| θ节律刺激对脑卒中后患者上肢运动功能和日常生活能力影响的Meta分析 |
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| 引用本文： | 夏渊,卢悦,李爱玲,王珍玉,潘新永,李永杰.θ节律刺激对脑卒中后患者上肢运动功能和日常生活能力影响的Meta分析[J].中国医学物理学杂志,2022,0(3):341-348. |
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| 作者姓名： | 夏渊 卢悦 李爱玲 王珍玉 潘新永 李永杰 |
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| 作者单位： | 1.武汉体育学院健康科学学院， 湖北 武汉 430079； 2.甘肃天水四零七医院神经外科， 甘肃 天水 741000； 3.贵州省骨科医院康复医学科， 贵州 贵阳 550002 |
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| 摘 要： | 目的:系统评价θ节律刺激（TBS）对脑卒中后患者上肢运动功能和日常生活活动能力的影响。方法:系统检索ProQuest、Scopus、PubMed、Embase、Cochrane Library、Web of Science、知网、万方、中国生物医学和维普数据库中关于TBS治疗脑卒中患者的随机对照试验，检索时间为建库至2021年4月。由两位评审员运用Cochrane手册对纳入文献进行风险质量评估，并在数据提取后运用RevMan5.3进行统计学分析。结果:最终获得14项研究，共329例受试者。Meta分析结果显示，与常规康复组相比，TBS组在降低美国国立卫生研究院卒中量表（NIHSS）评分［WMD=-4.11, 95%CI:-6.99~-1.23, P=0.005］，提高改良Barthel指数评分（MBI） ［WMD=9.54，95%CI:3.81~15.27，P=0.001］和改善手臂动作调查测试表评分（ARAT）［WMD=8.83, 95%CI:3.26~14.40, P=0.002］方面更优，差异有统计学意义（P<0.05）。另外，TBS组在提高上肢Fugl-Meyer量表（UE-FMA）评分［WMD=7.24, 95%CI:2.18~12.31, P=0.005］方面优于常规康复组；且亚组结果显示间歇性TBS（ITBS）在提高UE-FMA评分上可能比连续性TBS（CTBS）效果更优（P=0.04）。结论:基于当前证据，TBS可有效改善脑卒中患者上肢运动功能和日常生活活动能力，上述结论仍需更多高质量研究进一步证实。
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| 关 键 词： | θ节律刺激 脑卒中 上肢 运动功能 |
Effects of theta burst stimulation on upper limb motor function and activities of daily living in patients after stroke: a Meta analysis |
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| XIA Yuan,LU Yue,LI Ailing,WANG Zhenyu,PAN Xinyong,LI Yongjie.Effects of theta burst stimulation on upper limb motor function and activities of daily living in patients after stroke: a Meta analysis[J].Chinese Journal of Medical Physics,2022,0(3):341-348. |
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| Authors: | XIA Yuan LU Yue LI Ailing WANG Zhenyu PAN Xinyong LI Yongjie |
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| Affiliation: | 1. School of Health Sciences, Wuhan Sports University, Wuhan 430079, China 2. Department of Neurology, Tianshui 407 Hospital of Gansu, Tianshui 741000, China 3. Department of Rehabilitation Medicine, Guizhou Provincial Orthopedics Hospital, Guiyang 550002, China |
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| Abstract: | Abstract: Objective To systematically evaluate the effects of theta burst stimulation (TBS) on the upper limb motor function and activities of daily living in patients after stroke. Methods The randomized controlled trials of TBS in the treatment of stroke patients were retrieved from ProQuest, Scopus, PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, China Biomedicine (CBM) and Weipu databases, and the retrieval time was from the establishment of the database to April 2021. Two reviewers used the Cochrane manual to evaluate the risk and quality of the included literatures, and a statistical analysis by RevMan5.3 was carried out after data extraction. Results Fourteen literatures were finally included in the study, with a total of 329 subjects. Meta-analysis results showed that compared with conventional rehabilitation group, TBS group reduced the National Institutes of Health Stroke Scale (NIHSS) score ［WMD=-4.11, 95%CI (-6.99, -1.23), P=0.005］, improved the modified Barthel index (MBI) score ［WMD=9.54, 95%CI (3.81, 15.27), P=0.001］ and improved the action research arm test (ARAT) score ［WMD=8.83, 95%CI (3.26, 14.40), P=0.002］, and the differences were statistically significant (P<0.05). In addition, TBS group was better than conventional rehabilitation group in improving the upper extremity Fugl-Meyer assessment (UE-FMA) score ［WMD=7.24, 95%CI (2.18, 12.31), P=0.005］, and the subgroup results revealed that intermittent TBS might be more effective than continuous TBS in improving UE-FMA score (P=0.04). Conclusion Based on current evidence, TBS can effectively improve upper limb motor function and activities of daily living in stroke patients, but the above conclusion still needs to be further confirmed by more high-quality researches. |
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| Keywords: | Keywords: theta burst stimulation stroke upper limb motor function |
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