Effects of rTMS combined with gluteus medius muscle facilitation on gait,balance ability and limb function in elderly patients with post-stroke hemiplegia
Objective To explore the effects of repetitive transcranial magnetic stimulation(rTMS)combined with glu-teus medius muscle facilitation in the treatment of post-stroke hemiplegia in the elderly,analyze its effects on gait,balance abil-ity and limb function,and provide a method for the treatment of this disease.Methods 102 elderly stroke patients admitted to Huai'an First People's Hospital Affiliated to Nanjing Medical University from October 2022 to March 2024 were selected and di-vided into rTMS group and facilitation group according to different treatment methods,with 51 cases in each group.Both groups received conventional drug support treatment and rehabilitation training.The rTMS group received rTMS treatment,while the facilitation group received repeated facilitation of the gluteus medius muscle in addition to rTMS treatment.The gait,trunk ability[Chinese version of Trunk Injury Scale(TIS)],limb function[Fugl-Meyer assessment scale(FMA)],balance ability[Tinetti Balance and Gait Scale,Berg Balance Scale(BBS)and sitting and standing balance function]and the hemody-namic indicators[peak systolic velocity(PSV),blood flow(BF)]were compared between the two groups before and after treatment.Results After treatment,the step speed,step frequency,step length ratio of affected limb to healthy limb and sup-port time of affected limb and healthy limb in the two groups were quicker or larger than those of the same group before treat-ment(P＜0.05),while the gait cycle time and step width were shorter than those of the same group before treatment(P＜0.05).The differences between the two group were statistically significant(P＜0.05).The scores of subscales and total score of TIS,scores of upper limb movement and lower limb movement and total score of FMA,Tinetti score and BBS score and the PSV and BF of the brachial vein of the affected upper limb and PSV and BF of the common femoral vein of the affected lower limb increased in both groups compared with those in the same group before treatment(P＜0.05),while the average speed of the center of gravity swing,the trajectory of the center of gravity movement,and the length of the trajectory of the center of gravity movement per unit area decreased compared with those in the same group before treatment(P＜0.05),The differences between the two group were statistically significant(P＜0.05).Conclusion The combination of rTMS and gluteus medius muscle facilitation can significantly improve the gait and balance ability of elderly patients with post-stroke hemiplegia,increase the venous blood flow of lower limbs,and promote the recovery of trunk and limb function.
elderlystrokehemiplegiarepetitive transcranial magnetic stimulationgluteus medius muscle facilita-tiongait recoverylimb function
万方数据
维普
