group underwent sham-taVNS combined with DTT, while the observation group received active taVNS combined with DTT, for four weeks. Before and after treatment, they were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), modified Barthel Index (MBI) and motor-evoked potential (MEP) tests.
Results The FMA-UE scores, ARAT scores, MBI scores, MEP amplitude and MEP latency improved in both groups after treatment (|t| > 3.670, P < 0.01), and were superior in the observation group than in the control group (|t| > 3.081, P < 0.01).
Conclusion The combination of taVNS and DTT can significantly improve upper limb function, enhance activities of daily living, and promote neurological recovery in patients with ischemic stroke.

Key words: ischemic stroke, upper limb, dysfunction, transcutaneous auricular vagus nerve stimulation, dual-task training, motor-evoked potential

CLC Number:

R743.3

ZOU Congcong, WANG Xiaojun, MA Jinrong, LU Shangbo, DING Yong, WANG Hani, SONG Jianfei. Effect of transcutaneous auricular vagus nerve stimulation combined with dual-task training on upper limb function in patients with ischemic stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 513-519.

Figures/Tables 5

Table 1

Table 2

Comparison of FMA-UE scores between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	24.37±4.51	-5.258	< 0.001
		后测	31.63±5.29
观察组	30	前测	23.80±4.22	-7.392	< 0.001
		后测	36.50±6.85
治疗前两组均值差			0.57±1.13	0.502	0.617
治疗后两组均值差			-4.87±1.58	-3.081	0.003

Table 2

Table 3

Comparison of ARAT scores between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	20.20±4.05	-3.745	0.001
		后测	24.57±5.06
观察组	30	前测	19.47±4.17	-7.848	< 0.001
		后测	29.63±5.86
治疗前两组均值差			0.73±1.06	0.691	0.492
治疗后两组均值差			-5.07±1.41	-3.584	0.001

Table 3

Table 4

Comparison of MBI scores between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	44.47±6.04	-5.261	< 0.001
		后测	52.80±7.01
观察组	30	前测	44.33±5.25	-14.441	< 0.001
		后测	64.80±8.00
治疗前两组均值差			0.13±1.46	0.091	0.928
治疗后两组均值差			12.00±1.94	-6.179	< 0.001

Table 4

Table 5

Comparison of MEP between two groups pre- and post-treatment"

变量	组别	n	测试	$x - ± s$	t值	P值
MEP振幅/µV	对照组	30	前测	318.63±109.43	-6.450	< 0.001
			后测	539.40±147.47
	观察组	30	前测	312.40±105.78	-11.984	< 0.001
			后测	712.53±174.45
	治疗前两组均值差			6.23±27.79	0.224	0.823
	治疗后两组均值差			-173.13±41.71	-4.151	< 0.001
MEP潜伏期/ms	对照组	30	前测	28.54±1.52	3.670	0.001
			后测	27.19±1.65
	观察组	30	前测	28.70±1.95	9.087	< 0.001
			后测	25.22±1.46
	治疗前两组均值差			-0.16±0.45	-0.362	0.719
	治疗后两组均值差			1.98±0.40	4.920	< 0.001

Table 5

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组别	n	性别(男/女)/n	年龄/岁	病程/d	病灶部位 (左/右)/n	上肢Brunnstrom分期/期
组别	n	性别(男/女)/n	年龄/岁	病程/d	病灶部位 (左/右)/n	Ⅰ	Ⅱ	Ⅲ	Ⅳ	Ⅴ	Ⅵ
对照组	30	17/13	53.93±9.91	90.47±39.69	18/12	0	17	8	5	0	0
观察组	30	16/14	53.97±10.18	87.03±40.74	14/16	0	15	11	4	0	0
χ²/t值		0.067	-0.013	0.331	1.071	-0.303
P值		0.795	0.990	0.742	0.301	0.762

Effect of transcutaneous auricular vagus nerve stimulation combined with dual-task training on upper limb function in patients with ischemic stroke

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