经颅直流电刺激联合虚拟现实技术对脑梗死后上肢运动功能的影响  

Effect of transcranial direct-current stimulation plus virtual reality on the recovery of upper limb function in patients with cerebral infarction

作　　者：赵飞 谭杰文[2] 鲍晓[3] 刘河军[2] Zhao Fei;Tan Jiewen;Bao Xiao;Liu Hejun(Department of Rehabilitation Medicine,Panjin Central Hospital,PanJin 124010,China)

机构地区：[1]盘锦市中心医院康复医学科,辽宁盘锦124010 [2]中山大学孙逸仙纪念医院康复医学科 [3]粤北人民医院康复医学科

出　　处：《海军医学杂志》2021年第4期466-470,共5页Journal of Navy Medicine

基　　金：广东省重点培育学科医学技术项目(F2017SZDPY01)。

摘　　要：目的探讨经颅直流电刺激联合虚拟现实技术对脑梗死后上肢功能的作用。方法本研究将盘锦市中心医院康复医学科从2018年1月至2019年5月收治的78例脑梗死后患者随机分为对照组(A组)和经颅直流电联合虚拟现实组(B组)2组,每组39人。A组患者接受常规康复治疗;B组患者在常规康复治疗的基础上接受4周的经颅直流电刺激治疗和虚拟现实技术训练,每次训练45 min,每天2次,每周5 d,共4周。收集并分析干预前及干预4周后Fugl-Meyer上肢量表(the Fugl-Meyer upper-limb scale,UL-FMA)、改良Arthworth评分(modified Arshworth score,MAS)、改良Barthel指数(modified Barthel index,MBI)评定量表以及感觉运动诱发电位结果。结果干预前2组UL-FMA、MAS、MBI评分以及感觉运动诱发电位对比差异无统计学意义(P>0.05)。在第4周结束时,2组患者的UL-FMA、MAS、MBI评分以及感觉运动诱发电位比较差异有统计学意义(P<0.05)。结论经颅直流电刺激联合虚拟现实技术可以提高患者参与康复锻炼的主观能动性,且更加有效改善脑梗死后上肢运动功能,增强康复治疗效果。Objective To study the effect of transcranial direct-current stimulation(tDCS)plus virtual reality(VR)on the recovery of upper limb function in post-stroke patients.Methods Seventy-eight patients with cerebral infarction admitted to the Department of Rehabilitation Medicine,Panjin Central Hospital were randomly and equally divided into 2 groups:group A(the control group,n=39)and group B(the tDCS plus VR group,n=39).The patients in group A received routine rehabilitation therapy,5 times a week,two sessions a day,one session for 45 minutes,for 4 successive weeks.At the same time,the patients in group B received transcranial direct current stimulation(tDCS)and virtual reality(VR)training,for a duration of 4 weeks.The scores of Fugl-Meyer upper-limb scale(UL-FMA),the modified arshworth scores(MAS),the modified barthel indexes(MBI)and sensorimotor evoked potential were collected before intervention and 4 weeks after intervention,and then the assessment results before and after intervention were compared and analyzed.Results There were no statistical differences in the levels or scores of UL-FMA,MBI,MAS and sensorimotor evoked potential before intervention,when comparisons were made between the 2 groups(P>0.05).After 4 weeks of intervention,statistical differences could be noted in the levels or scores of UL-FMA,MAS,MBI,and sensorimotor evoked potential,when comparisons were made between the 2 groups(P<0.05).Conclusion Treatment with tDCS and VR following cerebral infarction could promote the patient initiative in active rehabilitation exercise and more effectively improve upper limb function of the patients following stroke.

关 键 词：经颅直流电刺激 虚拟现实技术 上肢功能 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]