重复经颅磁刺激疗法对痉挛型偏瘫儿童平衡功能及生活质量的影响

Clinical effect of repeated transcranial magnetic stimulation therapy on the balance function and life quality of children with spastic hemiplegia

目的探讨高频结合低频经颅磁刺激(TMS)疗法对痉挛型偏瘫儿童平衡功能和日常生活能力的影响。方法2018年6月至2019年12月在广东省妇幼保健院确诊并治疗的痉挛型偏瘫儿童40例,随机分为观察组和对照组各20例。在常规康复训练的基础上观察组受损半球给予高频TMS疗法治疗,未受损半球给予低频TMS疗法治疗;对照组受损侧半球给予高频TMS疗法治疗,未受损侧半球给予伪刺激治疗,两组均治疗3个月。均于治疗前后应用Berg平衡量表(BBS)、儿童功能独立性量表(WeeFIM)及儿童生活质量量表(PedsQLTM)进行疗效评估。结果治疗后两组BBS评分、WeeFIM评分、PedsQLTM评分均较治疗前提高,且观察组评分高于对照组,差异有统计学意义(P<0.05)。结论高频结合低频TMS疗法可改善痉挛型偏瘫儿童的平衡功能及功能独立性,从而提高其日常生活活动能力,改善生活质量。

Objective To explore the effect of high-frequency combined with low-frequency transcranial magnetic stimulation(TMS)therapy on balance function and daily living ability of children with spastic hemiplegia.Methods Totally 40 children with spastic hemiplegia,who were diagnosed and treated in Guangdong Women and Children’s Hospital from June 2018 to December 2019,were randomly divided into experimental group(n=20)and control group(n=20).On the basis of routine rehabilitation training,the experimental group was treated with high-frequency TMS in the damaged hemisphere,while the undamaged hemisphere was treated with low-frequency TMS;the control group was treated with high-frequency TMS in the damaged hemisphere,while the undamaged hemisphere was treated with pseudo-stimulation;both groups were treated for 3 months.Before and after the treatment,all patients were assessed with Berg Balance Scale(BBS),Functional Independence Measure Children’s Edition(WeeFIM)and Pediatric Quality of Life Inventory Measurement(PedsQLTM).Results After treatment,the BBS score,WeeFIM score and PedsQLTM score of the two groups were higher than those before treatment,and the scores of the experimental group were higher than those of the control group(P<0.05).Conclusion High-frequency combined with low-frequency TMS therapy can improve the balance function and functional independence of children with spastic hemiplegia,and improve their ability of daily life activities and quality of life.