经颅磁刺激联合康复功能训练对脑卒中后偏瘫病人步态、平衡能力及FMA评分的影响  

Effects of Transcranial Magnetic Stimulation Combined with Rehabilitation Training on Gait,Balance and FMA Score in Patients with Post-stroke Hemiplegia

作　　者：莫林宏[1] 刘爱贤[1] MO Linhong;LIU Aixian(Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100041,China)

机构地区：[1]首都医科大学附属北京康复医院,北京100041

出　　处：《中西医结合心脑血管病杂志》2020年第23期4065-4068,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨经颅磁刺激联合康复功能训练对脑卒中后偏瘫病人步态、平衡能力及简化Fugl-Meyer运动功能评定量表(FMA)评分的影响。方法选取本院2016年9月—2018年6月收治的脑卒中后偏瘫病人105例作为研究对象,随机分为两组,研究组53例,对照组52例。对照组给予康复功能训练,研究组在对照组基础上配合经颅磁刺激治疗。对两组治疗前后步态、平衡能力、FMA评分及日常生活能力进行评估。结果研究组总有效率明显高于对照组(P<0.05)。治疗前,两组步速、步频、跨步长比率(患肢/健肢)比较差异无统计学意义(P>0.05);治疗后,两组步速、步频、跨步长比率(患肢/健肢)都较治疗前有所改善,且研究组改善效果优于对照组(P<0.05)。治疗前,两组Berg平衡量表(BBS)评分和上肢、下肢FMA评分差异均无统计学意义(P>0.05);治疗后,两组BBS评分和上肢、下肢FMA评分均较治疗前升高,且研究组评分高于对照组(P<0.05);治疗前,两组改良Barthel指数(MBI)评分比较差异无统计学意义(P>0.05);治疗后两组MBI评分均高于治疗前,且研究组评分高于对照组(P<0.05)。结论经颅磁刺激联合康复功能训练能明显改善病人的步态,促进平衡性、肢体运动功能的恢复,提高日常生活能力。Objective To explore the effects of transcranial magnetic stimulation combined with rehabilitation training on gait,balance ability,and Fugl-Meyer Assessment Scale(FMA)score in patients with post-stroke hemiplegia.Methods One hundred and five patients with post-stroke hemiplegia were randomly divided into study group and control group,with 53 cases in study group and 52 cases in control group.The control group was treated with rehabilitation training,and the study group was treated with transcranial magnetic stimulation therapy on the basis of the control group.Gait,balance ability,FMA score and daily living ability of the two groups were were compared between the two groups.Results The total clinical efficacy of the study group was significantly higher than that of the control group(P<0.05).Before treatment,there was no significant difference in walking speed,stride frequency and stride length ratio(affected limb/healthy limb)between the two groups(P>0.05).After treatment,the walking speed,stride frequency and stride length ratio(affected limb/healthy limb)of two groups were improved,and those of the study group were better than those of the control group(P<0.05).Before treatment,there was no significant difference in BBS score and FMA score of upper and lower limbs between two groups(P>0.05).After treatment,BBS score and FMA score of upper and lower limbs in two groups were higher than those before treatment,and the scores in the study group were significantly higher than those in the control group(P<0.05).There was no significant difference in MBI scores between two groups before treatment(P>0.05),while the MBI scores of the two groups after treatment were higher than those before treatment,and the scores of the study group were significantly higher than those of the control group(P<0.05).Conclusion Transcranial magnetic stimulation combined with rehabilitation training could significantly improve the gait,promote the recovery of balance and limb motor function,and improve the daily living ability.

关 键 词：脑卒中 偏瘫 经颅磁刺激 康复功能训练 步态 平衡能力 Fugl-Meyer运动功能评定量表评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]