小脑间歇性θ短阵脉冲刺激联合运动疗法对脑卒中患者平衡及步行功能的影响

关键词：小脑  重复经颅磁刺激  θ短阵脉冲刺激  平衡  步态

Keywords:cerebellum  repetitive transcranial magnetic stimulation  theta burst stimulation  balance  gait

摘要：

      摘要 目的：探讨小脑间歇性θ短阵脉冲刺激（intermittent theta burst stimulation， iTBS）联合运动疗法对脑卒中患者平衡及步行功能的影响。 方法：选取伴有平衡功能及步行功能障碍的脑卒中患者60例，随机分为试验组和对照组，每组患者为30例。两组患者都接受运动疗法，运动疗法前，试验组行患侧大脑对侧小脑的iTBS治疗，对照组行相同部位的伪刺激，iTBS每日治疗1次，每周6次，连续治疗2周。治疗前后用Berg平衡量表（Berg balance scale， BBS）、Pro-kin平衡仪静态平衡测试、计时起立行走测试（timed up and go test， TUGT）、10米步行测试（10-meter walking test， 10MWT）和Tinetti步态评估量表（Tinetti performance oriented mobility assessment-gait， Tinetti POMA-G）评估两组患者的平衡及步行功能。 结果：治疗后两组患者BBS评分、Pro-kin平衡仪静态平衡测试相关参数、TUGT时间、10MWT步速和POMA-G评分均比治疗前改善（P＜0.001）。治疗后试验组BBS评分、Pro-kin平衡仪静态平衡测试闭眼状态平衡参数、TUGT时间、10MWT步速和Tinetti POMA-G评分均优于对照组（P＜0.05）。 结论：小脑iTBS联合运动疗法可有效改善脑卒中患者平衡及步行功能。

Abstract:

      Abstract Objective： To investigate the effects of cerebellar intermittent theta burst stimulation （iTBS） combined with exercise therapy on balance and walking function in stroke patients. Method： Sixty stroke patients with balance and gait disturbances were randomly assigned to an experimental group (n=30) and a control group (n=30). Both groups received exercise therapy. Before exercise therapy， the experimental group received iTBS treatment on the cerebellar hemisphere contralateral to the lesion， while the control group received sham stimulation at the same site. iTBS treatment was administered once daily， 6 times a week， for 2 consecutive weeks. The balance and gait functions were evaluated before and after treatment using the Berg balance scale （BBS）， Pro-kin balance master static balance test， Timed Up and Go Test （TUGT）， 10-meter walking test （10MWT）， and Tinetti performance oriented mobility assessment-gait （Tinetti POMA-G）. Result： After treatment， both groups of patients showed improvements in BBS scores， Pro-kin balance master static balance test parameters， TUGT time， 10MWT walking speed， and POMA-G scores compared to before treatment （P<0.001）. The experimental group showed better BBS scores， Pro-kin balance master static balance test parameters in eyes closed condition， TUGT time， 10MWT walking speed， and Tinetti POMA-G scores compared to the control group after treatment （P<0.05）. Conclusion： The combination of cerebellar iTBS and exercise therapy effectively improve balance and walking function in stroke patients.