体感模拟训练系统联合高频重复经颅磁刺激对脑卒中后上肢偏瘫患者上肢肌张力及脊髓运动神经元兴奋性的影响  

Effects of somatosensory simulation training system combined with high frequency repetitive transcranial magnetic stimulation on upper limb muscle tension and spinal motor neuron excitability in patients with upper limb hemiplegia after stroke

作　　者：刘朝丽 惠锦情 LIU Chaoli;HUI Jinqing(Exercise Therapy Department,Shaanxi Kangfu Hospital,Xi'an 710065,China)

机构地区：[1]陕西省康复医院运动疗法科,陕西西安710065

出　　处：《临床医学研究与实践》2024年第17期173-177,共5页Clinical Research and Practice

摘　　要：目的分析体感模拟训练系统联合高频重复经颅磁刺激对脑卒中后上肢偏瘫患者上肢肌张力及脊髓运动神经元兴奋性的影响。方法选择2019年3月至2022年4月我院收治的100例脑卒中后上肢偏瘫患者作为研究对象,以随机数字表法将其分为对照组、观察组,每组50例。对照组接受常规康复治疗,观察组在对照组基础上加施体感模拟训练系统联合高频重复经颅磁刺激。比较两组的干预效果。结果干预后,观察组的改良Ashworth评分量表(MAS)、临床痉挛指数(CSI)低于对照组,Fugl-Meyer运动功能评分量表上肢部分(U-FMA)评分高于对照组(P<0.05)。干预后,观察组的H波最大波幅(Hmax)、M波最大波幅(Mmax)及Hmax/Mmax低于对照组(P<0.05)。干预后,观察组的脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平高于对照组(P<0.05)。结论体感模拟训练系统联合高频重复经颅磁刺激用于脑卒中后上肢偏瘫患者康复治疗中,可改善神经功能及脊髓运动神经元兴奋性,促进上肢肌张力及上肢功能恢复,值得临床推广。Objective To analyze the effects of somatosensory simulation training system combined with high frequency repetitive transcranial magnetic stimulation on upper limb muscle tension and spinal motor neuron excitability in patients with upper limb hemiplegia after stroke.Methods A total of 100 patients with upper limb hemiplegia after stroke admitted in our hospital from March 2019 to April 2022 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 50 cases in each group.The control group received routine rehabilitation treatment,and the observation group received somatosensory simulation training system combined with high frequency repetitive transcranial magnetic stimulation on the basis of the control group.The intervention effects of the two groups were compared.Results After intervention,the scores of Modified Ashworth Scale(MAS)and the Clinic Spasticity Index(CSI)in the observation group were lower than those in the control group,and Upper Fugl-Meyer Motor Function Assessment(U-FMA)score was higher than that in the control group(P<0.05).After intervention,the H-wave maximum(Hmax),M-wave maximum(Mmax)and Hmax/Mmax in the observation group were lower than those in the control group(P<0.05).After intervention,the levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)in the observation group were higher than those in the control group(P<0.05).Conclusion The somatosensory simulation training system combined with high frequency repetitive transcranial magnetic stimulation in the rehabilitation treatment of patients with upper limb hemiplegia after stroke can improve the neurological function and spinal motor neuron excitability,promote the recovery of upper limb muscle tension and upper limb function,which is worthy of clinical promotion.

关 键 词：体感模拟训练系统 高频重复经颅磁刺激 脑卒中 上肢偏瘫 脊髓运动神经元兴奋性 上肢肌张力 

分 类 号：R473[医药卫生—护理学]