低频重复经颅磁刺激联合康复机器人治疗脑卒中手功能障碍的临床研究

关键词：重复经颅磁刺激治疗  康复机器人  脑卒中  手功能  

Keywords:repetitive transcranial magnetic stimulation  rehabilitation robot  stroke  hand dysfunction

摘要：

      摘要 目的：观察低频重复经颅磁刺激联合康复机器人对脑卒中患者手功能障碍的治疗效果。 方法：选取在我院康复科治疗的脑卒中手功能障碍患者36例，随机分为试验组（n=18）和对照组（n=18）。两组患者均接受常规治疗。对照组采用健侧1Hz重复经颅磁刺激治疗，试验组在对照组的基础上增加手功能康复机器人治疗，共持续治疗4周。于治疗前、治疗2周、治疗4周后采用皮质运动诱发电位（motor evoked potential， MEP）、中枢运动传导时间（central motor conduction time， CMCT）、患侧上肢Fugl-Meyer评分（Fugl-Meyer assessment， FMA）、运动强度指数（motricity index，MI）评分进行评定。 结果：治疗4周后两组患者MEP、CMCT、FMA、MI较治疗前均有明显改善，差异均有显著性意义（P<0.001）。治疗4周后试验组MEP、CMCT、FMA、MI较对照组明显改善，差异均有显著性意义（P<0.05）。 结论：健侧低频重复经颅磁刺激联合康复机器人可以明显改善脑卒中患者的手功能障碍。

Abstract:

      Abstract Objective：To observe the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation combined with rehabilitation robot on hand dysfunction in stroke patients. Method：Totally 36 patients with stroke hand dysfunction treated in the Rehabilitation Department of Jinshan Hospital were randomly divided into the experimental group （n=18） and the control group （n=18）. Both groups of patients received routine treatment. Both groups were treated with 1Hz repetitive transcranial magnetic stimulation on the unaffected side， and the experimental group was added by a hand function rehabilitation robot. Both groups were treated 5 times a week for 4 weeks. The assessment were evaluated before treatment， 2 weeks and 4 weeks after treatment, including the latency of cortical motor evoked potential （MEP）， central motor conduction time （CMCT）， Fugl-Meyer assessment（FMA） score and motor intensity index （MI） score. Result：After 4 weeks of treatment， MEP， CMCT， FMA and MI of the two groups were significantly improved compared with those before treatment（P<0.001）. After 4 weeks of treatment， MEP， CMCT， FMA and MI in the experimental group were significantly improved compared with those in the control group（P<0.05）. Conclusion：The contralateral low-frequency repetitive transcranial magnetic stimulation combined with rehabilitation robot can significantly improve hand dysfunction in stroke patients.