低频rTMS联合智能运动反馈训练对脑梗死恢复期患者运动功能的影响

Effect of low-frequency rTMS combined with intelligent motor feedback training on motor function of convalescent patients with cerebral infarction

目的探讨低频重复经颅磁刺激(rTMS)联合智能运动反馈训练对脑梗死恢复期患者神经功能、运动功能的影响。方法回顾性分析2020年7月至2021年5月同济大学附属杨浦医院收治的100例脑梗死恢复期患者的临床资料,依据治疗方式不同分为对照组和观察组各50例。对照组患者给予低频rTMS治疗并配合常规康复治疗,观察组患者在对照组治疗的基础上联合智能运动反馈训练治疗,1周为一个疗程,共治疗4个疗程。治疗4周后比较两组患者的治疗效果,以及治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer运动评分(FMA)、改良Ashworth评分(MAS)和改良Barthel指数量表评分,同时比较两组患者对治疗效果的满意率。结果观察组患者的治疗总有效率为94.00%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组患者的NIHSS、MAS评分降低,且观察组分别为(9.01±1.54)分、(1.31±0.23)分,明显低于对照组的(12.31±1.87)分、(2.34±0.37)分,差异均有统计学意义(P<0.05);治疗后,两组患者的FMA评分、Barthel指数升高,且观察组分别为(30.31±3.09)分、(62.18±6.18)分,明显高于对照组的(23.18±3.14)分、(51.18±5.41)分,差异均有统计学意义(P<0.05);观察组患者对治疗效果的满意率为96.00%,明显高于对照组的80.00%,差异有统计学意义(P<0.05)。结论低频rTMS联合智能运动反馈训练可提高脑梗死恢复期患者的治疗效果,有效改善患者的神经及运动功能,提高日常生活能力,可在临床推广应用。

Objective To explore the effects of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with intelligent motor feedback training on the neurological and motor functions of convalescent patients with cerebral infarction.Methods One hundred convalescent patients with cerebral infarction treated in Yangpu Hospital Affiliated to Tongji University from July 2020 to May 2021 were analyzed retrospectively.According to different treatment methods,they were divided into a control group and an observation group,with 50 cases in each group.The patients in the control group were treated with low-frequency rTMS combined with routine rehabilitation treatment,and the patients in the observation group were treated with intelligent motor feedback training on the basis of the treatment in the control group.All the patients were treated for four courses of treatment,with one week as one course of treatment.After 4 weeks of treatment,the treatment effects were compared.The changes of National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer motor score(FMA),modified Ashworth score(MAS),and modified Barthel index scale before and after treatment were recorded,and the satisfaction rates of the two groups were compared.Results The total effective rate of the observation group was 94.00%,which was significantly higher than 80.00%of the control group(P<0.05).After treatment,the NIHSS and MAS scores of the observation group and the control group significantly decreased,and the scores in the observation group were(9.01±1.54)points,(1.31±0.23)points,significantly lower than(12.31±1.87)points,(2.34±0.37)points of the control group;the FMA score and Barthel index significantly increased,and the scores in the observation group were(30.31±3.09)points,(62.18±6.18)points,significantly higher than(23.18±3.14)points,(51.18±5.41)points in the control group;the differences were all statistically significant(P<0.05).The satisfaction rate of patients in the observation group was 96.00%,which was significantly higher than 80.00%in the control group(P<0.05).Conclusion Low-frequency rTMS combined with intelligent motor feedback training can improve the therapeutic effect of convalescent patients with cerebral infarction,effectively improve their neurological and motor functions,and improve their ability of daily living,which can be popularized and applied in clinic.