高精度经颅直流电刺激联合康复机器人对亚急性期脑卒中患者上肢和手功能的效果

doi:10.3969/j.issn.1006-9771.2023.11.010

Abstract

Abstract:

Objective To investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) combined with rehabilitation robot on upper limb and hand dysfunction in patients with subacute stroke.

Methods From December, 2019 to December, 2021, 50 inpatients with subacute stroke in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 25) and experimental group (n = 25). Both groups received routine rehabilitation therapy, while the control group added sham HD-tDCS combined with rehabilitation robot, and the experimental group added HD-tDCS combined with rehabilitation robot, for four weeks. The upper limb and hand function was assessed with Action Research Arm Test (ARAT), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Motor Assessment Scale (MAS) before and after treatment.

Results After treatment, the scores of ARAT, FMA-UE and MAS increased in the two groups (∣Z∣ > 3.320, t > 6.379, P< 0.01), while the scores of FMA-UE and MAS were higher in the experimental group than in the control group (Z =-2.379, t = 3.181, P< 0.05), as well as the scores of grasping and gross motor of ARAT (∣Z∣ > 2.033, P< 0.05).

Conclusion The combination of HD-tDCS and rehabilitation robot can be more effective on upper limb and hand function in patients with subacute stroke than rehabilitation robot alone.

Key words: stroke, transcranial direct current stimulation, upper limb, rehabilitation robot

CLC Number:

R743.3

ZENG Yaqin, CHENG Ruidong, ZHANG Li, FANG Shan, DAI Yunlan, LÜ Qian, GONG Xinyi, YE Xiangming. Effect of high-definition transcranial direct current stimulation combined with rehabilitation robot on upper limb and hand function in patients with subacute stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(11): 1327-1332.

Figures/Tables 5

References 43

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组别	n	性别 (男/女)/n	年龄/岁	卒中半球 (左/右)/n	卒中类型 (脑梗死/脑出血)/n	病程/月	Brunnstrom分期
组别	n	性别 (男/女)/n	年龄/岁	卒中半球 (左/右)/n	卒中类型 (脑梗死/脑出血)/n	病程/月	上肢	手	下肢
对照组	25	16/9	56.12±12.16	8/17	15/10	1.5(1, 2.25)	2(1.5, 3)	3(1, 3)	3(2, 5)
试验组	25	14/11	59.88±13.54	13/12	17/8	1.25(1, 2)	3(2, 3)	3(1, 3.5)	3(2.5,4.5)
χ²/t/Z值		0.333	1.033	2.053	0.347	-0.586	-0.544	-0.281	-0.391
P值		0.564	0.307	0.152	0.556	0.558	0.586	0.779	0.696

组别	n	治疗前	治疗后	Z值	P值
对照组	25	0(0, 8)	3(0, 12)	-3.320	0.001
试验组	25	3(0, 16.5)	17(0, 34)	-3.726	< 0.001
Z值		-1.772	-1.951
P值		0.241	0.051

组别	n	治疗前	治疗后	Z值	P值
对照组	25	15(5.5, 22.5)	20(9.5, 27.5)	-3.829	< 0.001
试验组	25	16(7.5, 30.5)	34(16, 51)	-4.374	< 0.001
Z值		-0.857	-2.379
P值		0.381	0.017

组别	n	治疗前	治疗后	t值	P值
对照组	25	16.48±10.03	21.08±9.53	6.379	< 0.001
试验组	25	20.96±11.41	30.04±10.37	8.407	< 0.001
t值		1.475	3.181
P值		0.147	0.003

组别	n	抓		握		捏		粗大运动
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	25	0(0, 3)	0(0, 3.5)^a	0(0, 1)	0(0, 1.5)	0(0, 0)	0(0，1)	0(0, 3.5)	3(0, 5.5)^a
试验组	25	0(0, 5.5)	6(0, 12)^a	0(0, 1.5)	1(0, 5)^a	0(0, 2)	0(0，8)	1(0, 5.5)	7(0, 9)^a
Z值		-0.362	-2.174	-0.233	-1.559	-0.661	-1.646	-1.038	-2.033
P值		0.717	0.030	0.816	0.119	0.509	0.100	0.299	0.042

Effect of high-definition transcranial direct current stimulation combined with rehabilitation robot on upper limb and hand function in patients with subacute stroke

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