Application of intermittent Theta burst stimulation combined with rehabilitation training in the recovery of upper limb dyskinesia in patients with acute severe stroke
Objective To explore the application of combination of intermittent Theta burst stimulation and rehabilitation training in the recovery of upper limb dyskinesia in patients with acute severe stroke.Methods Ninety-four patients with acute stroke hemiplegia in our hospital were selected.The patients were divided into a training group and an electrical stimulation group by means of odd-even number method,47 in each group.The training group received routine rehabilitation training.The electrical stimulation group received intermittent Theta burst stimulation combined with rehabilitation training.The clinical efficacy(NIHSS),upper limb movement assessed by using Fugl-Meyer assessment(FMA),modified Barthel index(MBI)and upper limb movement index(MI),electrical stimulation indicators such as central motor conduction time(CMCT)and motor evoked potential(MEP),surface electromyogram signal and cerebral hemodynamics such as peripheral resistance,mean blood flow velocity and mean blood flow volume before and after treatment were compared between the two groups.Results On the 1 st,2 nd and 4 th weeks of treatment,the NHISS in both groups was decreased gradually(P＜0.05),and the NHISS score in the electrical stimulation group was significantly lower than that in the training group at each time point after treatment(P＜0.05).After treatment,the scores of FMA,MBI and MI were increased in the two groups(P＜0.05),and the electrical stimulation group had higher scores(P＜0.05).After treatment,CMCT and MEP in the two groups were declined significantly(P＜0.05),and the above two indicators were significantly lower in the electrical stimulation group than those in the training group(P＜0.05).After treatment,the surface electromyogram signals of biceps elbow flexion and triceps elbow extension were risen significantly in the two groups(P＜0.05),and the signals in the electrical stimulation group were significantly higher(P＜0.05),but biceps elbow extension and triceps elbow flexion revealed no statistical differences within or between the groups(P＞0.05).After treatment,the peripheral resistance in both groups was reduced significantly(P＜0.05)while the mean blood flow velocity and blood flow volume were enhanced significantly(P＜0.05).The peripheral resistance in the electrical stimulation group was significantly lower(P＜0.05)while the mean blood flow velocity and blood flow volume were significantly higher than those in the training group(P＜0.05).No obvious adverse reactions were found in the two groups.Conclusions Intermittent Theta burst stimulation combined with rehabilitation training can restore the upper limb motor function of patients with acute stroke hemiplegia,and improve the electromyogram signal and cerebral hemodynamics.It has a significant efficacy and is worth recommending.
Acute severe strokeIntermittent Theta burst stimulationRehabilitation trainingUpper limb motor function
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