重复经颅磁刺激联合步态适应性训练对脑卒中患者运动康复及生活质量的影响

Effects of Repetitive Transcranial Magnetic Stimulation Combined with Gait Adaptive Training on Motor Rehabilitation and Quality of Life in Patients with Stroke

目的研究重复经颅磁刺激联合步态适应性训练对脑卒中患者运动康复及生活质量的影响。方法选取2020年1月-2021年10月在我院诊治的60例脑卒中患者为研究对象,采用随机数字表法分为对照组和观察组,各30例。对照组采用常规康复治疗,观察组在对照组基础上给予重复经颅磁刺激联合步态适应性训练康复治疗,比较两组Fugl-Meyer运动功能评分、生活质量(SF-36)评分、步态功能指标、卒中患者运动功能(MAS)评分、Holden步行能力分级以及不良反应发生情况。结果两组Fugl-Meyer评分、SF-36评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组步频、步速、6 min步行试验距离均大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05);两组MAS评分均高于治疗后,且观察组高于对照组,差异有统计学意义(P<0.05);观察组步行能力4级、5级占比均大于对照组,3级占比小于对照组,差异有统计学意义(P<0.05),1级、2级占比小于对照组,差异无统计学意义(P>0.05);两组均未发生头痛、头晕等不良反应。结论脑卒中患者给予重复经颅磁刺激联合步态适应性训练康复治疗,可提高患者生活质量,改善运动功能,提升步行功能,且不会增加不良反应,是一种确切、可行的康复治疗方案。

Objective To study the effect of repetitive transcranial magnetic stimulation combined with gait adaptive training on motor rehabilitation and quality of life in patients with stroke.Methods A total of 60 patients with stroke in our hospital from January 2020 to October 2021 were selected and randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with conventional rehabilitation therapy,and the observation group was treated with repetitive transcranial magnetic stimulation combined with gait adaptive training rehabilitation therapy on the basis of the control group.The Fugl-Meyer motor function score,quality of life(SF-36)score,gait function index,motor function(MAS)score of stroke patients,Holden walking ability and incidence of adverse reactions were compared between the two groups.Results The Fugl-Meyer score and SF-36 score of the two groups were higher than those before treatment,and those in the observation group was higher than the control group,the difference was statistically significant(P<0.05).The walking frequency,walking speed and 6 min walking test distance of the two groups were greater than those before treatment,and those in the observation group was greater than the control group,the difference was statistically significant(P<0.05).The MAS scores of the two groups were higher than those after treatment,and that in the observation group was higher than the control group,the difference was statistically significant(P<0.05).The proportion of walking ability grade 4 and 5 in the observation group was higher than that in the control group,and the proportion of grade 3 was lower than that in the control group,the difference was statistically significant(P<0.05);the proportion of grade 1 and grade 2 in the observation group was less than that in the control group,and the difference was not statistically significant(P>0.05).No adverse reactions such as headache or dizziness occurred in both groups.Conclusion Repetitive transcranial magnetic stimulation combined with gait adaptive training can improve the quality of life of stroke patients,improve their motor function and walking function,and do not increase adverse reactions.It is an accurate and feasible rehabilitation therapy.