低频重复经颅磁刺激联合智能运动反馈训练对恢复期脑卒中患者上肢运动功能的影响

Impacts of low-frequency repetitive transcranial magnetic stimulation combined with intelligent motor feedback training on motor function of upper extremity in patients with stroke at recovery stage

目的探讨低频重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)联合智能运动反馈训练对恢复期脑卒中患者上肢运动功能的影响。方法前瞻性选取丽水市第二人民医院2018年1月至2019年12月收治的恢复期脑卒中患者200例为本次研究对象,随机分为两组,对照组与观察组,每组各100例。对照组开展常规康复训练,观察组开展低频rTMS联合智能运动反馈训练,观察比较两组患者治疗前后上肢肌力、上肢被动牵拉力、上肢功能恢复情况及不良事件发生情况。结果治疗前,两组患者上肢肌力、上肢被动牵拉力、上肢功能比较,差异均无统计学意义(P>0.05),治疗后观察组患侧上臂肌力、伸腕肌力、屈腕肌力等级明显提升,优于对照组;上肢被动牵拉力明显下降,低于对照组;FMA、MBI评分明显高于对照组,差异有统计学意义(P<0.05);两组患者治疗过程中均未发生严重不良反应。结论低频rTMS联合智能运动反馈训练可安全、有效促进恢复期脑卒中患者上肢运动功能恢复。

Objective To investigate the impacts of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with intelligent motor feedback training on motor function of upper extremity in patients with stroke at recovery stage.Methods A total of 200 patients with stroke admitted to the Second People′s Hospital of Lishui during the recovery stage from January 2018 to December 2019 were prospectively selected as the research subjects and were randomly divided into the control group(n=100)and the observation group(n=100).The control group was given conventional rehabilitation training,while the observation group was given low frequency rTMS combined with intelligent motor feedback training.The muscle strength of upper extremity,passive stretch strength of upper extremity,function recovery of upper extremity and incidence of adverse events of the two groups before and after treatment were observed and compared.Results Before treatment,the differences in the muscle strength of upper extremity,passive stretch strength of upper extremity,and function of upper extremity between the two groups were not statistically significant(P>0.05).After treatment,the grades of muscle strength of upper extremity,muscle strength of wrist extension,and muscle strength of wrist flexion on the affected side in the observation group were significantly improved,which were superior to those in the control group.The passive stretch strength of upper extremity was significantly decreased and lower than that of the control group.The FMA and MBI scores were significantly higher than those in the control group,with statistically significant differences(P<0.05).There was no serious adverse reaction observed in the treatment process of the two groups of patients.Conclusion Low frequency rTMS combined with intelligent motor feedback training can safely and effectively promote the motor function recovery of upper extremity in patients with stroke at recovery stage.