低频rTMS联合FES治疗脑卒中恢复期伴下肢痉挛及运动功能障碍患者的效果

Effect of Low Frequency rTMS Combined with FES in the Treatment of Stroke Patients with Lower Limb Spasm and Motor Dysfunction

目的探讨低频重复经颅磁刺激(rTMS)联合功能性电刺激(FES)治疗脑卒中恢复期伴下肢痉挛及运动功能障碍患者的效果。方法方便选取该院2020年11月—2021年5月60例脑卒中恢复期患者作为研究对象,按照计算机分组法分为对照组(31例)和观察组(29例),两组患者均进行常规脑卒中药物治疗和康复治疗,在此基础上,对照组辅以FES治疗,观察组辅以rTMS联合FES治疗。治疗后,评估患者下肢痉挛严重程度、下肢运动功能和日常生活活动能力。结果治疗前,两组各评价指标评分比较,差异无统计学意义(P>0.05);治疗后,两组Fugl-Meyer(FMA)、改良Barthel指数(MBI)评分均较治疗前提高,且观察组FMA(31.18±2.40)分、MBI(84.70±7.23)分高于对照组,差异有统计学意义(t=8.730、11.015,P<0.05);两组改良Ashworth(MAS)评分较治疗前降低,且观察组MAS(1.10±0.08)分低于对照组,两组比较差异有统计学意义(t=12.226,P<0.05)。结论低频rTMS联合FES能有效改善脑卒中恢复期患者的下肢痉挛程度及运动功能,提高患者日常生活活动能力。

Objective To explore the effect of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with functional electrical stimulation(FES)in the treatment of patients with lower limb spasticity and motor dysfunction during the recovery period of stroke.Methods Convenient select from November 2020 to May 2021,60 patients in the recovery period of stroke in this hospital were regarded as the research objects.According to the computer grouping method,the patients were divided into a control group(31 cases)and an observation group(29 cases).The patients in both groups were treated with conventional stroke medication and rehabilitation.On this basis,the control group was supplemented with FES treatment,and the observation group was supplemented with rTMS combined with FES treatment.After treatment,evaluated the severity of lower extremity spasm,lower extremity motor function and activities of daily living.Results Before treatment,there was no statistically significant difference between the two groups of evaluation index scores(P>0.05).After treatment,the scores of Fugl-Meyer(FMA)and Modified Barthel Index(MBI)in the two groups were higher than before treatment,and the FMA(31.18±2.40)points and MBI(84.70±7.23)points of the observation group were higher than those of the control group.The difference was statistically significant(t=8.730,11.015,P<0.05).The modified Ashworth(MAS)score of the two groups was lower than before treatment,and the MAS(1.10±0.08)points of the observation group was lower than that of the control group.The difference between the two groups was statistically significant(t=12.226,P<0.05).Conclusion Low-frequency rTMS combined with FES can effectively improve the degree of lower extremity spasm and motor function in patients with stroke recovery,and improve the patients'activities of daily living.