低频重复经颅磁刺激联合下肢康复机器人对脑卒中患者平衡和运动功能的影响

关键词：低频重复经颅磁刺激  下肢康复机器人  脑卒中  平衡功能  运动能力

Keywords:low frequency repetitive transcranial magnetic stimulation  lower limb robots  stroke  balance function  motor ability

摘要：

      摘要 目的：探讨低频重复经颅磁刺激联合下肢康复机器人对脑卒中患者平衡功能和运动能力的临床疗效。 方法：将符合纳入标准的60例脑卒中偏瘫患者随机分为经颅磁刺激组（A组）、下肢康复机器人组（B组）、经颅磁联合下肢康复机器人组（C组），每组20例，3组患者均接受常规康复治疗，在常规治疗的基础上，A组增加低频重复经颅磁刺激治疗，B组增加下肢康复机器人治疗，C组增加低频重复经颅磁刺激联合下肢康复机器人治疗，观察周期为4周，3组患者治疗前后分别使用Berg平衡量表和Pro-kin平衡测试仪测试评价患者的平衡功能，使用Fugl-Meyer下肢运动功能量表（FMA-L）和功能性步行量表（FAC）评估患者的下肢功能及步行能力。 结果：治疗前，3组患者的BBS、平衡测试、FMA-L、FAC组间差异无显著性意义（P>0.05），治疗4周后，组内比较，3组患者的BBS、平衡测试、FMA-L、FAC均较治疗前改善，差异有显著性意义（P<0.05）。组间比较，C组在BBS、平衡测试、FMA-L、FAC方面的改善明显高于A组和B组，差异均具有显著性意义（P<0.05）。 结论：低频重复经颅磁刺激联合下肢康复机器人对脑卒中患者的平衡功能和运动能力疗效显著，有助于改善患者的平衡功能，同时提高运动能力，可在临床上推广应用。

Abstract:

      Abstract Objective：To investigate the effect of low frequency repetitive transcranial magnetic stimulation (rTMS) combined with rehabilitation robot on balance function and motor ability of stroke patients. Method：Sixty stroke patients with hemiplegia who met the inclusion criteria were randomly divided into the rTMS group （group A），the lower limb robot group （group B） and the rTMS combined with lower limb robot group （group C）， with 20 subjects in each group. All the three groups also received conventional rehabilitation treatment for 4 weeks. The Berg balance scale (BBS) and Pro-kin balance test were used to evaluate the balance function of the three groups before and after treatment. The Fugl-Meyer assessment of lower extremity motor function （FMA-L） and functional ambulation category（FAC） scale were used to evaluate the patients' lower extremity function and walking ability. Result：Before treatment， there was no significant difference in BBS， balance test， FMA-L and FAC among the three groups （P>0.05）. After treatment， the BBS， balance test， FMA-L and FAC of the three groups were significantly improved compared with those before treatment（P<0.05）. The improvement of the BBS， balance test， FMA-L and FAC in group C was significantly higher than that in group A and group B （P<0.05）. Conclusion：Low frequency rTMS combined with lower limb rehabilitation robot has a significant effect on balance function and motor ability in stroke patients.