首页|智能镜像手套任务导向性训练联合低频重复经颅磁刺激对脑卒中患者手功能效果的随机对照试验

智能镜像手套任务导向性训练联合低频重复经颅磁刺激对脑卒中患者手功能效果的随机对照试验

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目的 观察智能镜像手套任务导向性训练联合低频重复经颅磁刺激(rTMS)对脑卒中患者手功能恢复的效果.方法 2022年10月1日至2023年6月30日,选择苏北人民医院脑卒中患者136例,随机分为对照组、镜像组、rTMS组和联合组,每组34例.各组均给予常规康复治疗,镜像组增加智能镜像手套任务导向性训练治疗,rTMS组增加低频rTMS治疗,联合组增加智能镜像手套任务导向性训练与低频rTMS治疗,共4周.比较治疗前后Fugl-Meyer评定量表上肢部分(FMA-UE)评分、Wolf运动功能测定量表(WMFT)评分和前臂伸肌群、屈肌群表面肌电均方根值(RMS)患侧/健侧比值;比较rTMS组和联合组治疗前后经颅磁刺激运动诱发电位(MEP)的差异.结果 对照组4例、镜像组7例、rTMS组5例、联合组6例脱落.4组FMA-UE、WMFT评分和前臂伸肌、屈肌群RMS比的组内效应(F>996.656,P<0.001)、组间效应(F>20.333,P<0.001)和交互效应(F>72.796,P<0.001)均显著,且联合组最优.治疗后,rTMS组和联合组MEP的振幅均增加(|t|>3.842,P<0.05),联合组明显高于rTMS组(t=-3.060,P<0.01).结论 智能镜像手套任务导向性训练联合低频rTMS可有效促进脑卒中患者手功能恢复.
Effect of intelligent mirror glove task-oriented training combined with low-frequency repetitive transcranial mag-netic stimulation on hand function in patients with stroke:a randomized controlled trial
Objective To explore the effect of task-oriented training of intelligent mirror gloves combined with low-frequency repeti-tive transcranial magnetic stimulation(rTMS)on hand function recovery in stroke patients.Methods From October 1st,2022 to June 30th,2023,136 stroke patients in Northern Jiangsu People's Hospital were ran-domly divided into control group,mirror group,rTMS group and combination group,with 34 patients in each group.All the groups received routine rehabilitation treatment.In addition,the mirror group received task-orient-ed training of intelligent mirror gloves,rTMS group received low-frequency rTMS,and the combination group received task-oriented training combined with low-frequency rTMS,for four weeks.The Fugl-Meyer Assess-ment-Upper Extremities(FMA-UE)score,Wolf Motor Function Test(WMFT)score,and surface electromyo-graphic root mean square(RMS)of forearm extensor and flexor muscle groups on the affected/healthy side be-fore and after treatment were compared.And the differences of transcranial magnetic stimulation-motor-evoked potentials(MEP)between rTMS group and combination group before and after treatment were also compared.Results Four cases in the control group,seven in the mirror group,five in rTMS group and six in the combination group dropped off.The intra-group effect(F>996.656,P<0.001),inter-group effect(F>20.333,P<0.001)and inter-action effect(F>72.796,P<0.001)were significant in the scores of FMA-UE and WMFT,and the RMS ratio of forearm extensor and flexor muscle groups among four groups,in which the combination group was the best.After treatment,the amplitude of MEP increased in rTMS group and combination group(|t|>3.842,P<0.05),and was higher in the combination group than in rTMS group(t=-3.060,P<0.01).Conclusion The task-oriented training of intelligent mirror gloves combined with low-frequency rTMS could effectively promote the recovery of hand function in stroke patients.

strokeintelligent mirror glovestask-oriented trainingrepetitive transcranial magnetic stimulationhand functionrandomized controlled trial

陈晨、孟兆祥、杨康、张敏杰、左亚南、王奎、张熙斌、全逸峰、金星

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苏北人民医院康复医学科,江苏扬州市 225001

脑卒中 智能镜像手套 任务导向性训练 重复经颅磁刺激 手功能 随机对照试验

扬州市科技计划项目

YZ2022099

2024

中国康复理论与实践
中国残疾人康复协会,中国医师协会,中国康复研究中心

中国康复理论与实践

CSTPCD北大核心
影响因子:1.354
ISSN:1006-9771
年,卷(期):2024.30(7)
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