Constraint-induced movement therapy in treatment of acute and sub-acute stroke: a meta-analysis of 16 randomized controlled trials

OBJECTIVE： The aim of this meta-analysis was to evaluate the clinical efficacy of constraint-induced movement therapy in acute and sub-acute stroke. DATA SOURCES： The key words were stroke, cerebrovascular accident, constraint-induced therapy, forced use, and randomized controlled trial. The databases, including China National Knowledge Infrastructure, WanFang, Weipu Information Resources System, Chinese Biomedical Literature Database, PubMed, Med- line, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, were searched for studies on randomized controlled trials for treating acute or sub-acute stroke published before March 2016. DATA SELECTION： We retrieved relevant randomized controlled trials that compared constraint-induced movement therapy in treatment of acute or sub-acute stroke with traditional rehabilitation therapy （tradi- tional occupational therapy）. Patients were older than 18 years, had disease courses less than 6 months, and were evaluated with at least one upper extremity function scale. Study quality was evaluated, and data that met the criteria were extracted. Stata 11.0 software was used for the meta-analysis. OUTCOME MEASURES： Fugl-Meyer motor assessment of the arm, the action research-arm test, a motor activity log for amount of use and quality of movement, the Wolf motor function test, and a modified Bar- thel index. RESULTS： A total of 16 prospective randomized controlled trials （379 patients in the constraint-induced movement-therapy group and 359 in the control group） met inclusion criteria. Analysis showed significant mean differences in favor of constraint-induced movement therapy for the Fugl-Meyer motor assessment of the arm （weighted mean difference （WMD） = 10.822; 95% confidence intervals （95% CI）： 7.419-14.226）, the action research-arm test （WMD = 10.718; 95% CI： 5.704-15.733）, the motor activity log for amount of use and quality of movement （WMD = 0.812; 95% CI： 0.331-1.293） and the modified Barthel index （WMD = 10.706; 95% CI： 4.417-16.966）. CONCLUSION： Constraint-induced movement therapy may be more beneficial than traditional rehabili- tation therapy for improving upper limb function after acute or sub-acute stroke.

Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia

Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusJon. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia.

Neurorestorative Effects of Constraint-Induced Movement Therapy after Stroke: An Integrative Review

Stroke has been considered as one of the main causes of death and of motor and cognitive sequels. Especially, many patients with upper limb hemiparesis improved their motor action and showed meaningful cortical changes after treatment with constraint-induced movement therapy. Therefore, this review aims to verify the literature about neuroimaging and behavioral evidences in the cortical reorganization through the use of the constraint-induced movement therapy. So, we conducted the literature research in indexed journals from many databases like Pubmed, Medline, Cochrane Database, Lilacs and Scielo. We concluded that the behavioral and neuroimaging studies using traditional and modified constraint-induced movement therapy promote cortical reorganization.

Functional magnetic resonance imaging evaluation of brain function reorganization in cerebral stroke patients after constraint-induced movement therapy

In this study, stroke patients received constraint-induced movement therapy for 3 weeks. Before and after constraint-induced movement therapy, the flexibility of their upper limbs on the affected side was assessed using the Wolf motor function test, and daily use of their affected limbs was assessed using the movement activities log, and cerebral functional reorganization was assessed by functional magnetic resonance imaging. The Wolf motor function test score and the movement activities log quantity and quality scores were significantly increased, while action performance time in the Wolf motor function test was significantly decreased after constraint-induced movement therapy. By functional magnetic resonance imaging examination, only scattered activation points were visible on the affected side before therapy. In contrast, the volume of the activated area was increased after therapy. The activation volume in the sensorimotor area was significantly different before and after therapy, and the activation area increased and appeared adjusted. In addition to the activated area around the lesions being decreased, there were also some new activated areas, including the supplementary movement area, premotor area and the ipsilateral sensorimotor area. Our findings indicate that constraint-induced movement therapy significantly improves the movement ability and daily use of the affected upper limbs in stroke patients and promotes cerebral functional reorganization.

Effectiveness of Modified Constraint Induced Movement Therapy and Bilateral Arm Training on Upper Extremity Function after Chronic Stroke: A Comparative Study

Statement of the Problem: Upper limb hemiparesis is a common impairment underlying disability after Stroke. Transfer of treatment to daily functioning remains a question for traditional approaches used in treatment of upper extremity hemiparesis. Approaches based on Motor Learning principles may facilitate the transfer of treatment to activities of daily living. Methodology: Forty one subjects with chronic stroke, attending department of occupational therapy, National Institute for the Orthopaedically Handicapped, Kolkata, West Bengal, India participated in a single blinded randomized pre-test and post-test control group training study. Subjects were randomized over three intervention groups receiving modified Constraint Induced Movement Therapy (n = 13), Bilateral Arm training (n = 14), and an equally intensive conventional treatment program (n = 14). Subjects in the bilateral arm training group participated in bilateral symmetrical activities, where as subjects in constraint induced movement therapy group performed functional activities with the affected arm only and conventional group received conventional Occupational Therapy. Each group received intensive training for 1 hour/day, 5 days/week, for 8 weeks. Pre-treatment and post-treatment measures included the Fugl-Meyer measurement of physical performance (FMA- upper extremity section), action research arm test, motor activity log. Assessments were administered by a rater blinded to group assignment. Result: Both m-CIMT (p = 0.01) and bilateral arm training (p = 0.01) group showed statistically significant improvement in upper extremity functioning on Action Research Arm Test score in comparison to the conventional therapy group (p = 0.33). The bilateral arm training group had significantly greater improvement in upper arm function (Proximal Fugl-Meyer Assessment score, p = 0.001);while the constraint induced movement therapy group had greater improvement of hand functions (Distal Fugl-Meyer Assessment score, p = 0.001. There is an improvement seen in Quality of movement in the Conventional Therapy group. (p = 0.001). Conclusion: Both the treatment techniques can be used for upper extremity management in patients with chronic stroke. Bilateral arm training may be used to improve upper arm function and m-CIMT may be used to improve hand functions, while the group that received modified constraint induced movement therapy had greater improvement.

Early constraint-induced movement therapy affects behavior and neuronal plasticity in ischemia-injured rat brains

Constraint-induced movement therapy is an effective rehabilitative training technique used to improve the restoration of impaired upper extremity movement after stroke. However, whether constraint-induced movement therapy is more effective than conventional rehabilitation in acute or sub-acute stroke remains controversial. The aim of the present study was to identify the optimal time to start constraint-induced movement therapy after ischemic stroke and to explore the mechanisms by which constraint-induced movement therapy leads to post-stroke recovery. Sixty-four adult male Sprague-Dawley rats were randomly divided into four groups: sham-surgery group, cerebral ischemia/reperfusion group, early constraint-induced movement therapy group, and late constraint-induced movement therapy group. Rat models of left middle cerebral artery occlusion were established according to the Zea Longa line embolism method. Constraint-induced movement therapy was conducted starting on day 1 or day 14 in the early constraint-induced movement therapy and late constraint-induced movement therapy groups, respectively. To explore the effect of each intervention time on neuromotor function, behavioral function was assessed using a balance beam walking test before surgery and at 8 and 21 days after surgery. The expression levels of brain-derived neurotrophic factor, nerve growth factor and Nogo receptor were evaluated using real time-polymerase chain reaction and western blot assay to assess the effect of each intervention time. The results showed that the behavioral score was significantly lower in the early constraint-induced movement therapy group than in the cerebral ischemia/reperfusion and late constraint-induced movement therapy groups at 8 days. At 21 days, the scores had significantly decreased in the early constraint-induced movement therapy and late constraint-induced movement therapy groups. At 8 days, only mild pyknosis appeared in neurons of the ischemic penumbra in the early constraint-induced movement therapy group, which was distinctly better than in the cerebral ischemia/reperfusion group. At 21 days, only a few vacuolated cells were observed and no obvious inflammatory cells were visible in late constraint-induced movement therapy group, which was much better than at 8 days. The mRNA and protein expression levels of brain-derived neurotrophic factor and nerve growth factor were significantly higher, but expression levels of Nogo receptor were significantly lower in the early constraint-induced movement therapy group compared with the cerebral ischemia/reperfusion and late constraint-induced movement therapy groups at 8 days. The changes in expression levels at 21 days were larger but similar in both the early constraint-induced movement therapy and late constraint-induced movement therapy groups. Besides, the protein nerve growth factor level was higher in the late constraint-induced movement therapy group than in the early constraint-induced movement therapy group at 21 days. These results suggest that both early(1 day) and late(14 days) constraint-induced movement therapy induces molecular plasticity and facilitates functional recovery after ischemic stroke, as illustrated by the histology. The mechanism may be associated with downregulation of Nogo receptor expression and upregulation of brain-derived neurotrophic factor and nerve growth factor expression.

天轨悬吊减重康复训练模式对脑卒中偏瘫患者下肢运动及平衡功能的影响

目的 探讨天轨悬吊减重康复训练模式对脑卒中偏瘫患者下肢运动及平衡功能的影响。方法 选取杭州市中医院2020年9月至2022年1月期间住院治疗的脑卒中偏瘫患者为研究对象,按照不同楼层病房分为对照组(n=35)和观察组(n=36)。对照组采用常规康复护理,观察组采用天轨悬吊减重康复训练模式,均干预20 d。干预前后使用下肢Fugl-Meyer运动功能评定量表、Berg平衡量表、Sheikh躯干控制能力评分表比较两组患者下肢运动功能及平衡功能。结果 观察组干预前后下肢Fugl-Meyer运动功能评定量表评分差值为(14.61±2.59)分,大于对照组的(10.17±2.50)分;观察组干预前后Berg平衡量表评分差值为(13.81±2.72)分,大于对照组的(8.80±2.94)分;观察组干预前后Sheikh躯干控制能力评分表评分差值为(21.19±11.65)分,大于对照组的(12.94±7.11)分。以上差异均有统计学意义(P<0.05)。结论 天轨悬吊减重康复训练模式可有效改善脑卒中偏瘫患者下肢运动功能,提高平衡功能及躯干控制能力。

机器人在脑卒中后运动障碍病人早期康复训练中应用的研究进展

对脑卒中后运动障碍概述、机器人分类、机器人辅助早期康复训练在脑卒中后运动障碍病人中的应用以及机器人在脑卒中后运动障碍病人早期康复训练中的不足与改进方向进行综述,以期为更好地改善病人运动功能、提高病人康复效果和生活质量提供参考。

中文阅读伴随词汇学习中的视觉复杂性效应:基于笔画数和词长的证据

通过两个实验考查重复学习新词过程中视觉复杂性效应的变化模式。采用阅读伴随词汇学习范式,将双字假词作为新词,嵌入15个语境,分5个时间段供被试阅读。实验1操纵新词笔画数(多、少),实验2操纵新词词长(两字词、三字词),记录大学生阅读句子时的眼动轨迹。结果发现,随着新词学习次数的增加,笔画数效应并未发生显著变化,表明笔画数作为反映汉字视觉复杂性的因素之一,同时作用于词汇学习的早期和晚期,符合视觉限制性假说;相比之下,随着新词学习次数的增加,词长效应逐步减小,表现出词长的“熟悉性”效应,符合视觉和语言共同限制性假说。上述发现表明,笔画数和词长在中文阅读伴随词汇习得中的作用机制存在差异:笔画数类似于一种低水平视觉信息,作用于词汇加工的视觉层;而词长则更加类似语言信息的加工方式,作用于词汇加工的较高层级。

基于数据挖掘探究经皮经颅电刺激治疗卒中后运动障碍刺激参数应用规律

目的 基于数据挖掘探究经皮穴位电刺激(TEAS)及经颅直流电刺激(tDCS)治疗卒中后运动障碍的刺激参数应用规律。方法 检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献数据库、PubMed、Web of Science 2000年1月-2023年5月发表的相关临床研究文献,进行质量评价后建立数据库。采用频次分析、关联规则及复杂网络分析探究核心腧穴及电刺激参数应用规律。结果 共纳入文献79篇,提取128组数据。TEAS核心腧穴主要包括外关、手三里、足三里、合谷、内关、阳陵泉等,上下肢最常用配伍为手三里-外关、阳陵泉-足三里;电刺激参数中频率选择多样,100 Hz最常用,刺激弛缓型偏瘫上肢腧穴时亦多选用2 Hz;其他电刺激参数应用较一致,多选用脉宽200~250μs的双向对称方波,刺激强度以患者耐受为度。t DCS刺激电极多置于脑部M1运动区在头皮的投影,安全刺激强度为1~2 mA。结论 采用TEAS治疗卒中后运动障碍应根据卒中后不同康复阶段患者肌肉状态选择刺激腧穴及电刺激参数,尤需关注刺激频率的选择。

基于眼动技术的VR认知训练在卒中后右脑半球损伤注意障碍患者中的康复应用

目的:评价基于眼动技术的VR认知训练在卒中后右脑半球损伤注意障碍患者康复中的疗效。方法:将40例右脑半球损伤脑卒中后注意障碍的患者随机分成2组,2组均进行常规治疗,观察组在其基础上进行眼动技术的VR认知康复训练替代常规治疗中认知功能训练。治疗前后分别采用MoCA评分,数字广度测试,字母删除测验,凝视时间评估。结果:治疗6周后,2组患者MoCA评分,数字广度测试,凝视时间均明显提高(P<0.05),而2组字母删除测验中错误删除数、总治疗时长治疗前后和组间无明显变化;治疗后观察组MoCA评分、字母删除测验中正确删除数、数字广度测试顺背数字和倒背数字、凝视时间指标改善程度优于对照组(P<0.05)。结论:基于眼动技术的VR认知康复训练可以有效改善卒中后右脑半球损伤注意障碍患者的注意功能。

间歇性气压联合踝泵运动对老年急性缺血性脑卒中患者住院期间下肢深静脉血栓的预防价值

目的 探讨间歇性气压联合踝泵运动对老年急性缺血性脑卒中患者住院期间下肢深静脉血栓的预防价值。方法 收集2020年2月至2022年12月首都医科大学附属北京友谊医院收治的126例老年急性缺血性脑卒中患者的临床资料,根据住院期间是否接受间歇性气压联合踝泵运动治疗分为联合组(n=57)和对照组(n=69)。比较两组患者住院期间下肢深静脉血栓发生率、D-二聚体水平、凝血功能指标以及住院期间并发症发生率。结果 住院期间共发生下肢深静脉血栓12例,联合组患者下肢深静脉血栓发生率低于对照组患者,差异有统计学意义(P﹤0.05)。联合组患者出院前D-二聚体水平低于对照组患者,差异有统计学意义(P﹤0.05)。两组患者出院前凝血功能指标及并发症发生率比较,差异均无统计学意义(P﹥0.05)。结论 间歇性气压联合踝泵运动对老年急性缺血性脑卒中患者住院期间下肢深静脉血栓有较高的预防价值和安全性,值得临床推广。

注意力训练结合奥塔戈运动在脑卒中后认知障碍病人中的应用

目的:探讨注意力训练结合奥塔戈运动对脑卒中后认知障碍(PSCI)病人认知功能、步行能力、步态及移动功能的影响。方法:选取2022年9月—2023年4月67例住院的PSCI病人作为研究对象,按照入院时间分为干预组(34例)和对照组(33例)。对照组实行常规护理措施,干预组在此基础上进行注意力训练结合奥塔戈运动,采用蒙特利尔认知评估量表、连线测试A-B、10 m步行速度测试及计时-起立行走试验对两组干预前后结果进行评价。结果:干预后干预组蒙特利尔认知评估量表得分高于对照组;连线测试A-B时间、10 m步行速度测试及计时-起立行走试验时间均少于对照组,差异均有统计学意义(P<0.05)。结论:注意力训练结合奥塔戈运动可改善认知功能,提高PSCI病人的步行能力、步态及移动功能,可促进PSCI病人康复。

巨刺法合针刺运动疗法治疗脑卒中恢复期运动障碍的临床研究

目的:探讨巨刺法合针刺运动疗法治疗脑卒中恢复期运动障碍的临床疗效。方法:收集2022年4月—2023年9月在吉林省松原市中医院住院的中风康复期患者90例,随机分为治疗组和对照组各45例。对照组患者给予常规针刺治疗,治疗组先行巨刺法合针刺运动疗法再行常规针刺治疗。比较两组临床疗效。结果:治疗后两组患者日常生活活动能力、运动功能Fugl-Meyer评分明显升高,且治疗组明显高于对照组(P<0.05)。治疗组患者治疗后上肢、下肢Brunnstrom评定优于对照组(P<0.05)。结论:巨刺法合针刺运动疗法能促进神经功能恢复,缓解肌肉痉挛和僵硬,从而恢复脑卒中患者运动功能,提高生活质量,临床疗效显著,值得临床推广。

八段锦摇头摆尾式联合PNF运动模式对脑卒中患者平衡功能的影响

目的:观察八段锦摇头摆尾式联合PNF颈部运动模式对脑卒中患者平衡功能的影响。方法:筛选60例符合纳入标准的脑卒中患者,采用随机数字表法分为对照组和观察组各30例。对照组患者接受常规康复治疗,观察组在对照组基础上联合运用八段锦摇头摆尾式及PNF颈部运动模式,两组患者均接受治疗3周。分别于治疗前后进行脑卒中患者姿势评定量表(PASS)评分、躯干损伤量表(TIS)评分、Berg平衡量表(BBS)评分评定。结果:治疗3周后,两组PASS评分、TIS评分、BBS评分均较治疗前明显提高(P<0.01),且观察组评分改善较对照组更明显(P<0.05)。TIS评分分项中静态坐位平衡及动态坐位平衡观察组与对照组改善差异有统计学意义(P<0.05),协调分项观察组与对照组改善差异无统计学意义(P>0.05)。结论:八段锦摇头摆尾式与PNF颈部运动模式相结合,可有效提升脑卒中患者姿势控制及平衡功能,较常规治疗展现出更佳的疗效。

第九届国际帕金森病暨运动障碍疾病研讨会/中国卒中学会移动医学上海分会会议纪要

本文简要介绍第九届国际帕金森病暨运动障碍疾病研讨会及中国卒中学会移动医学上海论坛的学术内容。会议在2023年6月8日—10日在上海召开,世界神经病学争议大会会务组核心团队支持,由上海交通大学医学院附属第一人民医院及其嘉定分院主办。王晓平、Amos D Korczyn和赵钢教授担任大会主席,来自巴基斯坦、以色列、美国、希腊和瑞典等国家近10位知名专家通过Zoom视频软件进行会议演讲,就帕金森病、脑血管病、癫痫、偏头痛、肝豆状核变性等罕见病进行了广泛的学术交流,并展开了类似世界神经病学争议大会的热烈讨论和辩论,邀请了多位专业的双语(英语⁃中文)同步翻译,取得了很好的交流效果,吸引了国际上超过30000人次以上的观众和听众来收看和收听。

针刺联合吞咽训练对脑卒中后假性球麻痹吞咽障碍患者吞咽功能的影响

目的:观察针刺联合吞咽训练对脑卒中后假性球麻痹吞咽障碍患者咽部运动功能及咽部食物残留情况的影响。方法:纳入脑卒中后假性球麻痹吞咽障碍患者80例,按随机数字表法分为联合组和吞咽训练组各40例。联合组剔除1例,吞咽训练组剔除2例,最终纳入研究联合组39例、吞咽训练组38例。2组均给予脑卒中常规治疗,吞咽训练组进行吞咽功能训练,联合组在吞咽功能训练基础上针刺廉泉、风府、风池、翳风、吞咽穴,治疗4周。治疗前后应用纤维喉镜吞咽功能检查(FEES)观察患者咽部运动(咽内缩、舌根后缩能力)能力、残留(会厌谷、梨状窦残留)情况,同时采用洼田饮水试验评分评估吞咽功能。结果:治疗后,2组咽内缩、舌根后缩能力均较治疗前提高(P<0.05),联合组咽内缩、舌根后缩能力均高于吞咽训练组(P<0.05)。2组会厌谷、梨状窦残留情况均较治疗前减少(P<0.05),联合组会厌谷、梨状窦残留情况均少于吞咽训练组(P<0.05)。2组洼田饮水试验评分均较治疗前降低(P<0.05),联合组洼田饮水试验评分低于吞咽训练组(P<0.05)。结论:针刺联合吞咽训练可提高脑卒中后假性球麻痹吞咽障碍患者的咽内缩、舌根后缩能力,减少会厌谷、梨状窦食物残留,改善其吞咽功能。

下颌收拢抗阻力运动配合早期VitalStim治疗仪对卒中后老年吞咽障碍患者康复效果的影响

目的 探讨下颌收拢抗阻力运动配合早期VitalStim治疗仪对卒中后老年吞咽障碍患者的康复效果。方法 选取2021年1月至2023年1月邯郸市第一医院收治的卒中后老年吞咽障碍患者124例作为研究对象,患者入院后依据康复干预方案不同分为观察组(n=60)与对照组(n=64)。观察组行下颌收拢抗阻力运动配合早期VitalStim治疗仪干预,对照组行早期VitalStim治疗仪干预。比较两组康复效果及干预前后吞咽功能、表面肌电检查指标、营养相关指标及生活质量评分差异。采用SPSS 22.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。结果 观察组总有效率(95.00%)显著高于对照组(82.81%),差异有统计学意义(P<0.05)。观察组干预后视频荧光吞咽摄影检查(VFSS)及洼田饮水实验评分显著低于干预前及对照组干预后,差异均有统计学意义(P<0.05)。观察组干预后表面肌电平均波幅显著高于干预前及对照组干预后,而表面肌电吞咽时限显著低于干预前及对照组干预后,差异均有统计学意义(P<0.05)。观察组干预后血清前白蛋白、血清白蛋白水平及微型营养评价精法评分显著高于干预前及对照组干预后,差异均有统计学意义(P<0.05)。观察组干预后世界卫生组织生存质量测定量表各维度评分显著高于干预前及对照组干预后,差异有统计学意义(P<0.05)。结论 下颌收拢抗阻力运动配合早期VitalStim治疗仪对卒中后老年吞咽障碍患者有较好的康复效果,在改善患者吞咽障碍的同时还能改善其营养状况、提高生活质量。

虚拟现实技术及强制性运动疗法对脑卒中偏瘫患者康复效果的影响

目的探讨虚拟现实技术及强制性运动疗法对脑卒中偏瘫患者康复效果的影响。方法选取2021年9月至2022年9月于陕西省榆林市第一医院就诊的脑卒中偏瘫患者80例作为研究对象,按照随机数字表法将其分为对照组和观察组,每组40例。对照组采用常规康复训练,观察组在常规康复训练的基础上加用虚拟现实技术及强制性运动疗法。观察并比较两组患者干预前后关节活动情况(评价指标为肩关节前屈、肩关节内收、肩关节外展与肘关节屈曲活动度)、上肢运动功能[采用简化的上肢运动功能量表(FMA-UE)进行评估]、平衡功能[应用平衡功能评价量表(FMA-B)进行评估]、日常生活活动能力[采用改良Barthel指数(MBI)评分进行评估]及生活质量(包括生理功能、躯体疼痛、总体健康、活力、社会功能、精神健康5个维度)。结果干预后,两组肩关节前屈、肩关节内收、肩关节外展、肘关节屈曲活动度以及FMA-UE、FMA-B、MBI评分和生活质量5个维度评分均较干预前升高(P<0.05);干预后观察组肩关节前屈、肩关节内收、肩关节外展、肘关节屈曲活动度以及FMA-UE、FMA-B、MBI评分和生活质量5个维度评分均高于对照组,差异均有统计学意义(P<0.05)。结论虚拟现实技术及强制性运动疗法对脑卒中偏瘫患者的康复效果明显,可提高关节活动度、上肢运动功能、平衡功能、日常生活活动能力和生活质量。

经颅磁刺激疗法在脑卒中康复治疗中的研究进展

脑卒中是多种原因导致的脑血管损伤,尽管患者经临床综合治疗后生命得以挽救,但常常遗留不同程度后遗症,其中吞咽功能障碍、肢体功能障碍、认知障碍、单侧忽略等最为常见。脑卒中患者一旦出现后遗症,会在一定程度上影响其日常生活能力及生活质量。脑卒中康复治疗近年受到广泛关注,其中物理疗法不断被用于脑卒中康复治疗中,并取得一定进展。经颅磁刺激疗法(transcranial magnetic stimulation,TMS)是无创神经刺激技术,具有安全、操作便捷、无痛等优点,能够平衡双侧大脑功能,达到脑卒中康复目的;近年被广泛应用,并取得一定进展。文章将对TMS在脑卒中康复治疗中的应用现状进行综述。