重复经颅磁刺激联合核心肌群康复训练对痉挛型脑瘫患儿运动功能与平衡能力的影响

Effects of Repetitive Transcranial Magnetic Stimulation Combined with Core Muscle Rehabilitation Training on Motor Function and Balance in Children with Spastic Cerebral Palsy

目的探究重复经颅磁刺激联合核心肌群康复训练对痉挛型脑瘫患儿运动功能与平衡能力的影响。方法选取2022年6月—2023年6月本院收治的82例痉挛型脑瘫患儿为研究对象,按照随机数字表法将其分为常规组和联合组,各41例。常规组采用重复经颅磁刺激仪治疗,联合组采用重复经颅磁刺激仪联合核心肌群康复训练。对比两组患儿的运动功能、肌张力、平衡能力、日常生活活动能力、脑血流动力学指标[脑动脉平均血流速度(Vm)、血管阻力指数(RI)]及康复效果。结果干预后,联合组粗大运动功能量表评分为(209.05±25.76)分,高于常规组的(174.81±23.52)分,改良Ashworth量表评分为(2.29±0.43)分,低于常规组的(2.92±0.57)分,组间差异有统计学意义(P<0.05);联合组Berg平衡量表评分为(45.96±6.08)分,高于常规组的(39.15±5.63)分,日常生活能力量表评分为(25.01±3.48)分,高于常规组的(20.63±3.05)分,组间差异有统计学意义(P<0.05);联合组的Vm为(74.38±6.12)cm/s,快于常规组的(67.51±5.36)cm/s,RI为(5.37±0.36),小于常规组的(5.83±0.41),组间差异有统计学意义(P<0.05)。联合组的康复总有效率为87.80%,高于常规组的68.29%,差异有统计学意义(P<0.05)。结论将重复经颅磁刺激仪联合核心肌群康复训练应用于痉挛型脑瘫,不仅能够改善患儿运动功能与脑血流动力学指标,还能够提升其平衡能力、日常生活活动能力和康复效果,可推广。

Objective To investigate the effects of repetitive transcranial magnetic stimulation combined with core muscle rehabilitation training on motor function and balance ability of children with spastic cerebral palsy.Methods A total of 82 children with spastic cerebral palsy admitted to our hospital from June 2022 to June 2023 were selected as the research objects and divided into the conventional group and the combined group,with 41 cases in each group According to random number table method.The conventional group was treated with repetitive transcranial magentic stimulation,while the combined group was treated with repetitive transcranial magentic stimulation combined with core muscle rehabilitation training.The motor function,muscle tone,balance ability,activity of daily living,cerebral hemodynamic index[mean cerebral artery flow velocity(Vm),vascular resistance index(RI)]and rehabilitation effect of the two groups were compared.Results After intervention,the Gross Motor Function Measure score of the combined group was(209.05±25.76)points,which was higher than(174.81±23.52)points of the conventional group,and the Modmed Ashworth Scale score was(2.29±0.43)points,which was lower than(2.92±0.57)points of the conventional group,with statistically significant differences between the groups(P<0.05);the Berg Balance Scale score was(45.96±6.08)points of the combined group,which was higher than(39.15±5.63)points of the conventional group,and the Activities of Daily Living Scale score was(25.01±3.48)points,which was higher than(20.63±3.05)points of the conventional group,with statistically significant differences between the groups(P<0.05);the Vm was(74.38±6.12)cm/s of the combined group,which was faster than(67.51±5.36)cm/s of the conventional group,and the RI was(5.37±0.36),which was lower than(5.83±0.41)of the conventional group,with statistically significant differences between the groups(P<0.05).The total effective rate of rehabilitation in the combined group was 87.80%,which was higher than 68.29%in the conventional group,and the difference was statistically significant(P<0.05).Conclusion The application of repetitive transcranial magnetic stimulation instrument combined with core muscle rehabilitation training in spastic cerebral palsy can not only improve the motor function and cerebral hemodynamic indexes,but also improve the balance ability,the ability of daily living activities and the rehabilitation effect of children,which can be extended.