rTMS联合肩前屈特定角度训练对脑卒中偏瘫患者上肢功能恢复的影响  

The influence of rTMS combined with shoulder flexion specific angle training on the recovery of upper limb function in stroke patients with hemiplegia

作　　者：李永义 张义发 徐秀芳 施伯瀚 袁伟伟 王金艳 夏家怡 LI Yongyi;ZHANG Yifa;XU Xiufang;SHI Bohan;YUAN Weiwei;WANG Jinyan;XIA Jiayi(Shanghai Second Rehabilitation Hospital,Shanghai 200431,China)

机构地区：[1]上海市第二康复医院,上海200431

出　　处：《中南医学科学杂志》2024年第5期779-781,共3页Medical Science Journal of Central South China

基　　金：上海市卫生健康委员会科研课题(20204Y0373);上海市第二康复医院科研项目(Y2020-23)。

摘　　要：目的 探究肩前屈特定角度训练结合重复经颅磁刺激(rTMS)对脑卒中偏瘫患者上肢功能恢复的影响。方法 选取95例脑卒中患者,分为联合组(rTMS联合肩前屈特定角度训练)和对照组(肩前屈特定角度训练)。比较两组治疗前后上肢及手部Brunnstrom分期评分、Fugl-Meyer运动功能评定量表(FMA)评分、改良Barthel指数(MBI)评分以及上肢感觉评分。结果 与治疗前比较,治疗后两组上肢及手部Brunnstrom分期评分、FMA评分和MBI评分提高,感觉评分下降;且联合组变化较对照组更显著(P<0.05)。结论 rTMS联合肩前屈特定角度训练可明显提高脑卒中偏瘫患者上肢力量、上肢功能及触觉能力,有效促进上肢功能恢复。Aim To explore the influence of shoulder flexion specific angle training combined with repetitive transcranial magnetic stimulation(rTMS) on upper limb function recovery in stroke patients with hemiplegia.Methods 95 stroke patients were selected and divided into a combination group(rTMS combined with shoulder flexion specific angle training) and a control group(shoulder flexion specific angle training).The Brunnstrom staging score for upper limbs and hands,Fugl-Meyer assessment(FMA) score,modified Barthel index(MBI) score,and upper limb sensory score before and after treatment between two groups were compared.Results Compared with the parameters before treatment,after treatment,the Brunnstrom staging score for upper limbs and hands,FMA score,and MBI score in both groups improved,while the upper limb sensory score decreased;and the changes in the combination group were more significant than those in the control group(P<0.05).Conclusion The combination of rTMS and specific angle training for shoulder flexion can significantly improve upper limb strength,upper limb function,and tactile ability in stroke patients with hemiplegia,effectively promoting upper limb function recovery.

关 键 词：RTMS 脑卒中 偏瘫 上肢功能 肩前屈特定角度训练 

分 类 号：R743.3[医药卫生—神经病学与精神病学]