低频重复经颅磁刺激联合Balance-Trainer训练对脑卒中后平衡功能及下肢运动功能的影响

Effects of low-frequency repetitive transcranial magnetic stimulation combined with Balance-Trainer training on balance function and lower limb motor function after stroke

目的探究低频重复经颅磁刺激(rTMS)联合Balance-Trainer训练对脑卒中患者平衡功能及下肢运动功能的影响。方法选择2021年1月至2022年1月在南通大学第二附属医院康复医学科住院的70例脑卒中患者,采用随机数字表法分为BT组(23例)、rTMS组(24例)和联合组(23例)。三组均接受常规的康复治疗,BT组增加Balance-Trainer训练,rTMS组增加rTMS治疗,联合组给予rTMS治疗和Balance-Trainer训练,治疗8周。比较三组治疗前后Berg平衡量表(BBS)、Fugl-Meyer下肢运动功能量表(FMA-LE)、改良Barthel指数量表(MBI)评分及稳定性指数(SI)得分;观察三组不良反应发生情况。结果治疗后,三组BBS、FMA-LE、MBI评分较治疗前升高,SI得分较治疗前降低;且联合组BBS、FMA-LE、MBI评分高于BT组及rTMS组,SI得分低于BT组及rTMS组(P<0.05)。所有患者在治疗过程中均未出现癫痫等不良反应。结论低频rTMS联合Balance-Trainer训练能有效改善脑卒中患者平衡功能和下肢运动功能,提高患者的日常生活能力。

Objective To explore the effects of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with Balance-Trainer training on balance function and lower limb motor function of patients after stroke.Methods A total of 70 stroke patients who were hospitalized in the Department of Rehabilitation Medicine,the Second Affiliated Hospital of Nantong University from January 2021 to January 2022 were selected,and they were divided into BT group(23 cases),rTMS group(24 cases),and combined group(23 cases).Patients of three groups received the conventional rehabilitation treatments,in addition,BT group added Balance-Trainer training,rTMS group added rTMS treatment,combined group added rTMS treatment and BT training.The Berg balance scale(BBS),Fugl-Meyer assessment scale for lower extremity(FMA-LE),modified Barthel index scale(MBI),and stability index(SI)scores were compared among three groups before and after treatment;the occurrence of adverse reactions among three groups were observed.Results After treatment,BBS,FMA-LE,and MBI scores of three groups were higher than those before treatment,SI score was lower than that before treatment;and BBS,FMA-LE,MBI scores of combination group were higher than those of BT group and rTMS group,SI score was lower than that of BT group and rTMS group(P<0.05).No adverse reactions such as epilepsy occurred in all patients during treatment.Conclusion Low-frequency rTMS combined with Balance-Trainer training can significantly improve the balance function and lower limb motor function of patients after stroke,and improve their abilities of daily life.