CIMT联合低频rTMS治疗对卒中后上肢痉挛患者神经功能、上肢功能及Barthel指数的影响  

Influence of CIMT Combined with Low-Frequency rTMS on Neurological Function,Upper Limb Function and Barthel Index in Patients with Upper Limb Spasm after Stroke

作　　者：李鹏 李哲 卢振东 侯瑞芳 郭巍 LI Peng;LI Zhe;LU Zhendong;HOU Ruifang;GUO Wei(Department of Rehabilitation Medicine,Xingtai Central Hospital/Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China;Outpatients Department,Xingtai Central Hospital/Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China;Department of Basic Medicine,Xingtai Medical College,Xingtai,Hebei 054000,China)

机构地区：[1]邢台市中心医院/邢台医学院附属医院康复医学科,河北邢台054000 [2]邢台市中心医院/邢台医学院附属医院门诊部,河北邢台054000 [3]邢台医学院基础医学部,河北邢台054000

出　　处：《转化医学杂志》2025年第3期110-115,共6页Translational Medicine Journal

基　　金：邢台市重点研发计划项目(2020ZC315)。

摘　　要：目的探讨强制性运动疗法(CIMT)联合低频重复经颅磁刺激(rTMS)治疗对卒中后上肢痉挛患者神经功能、上肢功能及Barthel指数(MBI)的影响。方法选取2023年9月至2024年9月邢台市中心医院收治的卒中后上肢痉挛患者,按照随机数表法分为对照组和观察组,每组73例。对照组采用常规康复干预,观察组在对照组基础上采用CIMT联合低频rTMS干预,比较2组患者治疗前及干预后神经功能、上肢功能、MBI评分、上肢痉挛程度、肱三头肌表面肌电值、生活质量及干预依从性。结果干预后,2组神经功能评分、上肢痉挛程度均低于治疗前,且观察组显著低于对照组(P<0.05);干预后,2组上肢功能评分、MBI评分、生活质量评分、肱三头肌伸肘积分肌电值、屈肘积分肌电值、干预总依从率均高于治疗前,且观察组显著高于对照组(P<0.05)。结论采用CIMT联合低频rTMS干预可显著改善卒中后上肢痉挛患者的神经功能,并提高其上肢功能、肌力、日常生活活动能力及干预依从性,减轻其上肢痉挛程度,提高其生活质量。Objective To study the influence of constraint-induced movement therapy(CIMT)combined with low-frequency repetitive transcranial magnetic stimulation(rTMS)on neurological function,upper limb function and the Modified Barthel index(MBI)in patients with upper limb spasm after stroke.Methods The study subjects were patients with upper limb spasm after stroke admitted to the hospital from September 2023 to September 2024.They were divided into the control group(n=73,receiving routine rehabilitation intervention)and the observation group(n=73,receiving CIMT combined with low-frequency rTMS intervention in addition to the control group's protocol)using the random number table method.The neurological function,upper limb function,MBI score,upper limb spasm degree,triceps surface electromyography value,quality of life and intervention compliance were compared between the two groups.Results After 8 weeks of intervention,the neurological function scores and degree of upper limb spasm decreased in the two groups,with the observation group showing lower values than the control group(P<0.05).Additionally,the upper limb function score,MBI score,quality of life scores,triceps brachii elbow extension integral electromyography value,elbow flexion integral electromyography value and total intervention compliance increased,with the observation group demonstrating higher values than the control group(P<0.05).Conclusion CIMT combined with low-frequency rTMS intervention can significantly improve the neurological function of patients with upper limb spasm after stroke,enhance the upper limb function,muscle strength,activities of daily living and intervention compliance,reduce the degree of upper limb spasm and improve the quality of life.

关 键 词：强制性运动疗法 低频重复经颅磁刺激 卒中后上肢痉挛 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]