经颅直流电刺激联合镜像疗法治疗脑卒中后上肢运动功能障碍患者的效果

Effect of transcranial direct current stimulation combined with mirror therapy for the treatment of patients with upper limb motor dysfunction after cerebral stroke

目的探讨经颅直流电刺激联合镜像疗法治疗脑卒中后上肢运动功能障碍患者的效果。方法将142例脑卒中后上肢运动功能障碍患者随机分为对照组和研究组,各71例。在常规康复治疗的基础上,对照组患者接受经颅直流电刺激治疗,研究组患者接受经颅直流电刺激联合镜像疗法治疗,两组均治疗6周。比较两组患者治疗前后的中枢运动传导时间(CMCT)、运动诱发电位皮质潜伏期、Fugl-Meyer评估量表上肢部分(FMA-UE)评分、Barthel指数得分、Wolf运动功能测试(WMFT)量表评分及生活质量。结果治疗6周后,两组患者的运动诱发电位皮质潜伏期、CMCT较治疗前缩短,生活质量各维度评分较治疗前升高,且研究组患者上述指标优于对照组(P<0.05);治疗3周后、6周后,两组患者的FMA-UE评分、Barthel指数得分、WMFT量表评分较治疗前提高,且研究组患者的上述得分高于对照组(P<0.05)。结论经颅直流电刺激联合镜像疗法能够有效改善脑卒中后上肢运动功能障碍患者患侧脑皮质兴奋性,提高上肢运动功能、手活动功能、日常生活活动能力及生活质量。

Objective To explore the effect of transcranial direct current stimulation combined with mirror therapy for the treatment of patients with upper limb motor dysfunction after cerebral stroke.Methods A total of 142 patients with upper limb motor dysfunction after cerebral stroke were randomly assigned to control group or research group,with 71 cases in each group.On the basis of routing rehabilitation therapy,the control group received transcranial direct current stimulation for treatment,whereas the research group was treated with transcranial direct current stimulation combined with mirror therapy.Both groups was treated for 6 weeks.The central motor conduction time(CMCT),motor evoked potential cortical latency,Fugl-Meyer Assessment for the Upper Extremity(FMA-UE)score,Barthel index score,Wolf Motor Function Test(WMFT)scale score,and quality of life were compared between patients of the two groups before and after treatment.Results After 6 weeks of treatment,both groups exhibited shorter motor evoked potential cortical latency and CMCT as compared with before treatment,whereas a elevated score of quality of life in various dimension as compared with before treatment,and the research group interpreted superior aforesaid indices to compared with the control group(P<0.05).After 3 and 6 weeks of treatment,both groups indicated elevated scores of FMA-UE,Barthel index,and WMFT scale as compared with before treatment,and the research group yielded higher scores as above as compare with the control group(P<0.05).Conclusion Transcranial direct current stimulation combined with mirror therapy can effectively ameliorate cortical excitability of the affected side in patients with upper limb motor dysfunction after cerebral stroke,and improve upper limb motor function,hand movement function,ability of daily living activities,and quality of life.