高频重复经颅磁刺激联合计算机运动反馈训练对脑卒中患者手功能的影响

Efficicy of high frequency repetitive transcranial magnetic stimulation combined with computer motion feedback training on hand function of stroke patients

目的探讨高频重复经颅磁刺激(HF-rTMS)联合计算机运动反馈训练对脑卒中患者手功能的影响。方法将120例脑卒中患者随机分为对照组60例,采取HF-rTMS治疗;研究组60例,采取HF-rTMS治疗联合计算机运动反馈训练,均连续治疗4周。比较治疗前后上肢运动功能、上肢感觉功能、手功能、步行功能、认知功能及生活质量变化。结果治疗后2组患侧手指各项功能评分及FMA评分均增加,腕屈肌MAS评分及触觉阈值、两点辨别觉均减小,研究组变化更明显(P<0.05)。治疗后2组患者FAC评分及步幅、步速、步频均增加,研究组增加更明显(P<0.05)。治疗后2组患者MoCA、SS-QOL评分均增加,研究组变化更明显(P<0.05)。结论HF-rTMS联合计算机运动反馈训练对脑卒中患者上肢运动功能、上肢感觉功能及手功能的改善效果更明显,还有助于患者步行功能、认知功能的改善,提升生活质量。

Objective To explore the efficicy of high frequency repetitive transcranial magnetic stimulation(HF-rTMS)combined with computer motion feedback training on hand function of stroke patients.Methods One hundred and twenty stroke patients were randomly divided into the control group(60 cases,given HF-rTMS treatment)and the research group(60 cases,combined with computer exercise feedback training),they were treated for 4 consecutive weeks.The changes in upper limb motor function,upper limb sensory function,hand function,walking function,cognitive function and quality of life were compared before and after treatment.Results The various functional scores of the affected fingers and FMA scores after treatment of the two groups increased,and the flexor wrist muscle MAS score,tactile threshold and two-point discrimination reduced,the changes of the research group were more obvious(P<0.05).The FAC score and stride length,pace and step frequency after treatment of the two groups increased,and the increase was more significant in the research group(P<0.05).The scores of MoCA and SS-QOL after treatment of the two groups increased,and the changes in the research group were more obvious(P<0.05).Conclusion HF-rTMS combined with computer motion feedback training has more obvious improvement effects on the upper limb motor function,upper limb sensory function and hand function of stroke patients,it also helps to improve walking function and cognitive function,improve the quality of life.