摘要
目的观察重复经颅磁刺激联合绳带捆绑肌肉训练对脑卒中偏瘫患者运动功能的影响。方法选取109例脑卒中偏瘫患者,依据信封法分为对照组(54例)和观察组(55例)。对照组采用绳带捆绑肌肉训练康复,观察组在对照组基础上联合重复经颅磁刺激康复。比较两组中枢运动传导时间(CMCT)、运动诱发电位(MEP)、步速、步频、跨步长比率、积分肌电值(iEMG)、协同收缩率(CR)及Fugel-Meye运动功能评定量表(FMA)、美国国立卫生研究院卒中量表(NIHSS)、Berg平衡量表(BBS)及改良Barthel指数(MBI)评分。结果治疗后,两组CMCT均较治疗前缩短,且观察组CMCT(9.45±1.08)ms短于对照组的(10.18±1.27)ms;MEP均较治疗前升高,且观察组MEP(1.35±0.24)mV高于对照组的(1.24±0.27)mV(P<0.05)。治疗后,两组步速、步频及跨步长比率均较治疗前升高,且观察组步速(53.85±5.22)cm/s、步频(90.33±6.47)次/min及跨步长比率(1.22±0.13)%均高于对照组的(50.85±4.86)cm/s、(86.57±7.12)次/min、(1.15±0.14)%(P<0.05)。治疗后,两组iEMG均较治疗前升高,且观察组iEMG(52.18±11.25)μV高于对照组的(47.03±10.84)μV;CR均较治疗前降低,且观察组CR(38.70±4.28)%低于对照组的(41.72±5.64)%(P<0.05)。治疗后,两组FMA、BBS及MBI评分均较治疗前上升,且观察组高于对照组;NIHSS评分均较治疗前降低,且观察组低于对照组(P<0.05)。结论重复经颅磁刺激联合绳带捆绑肌肉训练更有利于脑卒中偏瘫患者运动功能的康复。
Objective To observe the effect of repeated transcranial magnetic stimulation combined with rope binding muscle training on motor function of patients with post-stroke hemiplegia.Methods A total of 109 patients with post-stroke hemiplegia were selected and divided into a control group(54 cases)and an observation group(55 cases)according to envelope method.The control group received rope binding muscle training,and the observation group received repeated transcranial magnetic stimulation on the basis of the control group.Both groups were compared in terms of central motor conduction time(CMCT),motor evoked potentials(MEP),walking speed,stride frequency,stride length ratio,integrated electromyography(iEMG),synergistic contraction rate(CR),and Fugel-Meye Assessment(FMA),National Institutes of Health Stroke Scale(NIHSS),Berg Balance Scale(BBS),and modified Barthel Index(MBI)scores.Results After treatment,CMCT in both groups was shorter than that before treatment,and CMCT of(9.45±1.08)ms in the observation group was shorter than(10.18±1.27)ms in the control group;MEP in both groups was higher than that before treatment,and MEP of(1.35±0.24)mV in the observation group was higher than(1.24±0.27)mV in the control group(P<0.05).After treatment,the walking speed,stride frequency and stride length ratio in both groups increased compared with those before treatment;in the observation group,the walking speed was(53.85±5.22)cm/s,the stride frequency was(90.33±6.47)steps/min and the stride length ratio was(1.22±0.13)%,which were higher than(50.85±4.86)cm/s,(86.57±7.12)steps/min,and(1.15±0.14)%in the control group(P<0.05).After treatment,iEMG in both groups increased compared with that before treatment,and iEMG of(52.18±11.25)μV in the observation group was higher than(47.03±10.84)μV in the control group;CR in both groups decreased compared with that before treatment,and CR of(38.70±4.28)%in the observation group was lower than(41.72±5.64)%in the control group(P<0.05).After treatment,FMA,BBS and MBI scores in both groups increased compared with those before treatment,and the observation group was higher than the control group;NIHSS scores in both groups decreased compared with those before treatment,and the observation group was lower than the control group(P<0.05).Conclusion Repetitive transcranial magnetic stimulation combined with rope binding muscle training is more conducive to the rehabilitation of motor function in patients with poststroke hemiplegia.
作者
张琳
ZHANG Lin(Department of Neurology,Dongda Hospital of Shanxian County,Heze 274300,China)
出处
《中国实用医药》
2024年第23期166-169,共4页
China Practical Medicine
关键词
重复经颅磁刺激
绳带捆绑肌肉训练
脑卒中偏瘫
运动诱发电位
积分肌电值
Repeated transcranial magnetic stimulation
Rope binding muscle training
Post-stroke hemiplegia
Motor evoked potential
Integrated electromyography
