高频重复经颅磁刺激联合新bobath治疗对脑卒中偏瘫患者上肢功能的影响

Effects of High Frequency Repetitive Transcranial Magnetic Stimulation Combined With New Bobath Concept on Upper Limb Function in Stroke Patients

目的:观察高频重复经颅磁刺激(HF-rTMS)联合新bobath技术治疗对脑卒中偏瘫患者上肢功能的影响。方法:将60例首次发病的脑卒中患者随机分为对照组和观察组,每组30例。2组患者均接受常规康复训练。其中,对照组联合新bobath技术治疗;观察组在对照组基础上联合高频重复经颅磁刺激治疗。两组患者在治疗前和治疗后4周,采用日常生活活动能力改良Barthel指数(MBI)、Fugl-Meyer运动功能评分上肢部分(FMA-UE)、偏瘫上肢功能测试(香港版FTHUE-HK)进行评定。结果:治疗4周后,2组患者的MBI、FMA-UE、FTHUE-HK评分较治疗前提高(P<0.05),且观察组优于对照组(P<0.05)。结论:在常规康复训练的基础上,高频重复经颅磁刺激联合新bobath技术治疗能明显改善脑卒中患者的上肢运动功能及日常生活活动能力,其效果强于仅联合使用新Bobath技术,值得临床推广。

Objective:To observe the effect of high-frequency repetitive transcranial magnetic stimulation(HF-RTMS) combined with new Bobath concept on upper limb function in stroke patients with hemiplegia.Methods:60 patients with first-onset stroke were randomly divided into control group and observation group,30 cases in each group.Both groups received routine rehabilitation training.The control group was treated with the new Bobath concept.The observation group was treated with high-frequency repetitive transcranial magnetic stimulation on the basis of the control group.The modified Barthel index of activities of daily living(MBI),Fugl-Meyer Motor Function Score Upper extremity(FMA-UE) and hemiplegic upper extremity function test(FTHUE-HK)were used to evaluate the patients before and 4 weeks after treatment.Results:After 4 weeks of treatment,the MBI,FMA-UE and FTHUE-HK scores were improved than before treatment(P<0.05),and the observation group was better than the control group(P<0.05).Conclusion:On the basis of routine rehabilitation training,high-frequency repetitive transcranial magnetic stimulation combined with new Bobath technology can significantly improve the upper limb motor function and activities of daily living of stroke patients,and its effect is stronger than that of only combined with new Bobath concept,which is worthy of clinical promotion.