探讨高低频交互rTMS对老年脑卒中偏瘫患者肢体功能、吞咽功能及日常生活活动能力的影响

Effect of high and low frequency interactive rTMS on limb function,swallowing function and daily living activities in elderly stroke patients with hemiplegia

目的探讨高低频交互重复经颅磁刺激(rTMS)对老年脑卒中偏瘫患者肢体功能、吞咽功能及日常生活活动能力的影响。方法回顾性分析唐山市工人医院2017年8月至2021年12月收治的120例脑卒中偏瘫患者的临床资料,依据治疗方案不同分为低频组、高频组及交互组,各40例,3组均予以常规康复干预,在常规康复干预的基础上低频组给予低频rTMS治疗(刺激频率1 Hz,刺激强度90%静息动动阈值(RMT),刺激时间25 s,间隔时间5 s),高频组给予高频rTMS治疗(刺激频率5 Hz,刺激强度90%RMT,刺激时间5 s,间隔时间25 s),交互组予以高低频交互rTMS治疗,观察3组上肢运动功能、吞咽功能及日常生活活动能力的变化情况。结果与治疗前比较,治疗后,3组患者的上肢Fugl-Meyer评分、改良Barthel指数分值均增加,且交互组高于低频组、高频组,差异均有统计学意义(P<0.05);治疗后,3组患者上肢正中神经的F波潜伏期均缩短,改良Ashworth量表评分均减少,且交互组少于低频组、高频组,差异均有统计学意义(P<0.05)。结论对老年脑卒中偏瘫患者予以高低频交互rTMS治疗,可显著改善患者肢体运动功能与吞咽功能,提升其日常生活能力。

Objective To investigate the effect of the high and low-frequency interactive repetitive transcranial magnetic stimulation(rTMS)on limb function,swallowing function and daily living activities in elderly stroke patients with hemiplegia.Methods A total of 80 stroke patients with hemiplegia admitted to Tangshan Workers'Hospital from August 2017 to December 2021 were collected,and randomly divided into the observation group and the control group with 40 cases in each.The control group received conventional rehabilitation intervention and low-frequency rTMS.The observation group received conventional rehabilitation intervention and high and low frequency interactive rTMS.Motor function,swallowing function,and activities of daily living in the two groups were observed.Results After treatment,the Fugl-Meyer scores assessment upper extremity and modified Barthel index(MBI)scores of the two groups were increased,and the observation group had higher scores than those in the control group.The modified Ashworth scale(MAS)scores were decreased,and the observation group had lower scores than those in the control group(P<0.05).After treatment,F-wave latency of upper limb median nerve were reduced,and F-wave latency of upper limb median nerve in the observation group were shorter than those in the control group(P<0.05).Conclusion High and low frequency interactive rTMS can significantly improve limb motor function and activities of daily living of elderly stroke patients with hemiplegia.