分级运动表象联合重复经颅磁刺激对脑卒中患者上肢功能的效果  

Effect of graded motor imagery combined with repetitive transcranial magnetic stimulation on upper limb function of stroke patients

作　　者：贾凡 赵莹 王钊 陈杰 鲁思涵 张明 JIA Fan;ZHAO Ying;WANG Zhao;CHEN Jie;LU Sihan;ZHANG Ming(Xuzhou Rehabilitation Hospital,Xuzhou Medical University,Xuzhou,Jiangsu 221003,China;Xuzhou Clinical College of Xuzhou Medical University/Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China)

机构地区：[1]徐州医科大学附属徐州康复医院,江苏徐州市221003 [2]徐州医科大学徐州临床学院/徐州市中心医院,江苏徐州市221009

出　　处：《中国康复理论与实践》2023年第5期516-520,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：徐州市医学重点人才项目(No.XWRCHT20220045)。

摘　　要：目的探讨分级运动表象(GMI)联合重复经颅磁刺激(rTMS)对脑卒中患者上肢功能和日常生活活动能力的影响。方法2022年6月至2023年2月,徐州医科大学附属徐州康复医院和徐州市中心医院收治的脑卒中患者45例,随机分为常规组、GMI组和联合组,每组15例。3组均接受常规康复训练,GMI组增加GMI,联合组增加GMI和rTMS,共4周。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)、上肢动作研究量表(ARAT)、改良Barthel指数(MBI)和中国香港版偏瘫上肢功能测试(FTHUE-HK)进行评定。结果治疗后,3组FMA-UE、ARAT、MBI评分及FTHUE-HK分级均较治疗前显著提高(|t|>9.681,P<0.001),联合组最优(F>13.241,P<0.001)。结论GMI联合rTMS可进一步改善脑卒中患者上肢运动功能,提高日常生活活动能力。Objective To explore the effects of graded motor imagery(GMI)combined with repetitive transcranial magnetic stimulation(rTMS)on upper limb function and activities of daily living of stroke patients.Methods From June,2022 to February,2023,45 stroke patients from Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital were recruited and divided into control group(n=15),GMI group(n=15)and combined group(n=15)randomly.All the groups received conventional rehabilitation,in addition,GMI group received GMI and the combined group received GMI and rTMS,for four weeks.They were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Action Research Arm Test(ARAT),modified Barthel Index(MBI)and Hong Kong version of Functional Test for the Hemiplegic Upper Extremity(FTHUE-HK)before and after treatment.Results The scores of FMA-UE,ARAT and MBI,and grades of FTHUE-HK improved in all the groups after treatment(|t|>9.681,P<0.001),and all these indexes were the best in the combined group(F>13.241,P<0.001).Conclusion GMI combined with rTMS can further improve the motor function of upper limbs and activities of daily living of stroke patients.

关 键 词：脑卒中 上肢 运动功能 经颅磁刺激 分级运动表象 

分 类 号：R743.3[医药卫生—神经病学与精神病学]