低频重复经颅磁刺激联合MOTOmed智能运动训练系统对脑卒中偏瘫患者上肢痉挛的影响

目的:探讨低频重复经颅磁刺激(rTMS)联合MOTOmed智能运动训练系统对脑卒中偏瘫患者上肢痉挛和运动功能的影响.方法:将90例脑卒中恢复期偏瘫患者随机分为联合治疗组、rTMS治疗组和伪rTMS治疗组,每组各30例.伪rTMS治疗组患者在常规康复治疗基础上辅以rTMS假刺激治疗,rTMS治疗组患者在常规康复治疗基础上...

Effects of low-frequency repetitive transcranial magnetic stimulation combined with MOTOmed gracile on upper limb spasticity after stroke

Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation combined with MOTOmed gracile on the upper limb motor function and activities of daily living(ADL)in stroke patients with hemiplegia.Method:90 stroke patients with hemiplegia were divided into combined treatment group,rTMS treatment group and sham rTMS treatment group with 30 patients in each group.The sham rTMS group received routine rehabilitation and sham rTMS treatment.The rTMS treatment group and combined treatment group both received routine rehabilitation and 1Hz rTMS treatment at primary motor area(M1)for four weeks.In addition,the combined treatment group was trained with MOTOmed gracile.Their upper limb motor function and ADL were assessed with modified Ashworth scale(MAS),Fugl-Meyer assessment upper extremity(FMA-UE),modified Barthel index(MBI),upper limb F-wave and H-reflex parameters before and after treatment.Result:After treatment for 4weeks,the scores of MAS,MBI and FMA-UE,the parameters of F-wave amplitude,latency and Hmax/Mmax were significantly improved in the three groups than before treatment(P<0.05).After 4 weeks of treatment,the scores of MAS,MBI and FMA-UE,the parameters of F-wave amplitude,latency and Hmax/Mmax were significantly improved in the combined treatment group than other groups(P<0.05).The MAS scores of wrist flexion and elbow flexion,the parameters of F-wave amplitude,latency and Hmax/Mmaxratio in rTMStreatment group were significantly lower than that of the sham rTMS treatment group(P<0.05),but the FMA-UE and BI scores after treatment between rTMS treatment group and sham rTMS treatment group did not showed significant difference(P>0.05).Conclusion:rTMS combined with MOTOmed gracile can be applied for rehabilitation of upper limb spasticity after stroke.