摘要
目的:探讨重复经颅磁刺激(rTMS)联合核心稳定训练对脑卒中患者的治疗效果.方法:将符合标准的45例脑卒中偏瘫患者随机分为对照组、磁刺激组和联合组各15例.3组常规治疗相同,对照组进行假rTMS+核心稳定性训练;磁刺激组在常规康复治疗基础上增加健侧1Hz rTMS;联合组在常规康复治疗基础上增加健侧1Hz rTMS联合核心稳定训练.3组均持续干预3周.比较3组治疗前后的腹横肌(TrA)、腹内斜肌(IO)和腹外斜肌(EO)的厚度,同时进行Fugl-Myer运动功能(FMA)、Berg平衡量表(BBS)及改良Barthel指数(MBI)评定.结果:治疗3周后,3组FMA、BBS和MBI评分均较治疗前明显提高(均P＜0.001);联合组和磁刺激组患侧TrA、IO及EO的厚度与治疗前相比均明显增加(均P＜0.05),而对照组上述指标较治疗前增加差异无统计学意义.组间比较,联合组的FMA、患侧TrA厚度分别与磁刺激组比较,联合组的FMA、BBS、MBI、患侧TrA和患侧EO厚度分别与对照组比较,磁刺激组MBI与对照组比较,差异均有统计学意义(均P＜0.05).3组健侧TrA、IO和EO厚度组内及组间比较,差异均无统计学意义.结论:低频rTMS联合核心稳定性训练能明显提高患者运动功能和平衡功能,改善日常生活活动,值得在临床推广应用.
Abstract
Objective:To explore the effect of repetitive transcranial magnetic resonance spectroscopy(rTMS)combined with core stabilization training on the recovery of stroke patients.Methods:A total of 45 patients with stroke hemiplegia who met the criteria were randomly divided into a control group(n=15),a magnetic stimulation group(n=15),and a combination group(n=15).The routine treatment was the same in the three groups,while the control group received sham rTMS+core stability training;In the magnetic stimulation group,1 Hz rTMS was added to the contralateral side on the basis of conventional rehabilitation treatment.The combination group was giv-en 1 Hz rTMS combined with core stabilization training on the contralateral side on the basis of conventional rehabil-itation treatment.All three groups were continuously intervened for 3 weeks.The thickness of transversus abdomi-nis muscle(TrA),internal oblique muscle(IO),and external oblique muscle(EO)in the three groups before and after treatment were compared,and the Fugl-Myer motor function(FMA),Berg balance scale(BBS),and modified Barthel index(MBI)were evaluated.Results:There was no statistically significant difference in the general informa-tion among the three groups before treatment(P＞0.05).After 3 weeks of treatment,there were statistically sig-nificant differences in FMA,BBS,and MBI in the three groups compared to those before treatment(P＜0.001).The thickness of TrA,IO,and EO on the affected side of the three groups after treatment increased compared to that before treatment.Among them,the combination group and magnetic stimulation group showed a significant in-crease compared to that before treatment(all P＜0.05),while the control group showed no significant increase com-pared to that before treatment.The FMA and TrA thicknesses on the affected side in the combined group were com-pared with those of the magnetic stimulation group,respectively.The FMA,BBS,MBI,the thickness of TrA and EO on the affected side in the combined group were compared with those of the control group,respectively.The dif-ferences in the MBI between the magnetic stimulation group and the control group were statistically signifi-cant(P＜0.05).There was no statistically significant difference in the thickness of TrA,IO,and EO on the contralateral side within and between the three groups.Conclusion:Low frequency rTMS combined with core stability training can significantly improve patients'motor and balance functions,and improve their activities of dai-ly living,which is worth promoting and applying in clinical practice.
维普
万方数据