小脑间歇性θ爆发式磁刺激对亚急性期脑卒中患者静态平衡和步行功能的影响

关键词：脑卒中  小脑  间歇性θ爆发式磁刺激  平衡  步行

Keywords:stroke  cerebellar  intermittent theta burst stimulation  balance  walking

摘要：

      摘要 目的：探讨间歇性θ爆发式磁刺激（intermittent theta burst stimulation，iTBS）作用于小脑对亚急性脑卒中患者静态平衡和步行功能的疗效观察。 方法：选择28例于本院就诊的亚急性脑卒中患者，随机分为2组（试验组14例，对照组14例）。两组均接受康复训练。试验组接受2周共10次偏瘫侧小脑外侧区域iTBS，对照组接受2周伪刺激iTBS。两组患者在干预前后进行站立或行走任务评估。在站立任务中，通过Prokin平衡仪采集静态平衡数据。在行走任务中，通过Vicon三维运动捕捉系统采集步行数据。采用重复测量方差分析比较两组患者在干预前后平衡和步行数据。 结果：干预前两组患者的一般资料、平衡功能、步行功能无显著性差异（P＞0.05）。干预2周后，在平衡功能方面，试验组前后方向平均摆动速度（P＜0.001）、摆动面积（P＜0.001）和摆动轨迹长度（P＜0.001）显著下降，对照组无显著改变（P＞0.05）。在步行功能方面，试验组干预后步频加快（P＜0.001），对照组无显著改变（P＞0.05）。 结论：小脑iTBS可以有效地改善亚急性脑卒中患者的静态平衡和步行功能。

Abstract:

      Abstract Objective： To investigate the effects of intermittent theta burst stimulation （iTBS） on the static balance and walking function in patients with subacute stroke. Method： Twenty-eight patients with subacute stroke were randomly divided into 2 groups (14 cases in the experimental group and 14 cases in the control group). Both groups received rehabilitation training. The experimental group received 10 times iTBS targeting the lateral cerebellar region of the hemiplegic side for 2 weeks, while the control group received sham iTBS. Patients in both groups were assessed for standing or walking tasks before and after treatment. Static balance data were collected using the Prokin balance testing instrument during standing tasks. For walking tasks, gait parameters were recorded using the Vicon motion capture system. Repeated-measures ANOVA was used to compare balance and gait data between the two groups before and after the treatment. Result: No significant differences were observed in baseline characteristics, balance function, or walking function between the two groups before treatment （P＞0.05）.After treatment， the experimental group showed significant improvements in balance function, including reduced average sway velocity of the center of pressure in the anterior-posterior direction (P＜0.001）, decreased sway area of the center pressure （P＜0.001）, and the shorter trajectory path length of the center pressure （P＜0.001）. In contrast, the control group exhibited no significant changes（P＞0.05）.Regarding walking function, the experimental group demonstrated a significant increase in step frequency （P＜0.001）, while the control group showed no significant change （P＞0.05）. Conclusion: Cerebellar iTBS can effectively enhance static balance and walking function in patients with subacute stroke.