经颅直流电刺激联合运动想象疗法改善脑卒中偏瘫病人上肢运动功能及认知功能的效果  

Effects of transcranial direct current stimulation combined with motor imagery training on upper limb motor function and cognitive function in patients with hemiplegia after stroke

作　　者：任莎莎[1] 程凯[1] 许亮[1] 周末[1] 高明霞[1] REN Sha-sha;CHENG Kai;XU Liang;ZHOU Mo;GAO Ming-xia(Department of Rehabilitation Medicine,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)康复医学科,江苏省南京市210006

出　　处：《实用老年医学》2023年第5期449-453,共5页Practical Geriatrics

基　　金：南京医科大学科技发展基金一般项目(NMUB2020206)。

摘　　要：目的观察经颅直流电刺激(tDCS)联合运动想象疗法(MIT)改善脑卒中偏瘫病人上肢运动功能、认知功能的效果。方法将84例脑卒中偏瘫病人按随机数表法分为tDCS组、MIT组和联合组,每组28例。治疗前和治疗4周后,分别采用Fugl-Meyer功能评分上肢部分(FMA-UE)、Wolf运动功能评价量表(WMFT)、MMSE、MoCA及改良Barthel指数(MBI)对3组病人进行疗效评定。结果治疗4周后,3组病人的FMA-UE、WMFT、MMSE、MoCA及MBI评分均较治疗前改善(均P<0.05),且联合组显著优于tDCS组和MIT组(P<0.05)。结论tDCS联合MIT可显著改善脑卒中偏瘫病人上肢运动功能和认知功能,提高日常生活活动能力及生存质量。Objective To observe the effect of transcranial direct current stimulation(tDCS)combined with motor imagery training(MIT)on upper limb motor function and cognitive function in the patients with hemiplegia after stroke.Methods A total of 84 patients with hemiplegia after stroke were randomly divided into tDCS group,MIT group and combination group,with 28 cases in each group.Before and 4 weeks after treatment,Fugl Meyer assessment for the upper extremity(FMA-UE),Wolf motor function test(WMFT),Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment Scale(MoCA)and modified Barthel Index(MBI)were used to evaluate the effect in the three groups.Results After 4 weeks of treatment,the scores of FMA-UE,WMFT,MMSE,MoCA and MBI in the three groups were significantly improved compared with those before treatment(all P<0.05),especially in the combination group(P<0.05).Conclusions tDCS combined with MIT can significantly improve the motor function of upper limb and cognitive function in the patients with hemiplegia after stroke,and improve the ability of the activities of daily living.

关 键 词：脑卒中 经颅直流电刺激 运动想象疗法 上肢运动功能 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R49[医药卫生—临床医学]