经颅磁刺激联合多感官游戏训练对脑卒中后上肢痉挛患者上肢运动功能的影响

Effect of Transcranial Magnetic Stimulation Combined with Multisensory Game Training on Upper Limb Motor Function in Patients with Upper Limb Spasticity after Stroke

目的分析经颅磁刺激联合多感官游戏训练对脑卒中后上肢痉挛患者上肢运动功能的影响。方法选取该院2021年7月—2022年7月收治的58例脑卒中后上肢痉挛障碍患者为研究对象,按照随机数字表法分为两组,各29例。对照组患者采用多感官游戏训练,观察组患者于此基础上加用经颅磁刺激治疗,两组均持续治疗4周。对比治疗前、后两组患者的改良Ashworth量表、Fugl-Meyer上肢运动障碍评估量表(FMA-UL)、改良Barthel指数(MBI)评分的变化情况。结果治疗4周后,观察组的肩外展、肩前屈评分分别为(0.59±0.87)分、(0.31±0.61)分,与对照组的(0.94±1.01)分、(0.55±0.82)分相当,组间差异无统计学意义(P>0.05);观察组的伸肘、屈肘评分分别为(1.18±0.77)分、(1.24±0.63)分,均低于对照组的(1.69±0.92)分、(1.68±0.85)分,观察组的FMA-UL、MBI评分分别为(43.66±10.67)分、(71.33±8.64)分,均高于对照组的(32.55±8.07)分、(61.44±7.59)分,组间差异有统计学意义(P<0.05)。结论经颅磁刺激联合多感官游戏训练可明显改善患者的上肢痉挛程度,提高患者的上肢运动能力,进一步改善患者的日常生活活动能力。

Objective To analyze the effects of transcranial magnetic stimulation combined with multi-sensory play training on upper limb motor function in patients with upper limb spasm after stroke.Methods 58 patients with upper limb spasm disorder after stroke admitted to the hospital from July 2021 to July 2022 were selected as the study objects,and were divided into two groups according to random number table method,with 29 cases each.Patients in the control group received multi-sensory game training,and patients in the observation group were treated with transcranial magnetic stimulation on the basis of this,and both groups were treated for 4 weeks.The changes of the modified Ashworth Scale,Fugl-Meyer Upper Limb Motor Impairment Assessment Scale(FMA-UL)and modified Barthel index(MBI)scores were compared between the two groups before and after treatment.Results After 4 weeks of treatment,the scores of shoulder abduction and shoulder flexion were(0.59±0.87)points,(0.31±0.61)points in the observation group were similar to(0.94±1.01)points and(0.55±0.82)points in the control group,with no statistical significance between the groups(P>0.05).The scores of elbow extension and elbow flexion were(1.18±0.77)points,(1.24±0.63)points in the observation group were lower than(1.69±0.92)points and(1.68±0.85)points of the control group.The FMA-UL and MBI scores of the observation group were(43.66±10.67)points and(71.33±8.64)points,respectively,which were higher than(32.55±8.07)points and(61.44±7.59)points of the control group,and the difference was statistically significant between the groups(P<0.05).Conclusion Transcranial magnetic stimulation combined with multi-sensory game training can significantly improve the degree of spasticity of the upper limb,improve the upper limb motor ability,and further improve the ability of daily living.