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刘思豪,李 哲,郭钢花,关晨霞,乐 琳,郝道剑,李 颖.低频重复经颅磁刺激改善脑卒中屈肘肌痉挛及运动功能的临床研究[J].中国康复医学杂志,2019,(11):1328~1332
低频重复经颅磁刺激改善脑卒中屈肘肌痉挛及运动功能的临床研究    点此下载全文
刘思豪  李 哲  郭钢花  关晨霞  乐 琳  郝道剑  李 颖
郑州大学第五附属医院康复医学科450052
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摘要:
      摘要 目的:探讨低频(1Hz)重复经颅磁刺激(rTMS )干预脑卒中患者健侧大脑半球M1区对患侧屈肘肌痉挛的治疗效果。 方法:40例脑卒中伴肘部痉挛患者随机分为rTMS组(n=20)和对照组(n=20)。两组患者均给予常规康复治疗,rTMS组额外给予健侧M1区低频rTMS治疗。治疗前后,两组患者分别测量患侧肘关节被动伸展时肱二头肌及主动伸展时肱三头肌的均方根值(RMS)、运动诱发电位(MEPs)、改良Ashworth分级(MAS)、Fugl-Meyer上肢评定(UFMA)和改良Barthel指数(MBI)。 结果:治疗4周后,rTMS组和对照组各组患者患侧肱二头肌的RMS、肱三头肌的RMS、MAS、UFMA和MBI 较本组治疗前均明显改善(P<0.05),并且rTMS组患者的改善更为显著(P<0.05)。对照组治疗后MEPs波幅较治疗前无显著性差别(P>0.05),rTMS组治疗后MEPs波幅较前显著提高(P<0.05)。 结论:低频rTMS有助于改善脑卒中患者患侧上肢屈肘肌痉挛,提高运动功能。
关键词:脑卒中  重复经颅磁刺激  痉挛
Clinical research on the influence of low-frequency repetitive transcranial magnetic stimulation on spasticity and motor function of patients after stroke    Download Fulltext
Department of Rehabilitation,The Fifth Affiliated Hospital of Zhengzhou University,450052
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Abstract:
      Abstract Objective:To investigate the clinical effect of low-frequency repetitive transcranial magnetic stimulation on elbow flexor spasticity in stroke patients. Method:Forty patients were randomly divided into rTMS group and control group with 20 in each. All of the patients in both groups received conventional treatment. The patients in rTMS group were given repetitive magnetic stimulation over the contralesional motor cortex in addition. Before and after treatment, the following data were acquired for each subject and compared between the rTMS group and the control group, including the Root mean square(RMS)of the ipsilateral biceps and triceps recorded by surface electromyography(sEMG), the motor evoked potentials(MEPs), and the Modified Ashworth Scale(MAS),Fugl-Meyer Assessment (FMA) of upper limbs and the modified Barthel Index(MBI). Result:After 4 weeks, the MAS, the RMS of the biceps and triceps,the amplitude of MEPs of biceps,and the scores of FMA and MBI were all larger in the rTMS group than that in the control group(P<0.05). Conclusion:Low-frequency Repetitive Transcranial Magnetic Stimulation can reduce elbow flexor spasticity after stroke and improve upper limb motor function.
Keywords:stroke  repetitive transcranial magnetic stimulation  spasticity
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