低频重复经颅磁刺激联合肌电生物反馈疗法对脑卒中患者上肢功能的临床研究  

Low-frequency repetitive transcranial magnetic stimulation combined with electromyographic biofeedback therapy for upper limb function after stroke

作　　者：刘思豪 李哲[1] 刘骞豪 李颖[1] 郝道剑[1] Liu Sihao;Li Zhe;Liu Qianhao(Department of Rehabilitation Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院,郑州450000

出　　处：《中国康复》2018年第6期451-454,共4页Chinese Journal of Rehabilitation

基　　金：河南省省直医疗机构医疗服务能力提升工程建设项目经费资助(豫财社[2017]149号)

摘　　要：目的:观察低频重复经颅磁刺激(rTMS)联合肌电生物反馈(EMGBFT)治疗脑卒中患者上肢痉挛及其运动功能的临床疗效。方法:脑卒中伴上肢痉挛患者45名,随机分为3组(A、B、C),每组患者各15名。3组患者均给予常规康复治疗,B组另外给予EMGBFT治疗,C组另外给予低频rTMS联合EMGBFT治疗。3组患者均于治疗前、治疗4周后和第8周随访时进行改良Ashworth分级、表面肌电图(sEMG)、上肢Fugl-Meyer评定法(UFMA)以及改良Barthel指数(MBI)进行评估。结果:治疗4周时,3组患者改良Ashworth分级、sEMG、UFMA和MBI较治疗前差异有统计学意义(P<0.05),C组的评估指标与其余2组比较差异均有统计学意义(P<0.05)。第8周随访时A组患者各项评估指标较第4周时差异有统计学意义(P<0.05),其余2组患者变化无统计学差异。结论:低频重复经颅磁刺激联合肌电生物反馈治疗可以有效缓解脑卒中患者上肢痉挛,提高上肢功能。Objective:To investigate the clinical effect of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with electromyographic biofeedback therapy(EMGBFT)for upper extremity spasticity and motor function in stroke patients.Methods:Forty-five patients were randomly divided into 3 groups(A,B and C)with 15 in each.All patients in groups A,B and C received conventional rehabilitation,those in group B received EMGBFT,and those in group C received low frequency rTMS combined with EMGBFT additionally.Before and 4 and 8 weeks after treatment,all patients were evaluated by Modified Ashworth Scale(MAS),surface electromyography(sEMG),Fugl-Meyer Assessment of upper limbs(UFMA),and modified Barthel Index(MBI).Results:There was significant difference in MAS,sEMG,UFMA and MBI before and after treatment for 4 weeks in all patients(P<0.05),and between group C and the other two groups after treatment for 4 weeks(P<0.05).There was significant difference in all measurements between the 8th week and 4th week in group A.Conclusions:Low-frequency rTMS combined with EMGBFT can effectively reduce upper limb spasticity and improve function in stroke patients.

关 键 词：经颅磁刺激 肌电生物反馈 脑卒中 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]