反复促通技术联合rTMS对卒中后下肢运动功能障碍患者的康复效果

Rehabilitation effect of repeated facilitation technique combined with repeated transcranial magnetic stimulation on the patients with lower limb motor dysfunction after stroke

目的 探讨反复促通技术联合重复经颅磁刺激(rTMS)对卒中后下肢运动功能障碍患者下肢运动功能及步态恢复的康复效果。方法 选取2022-01—06黑龙江中医药大学附属第四医院康复科收治的80例脑卒中后下肢运动功能障碍患者,分为对照组(n=40)和观察组(n=40)。对照组采用r TMS治疗,观察组实施反复促通技术联合rTMS治疗。比较2组患者治疗前后下肢运动功能量表(FMA)、Berg平衡量表(BBS)、10 m步行时间、血清同型半胱氨酸(Hcy)、血管紧张素转化酶(ACE)水平以及步行功能量表(FAC)分级、改良Barthel指数(MBI)和改良Ashworth指数(MAS)分级效果。结果 观察组治疗4周、8周后FMA、BBS、FAC、MBI评分均显著高于对照组(P<0.05)。观察组治疗4周、8周后10 m步行时间与Hcy、ACE水平显著低于对照组(P<0.05)。观察组治疗4周、8周后肌肉痉挛改善程度优于对照组(P<0.05)。结论 反复促通技术联合rTMS能有效促进脑卒中下肢运动功能障碍患者下肢运动功能和平衡功能的恢复,降低血清Hcy、ACE水平,对提高患者步数以及步态恢复均有积极的作用。

Objective To explore the rehabilitation effect of repeated facilitation technique combined with repeated transcranial magnetic stimulation(rTMS)on lower limb motor function and gait recovery in patients with lower limb motor dysfunction after stroke.Methods Eighty patients with lower limb motor dysfunction after stroke admitted to the Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2022 to June 2022 were selected and divided into control group(n=40)and observation group(n=40).The con⁃trol group was treated with rTMS,and the observation group was treated with repeated facilitation technique com⁃bined with rTMS.Lower limb motor function scale(FMA),Berg balance scale(BBS),10 were compared between the two groups before and after treatment m walking time,serum homocysteine(Hcy),angiotensin converting en⁃zyme(ACE)levels,and the grading effects of walking function scale(FAC),modified Barthel index(MBI)and modified Ashworth index(MAS).Results The FMA,BBS scores,FAC,and MBI scores were significantly higher than the control group(P<0.05).Walking time,Hcy and ACE levels after 4 weeks and 8 weeks were significantly lower than those of the control group(P<0.05).The improvement of muscle spasm was better after 4 and 8 weeks than in the control group(P<0.05).Conclusion Repeated promotion technology combined with rTMS can effec⁃tively promote the recovery of lower limb motor function and balance function after stroke,reduce the Hcy and ACE level of patients,and have a positive impact on improving the step number and gait recovery of patients.