间歇性θ节律刺激对脑梗死患者偏瘫侧肱二、三头肌表面肌电信号及其功能的影响

The effect of intermittentθburst stimulation on sEMG and function of biceps brachii and triceps in pa?tients with cerebral infarction

目的:了解间歇性θ节律刺激(iTBS)对脑梗死患者偏瘫侧肱二头肌、肱三头肌表面肌电信号(RMS、CR)及其功能的影响。方法:选择符合入选标准的脑梗死偏瘫患者43例,随机分成刺激组(22例)及对照组(21例)。对照组行常规康复,刺激组在常规康复基础上于病灶侧大脑M1区实施为期2周的iTBS刺激。分别于治疗前、治疗2周后采集偏瘫侧肱二头肌、肱三头肌均方根值(RMS)、协同收缩率(CR)及上肢Fugl-Meyer(FMA-UL)评分、改良Barthel指数(MBI)。对数据行统计学分析比较。结果:治疗2周后,两组患者的RMS值、FMA-UL及MBI评分均较治疗前明显增加(P<0.05),CR值均较治疗前显著下降(P<0.01);且刺激组RMS、CR值、FMA-UL及MBI评分变化均较对照组显著(P<0.05)。结论:与单纯常规康复相比,在常规康复基础上联合iTBS刺激更能提高脑梗死患者偏瘫侧上肢肱二头肌、肱三头肌的均方根值,降低其协同收缩率;同时也更有利于脑梗死患者偏瘫侧上肢及整体功能的改善。

Objective:To investigate the effect of intermittent theta burst stimulation(iTBS)on the sEMG signal and function of biceps brachii and triceps in the hemiplegic upper limb of cerebral infarction patients.Method:Forty-three cases of hemiplegic patients with cerebral infarction were selected and randomly divided into two groups.The control group was given routine rehabilitation,and the stimulation group was treated with routine rehabilitation and iTBS in the M1 area of the affected side for two weeks.The RMS,CR,FMA-UL and MBI score were evaluated before and after treatment.Result:In both groups after 2 weeks treatment,the RMS,FMA and MBI scores of patients increased significantly compared with those before treatment(P<0.05),and the CR were significantly lower than before(P<0.01).The changes of all indexes in the stimulation group were more significant than those in the control group(P<0.05).Conclusion:Combining iTBS with routine rehabilitation can obviously increase the RMS values of biceps brachii and triceps and reduce the CR as flexing and stretching the elbow in the hemiplegic upper limb of cerebral infarction patients.Those were beneficial to improve the overall function of the upper limb and activity of daily living.