下肢过早负重对脑卒中偏瘫患者肢体运动功能的影响

目的研究下肢过早负重对脑卒中偏瘫患者肢体运动功能的影响。方法采用病例对照研究选取80例脑卒中患者,分别为正规康复组40例和非正规康复组40例,两组患者均给予了2个月规范的康复治疗,但非正规康复组患者康复治疗期间过早下肢负重。结果非正规康复组与正规康复组患者在入组前肢体运动功能差异无统计学意义,治疗2个月后其肢体功能恢复不及正规康复组(P<0.05)。结论过早下肢负重对脑卒中偏瘫患者肢体运动功能恢复不利。     

急性脑卒中的综合治疗及SPECT动态观察

目的探讨药物治疗合以早期康复为主要手段的综合性治疗措施对急性脑卒中治疗的优越性及脑SPECT在急性脑卒中患者脑血流灌注状态的动态变化。方法选择118例首次发病的急性脑卒中病人,随机分为康复组62例,56例为对照组,入选标准为经CT或MRI确诊发病48小时内的急性偏瘫,诊断符合第四届全国脑血病会议诊断标准。分别用Fulg—Meyer和Barthel指数评定患者的运动功能和ADL能力,比较两组主要临床指标及动态检查脑放射性核素显像SPECT,观察脑部病灶周围及时侧的脑血流灌注状态。结果康复组3个月内病死率为6．45％,对照组为10．71％（P〈0．01）;治疗后两组的Fulg—Meyer评分及Barthel指数均有改善,但康复组改善更明显,差异有显著性意义（P〈0．05）;康复组SPECT变化显示1个月后局部脑损伤灶周围及对侧脑组织的血供有明显改善。结论药物治疗合以早期康复为主要手段的综合性治疗模式下的急性脑卒中患者的预后,比单纯药物治疗的疗效更具有优越性,单纯追求药物在疾病转归中的价值可能是个误区。康复体疗可以促进局部脑损伤灶周围及对侧脑组织的血供．有利于瘫痪肢体的功能康复。     

症状性椎基底动脉狭窄血管内支架成形术疗效观察

目的 探讨血管内支架治疗椎基底动脉狭窄的安全性、有效性及与药物治疗相比的优越性.方法 对我院2005-05-2010-05收治的27例椎基底动脉狭窄的患者行血管内支架植入术治疗(支架组),对同期32例椎基底动脉狭窄的患者采取单纯药物治疗(药物组),比较2组发病后3个月、6个月、12个月及1 a后卒中及TIA发生率、美国国立卫生院卒中量表神经功能缺损评分(NIHSS).结果 支架组:1例因径路差而手术终止;1例术中发生蛛网膜下腔出血,最终死于脑干梗死;5例术中出现一过性头晕、恶心、呕吐,支架释放后症状迅速改善;1例出现穿刺点血肿,局部压迫处理后血肿未再扩大.随访中,1例椎动脉开口部位支架于术后6个月再次TIA发作,复查造影证实为支架内再狭窄,单纯球囊扩张治疗症状缓解;1例椎动脉V4段支架于术后2 a再次出现眩晕、共济失调,造影证实为支架内再狭窄,球囊扩张后症状消失.1例手术失败者于术后18个月再次脑干梗死.药物组:发病后3个月、6个月、12个月、1 a后分别有5例、7例、6例及13例卒中复发,3例1 a后随访,死于脑干梗死.2组卒中、TIA复发率及神经功能评分比较,支架组均低于药物组,差异有统计学意义(P＜0.05).结论 血管内支架成形术治疗症状性椎基底动脉狭窄安全、有效,与内科药物治疗相比,能更好地预防卒中复发,值得临床推广应用.     

基于PEO模式的家庭作业治疗对卒中偏瘫患者功能预后的影响

目的 研究基于人-环境-作业（person-environment-occupation,PEO）模式的家庭作业治疗对卒中偏瘫患者上肢功能、日常生活活动能力及生活质量的影响。方法 前瞻性、连续纳入2020年1月—2020年12月南京市浦口人民医院（原南京市浦口区中心医院）康复医学科出院的卒中偏瘫患者,随机分为试验组和对照组,并分别建立微信群聊,对照组定期更新康复小视频,有任何问题随时咨询。试验组基于PEO模式,个性化更新每位患者的小视频,两组分别于出院时、出院3个月、6个月和12个月分别进行Fugl-Meyer运动功能量表上肢部分（Fugl-Meyer assessment upper extremity scale,FMA-UE）、日常生活活动能力Barthel指数（Barthel index,BI）及卒中专用生活质量量表（stroke-specific quality of life scale,SS-QOL）的评定。结果 最终纳入卒中偏瘫患者60例,平均年龄（63.10±6.83）岁,其中男性30例。将入组患者随机分为对照组和试验组各30例。组内比较显示,试验组出院3个月BI评分...     

Subthreshold depression and cognitive impairment but not demented in stroke patients during their rehabilitation

Background –  Subthreshold depression (sD) and cognitive impairment but not demented (CIND) in stroke patients are associated with poorer rehabilitative outcomes. Their diagnosis can easily be operationalized using validated scales.
Aim –  The aim of the study was to ascertain the prevalence of depressive symptoms and cognitive impairment in stroke patients during three crucial stages of the rehabilitative process, viz. upon admission, upon planned discharges from rehabilitation hospitals and at 6 months post-stroke, using validated scales like the Geriatric Depression Scale and Abbreviated Mental Test (recommended by the British Geriatric Society). Their baseline risk factors were also ascertained.
Results –  On admission, the prevalence of depressive symptoms and cognitive impairment was 60% and 54% respectively. The prevalence upon planned discharges and 6 months post-stroke, respectively, of depressive symptoms was 38% and 34% and that of impaired cognition was 33% and 40%. Baseline independent correlates at 6 months post-stroke depressive symptoms were: recurrent stroke (OR 3.34); on admission cognitive impairment (OR 4.78) and ADL dependence (OR 5.28). And that of cognitive impairment were: increasing age (OR 8.07); post-stroke dysphagia (OR 4.58); on admission cognitive impairment (OR 23.95) and on admission depressive symptoms (OR 3.50).
Conclusions –  Continuous screening and appropriate intervention, especially at baseline, would significantly decrease the burden posed by stroke patients with such psychological impairments in the community.     

Vergleich deutscher und türkischer Patienten mit ischämischem Schlaganfall

BACKGROUND: Until now no data has been available on possible specific features of the Turkish minority in Germany with respect to stroke. PATIENTS AND METHODS: We compared 20 Turkish stroke patients with matched German controls analyzing risk factors, findings at admission, rehabilitative treatments, and psychosocial aspects. RESULTS: In the Turkish group the interval between onset of symptoms and admission was longer (532 min vs 255 min, P < 0.01). All other findings during acute treatment and rehabilitation were comparable. At follow-up after 22 months, the Barthel index was 90 for the Turks and 100 for the Germans. The Turkish patients reported more consultations with physicians than their German counterparts (68 vs 12 per year, P < 0.01). Scores for quality of life and outcome did not differ. The Turkish patients more frequently required care and had a higher degree of disability. CONCLUSIONS: Turkish stroke patients have a longer time to admission. Risk factors, findings at admission, and treatment in the acute phase and rehabilitation are comparable. Several findings point towards a different health behavior. These results highlight the need for specific education of the Turkish population in Germany.     

The course of blood pressure in acute stroke is related to the severity of the neurological deficits

OBJECTIVES: To evaluate how soon after stroke the diagnosis of hypertension could be established. METHODS: In a prospective study including 1192 patients with acute stroke within 6 h, blood pressure was measured serially at 2-h intervals during the first 24 h. Results are presented as mean arterial blood pressure (MAP). The Scandinavian Stroke Scale (SSS) assessed the neurological deficit. RESULTS: In 779 patients with mild to moderate ischaemic stroke or transient ischaemic attack (TIA) and SSS > 25, MAP was 118 mmHg (CI 95%: 116-119 mmHg) on admission and 109 mmHg (CI 95%: 108-110 mmHg) 4 h later (paired t-test, P < 0.001). No such early decrease was observed in 228 patients with severe cerebral infarction (CI). In mild to moderate ischaemic stroke or TIA, MAP at 24 h was not different from MAP at 3 months in paired t-test. CONCLUSIONS: Blood pressure 24 h after admission in patients with mild to moderate CI or TIA was representative of the patient's blood pressure 3 months after stroke. A diagnosis of arterial hypertension can be established a few days after stroke.     

Prognostic factors in the recovery of the ability to walk after stroke

We have studied the recovery of walking ability on being discharged from a department of physical medicine and rehabilitation in patients with hemiplegia after stroke, and the factors influencing this recovery. This prospective study was based on 93 patients. The patients, who were considered to be ambulatory, were able to move 10 metres on their own or with supervision when they were discharged. The potentially influential factors studied were: age, the aetiology and the side of hemiplegia, co-morbidity, the delay in starting rehabilitation, the neurological damage evaluated by the middle cerebral artery scale of Orgogozo, the initial functional damage evaluated by the functional score carried out within the scale of Functional Independence Measure (FIM), the existence of aphasia, of a depressive or hemineglect syndrome, presence of superficial or profound sensory disorders, incontinence at the start of rehabilitation and at one month after stroke, the existence of cognitive or psychiatric disorders. The non-parametric Mann-Whitney, the [Chi ]₂, and the correlation test were used. The threshold of significance was .05. Based on 93 patients (47 women and 46 men, average age 64.8) 87.1% were walking at discharge, on average 3 months after stroke. The predictive factors or those linked to an absence of recovery were the presence of superficial sensory disorders, the initial neurological damage, the initial functional damage, the presence of a depressive syndrome, and urinary incontinence. We stress the significance of the sensorimotor and initial functional damage, and of incontinence in establishing a prognosis for recovery of walking ability, in order to decide the objectives and the rehabilitative treatment for each patient.     

Management and outcome of patients with transient ischemic attack admitted to a stroke unit

BACKGROUND: The way in which patients with transient ischemic attack (TIA) are investigated and treated varies substantially worldwide. There are no data on the management and outcome of TIA patients admitted to a stroke unit. We assessed to what extent rapid management of TIA patients admitted to a stroke unit led to specific treatments which can prevent stroke and evaluated the early risk and predictors of stroke in these patients. METHODS: From January 2003 to November 2005, 203 consecutive patients with a recent (<48 h) TIA were admitted to our stroke unit. All patients had a diffusion-weighted imaging (DWI) on admission, a standardized etiological workup, and were followed up to 3 months. RESULTS: The median (interquartile range) time from TIA onset to admission to the stroke unit was 12 h (5-25). DWI revealed acute lesions in 64 patients (32%). Of the 203 patients, 147 (72%) were treated by antiplatelet therapy and 56 (28%) with high doses of heparin, soon after their admission. In addition, 7 patients (3%) had a carotid revascularization. The risk of stroke was 2.5% (95% CI, 0.3-4.7) at 1 week, and 3.5% (1.0-6.1) at 3 months. In multivariate analysis, a score > or =5 at the previously validated ABCD score (HR = 5.0; 1.0-25.8; p = 0.06) and the presence of DWI abnormalities (HR = 10.3; 1.2-86.7; p = 0.03) were independent predictors of stroke at 3 months. CONCLUSION: Early management of TIA in a stroke unit leads to specific treatments in a significant proportion of cases. The presence of acute lesions on DWI and the ABCD score predict the 3-month risk of stroke after TIA.     

Creation of a regional stroke network in Tours hospital (France): consequences for stroke care and thrombolysis

INTRODUCTION: Our university hospital serves a population of 300 000 inhabitants. Stroke is the leading cause of admission in our department of neurology. In June 2003, when the Emergency Department (ED) was closed in our institution, was created an acute stroke network (ASN), comprising 2 beds of direct admission and thrombolysis in the intensive care unit, and 4 beds dedicated to stroke care in the department of neurology, in which standardized stroke care protocols were implemented. OBJECTIVE: The aim of this study was to evaluate changes in stroke care related to the creation of the ASN in terms of delays of arrival, imaging, use of intravenous (IV) thrombolysis, and outcome of patients. We conducted a prospective study during 18 months to evaluate characteristics of patients admitted with suspected stroke or transient ischemic attack (TIA) in the newly created ASN and to assess conditions of treatment with IV thrombolysis in terms of safety and efficacy. We also compared the outcome data before and after the creation of the ASN. METHODS: For each patient admitted in our hospital for suspected stroke or TIA, were prospectively collected clinical and outcome data (age, mode of transport, delay of arrival after the onset of symptoms (OS), treatment with IV thrombolysis, outcome and discharge). This study was conducted in the ED during six months in 2002, and in the ASN during 18 months, for all patients admitted for stroke. RESULTS: Three hundred and sixty four patients were admitted in the ASN. Emergency medical services (EMS) were used in half of cases for transport, and median delay of admission after the OS was 2h and 52 min. Median delay of imaging was 1 h and 45 min. Seventeen patients (8.5 p. 100 of ischemic stroke patients) were treated with IV thrombolysis, with an initial good outcome in 9 patients, 7 with a dramatic recovery). The main reason for therapeutic abstention for untreated patients admitted in the first 3 hours was a mild deficit with a NIHSS<6. Compared with the previous management in the ED, patients in the ASN were younger, had more severe neurological symptoms, the EMS transport was the main mode of transport (versus used in 17 p. 100 of cases in 2002), and the delay of admission was significantly lower: 2 h 52 versus 5 h 10 (p<0.02). After adjustment on the main predictive factors, only patients with hemorrhagic strokes had a better outcome after the creation of the ASN. CONCLUSIONS: Creation of an ASN was associated with a significant decrease of admission and imaging delays, due to a strong collaboration with EMS, and with a better outcome for hemorrhagic stroke patients. Treatment with intravenous thrombolysis in the first 3 hours could be used widely and was efficient and safe. However, the creation of dedicated stroke units for all stroke patients remains necessary to improve quality of care and outcome.     

Dual extradural cortical stimulation in chronic stroke patients with large infarcts: technical case report

Abstract

Objective and importance: Recent works on extradural cortical stimulation have been successful in improving neurological recovery in chronic stroke patients. On the other hand, single perirolandic stimulations are often associated with disappointing results.

Clinical presentation: We report two cases of chronic stroke in which the magnitude of infarct was too large to be improved with single perirolandic stimulation. Patient 1 had severe hemiplegia associated with large cortical infarct in the right frontoparietal area. The patient could neither stand independently or walk. Patient 2 had hemiplegia and aphasia due to cortical infarct in the left middle cerebral artery territory. Both patients had intensive rehabilitative training for more than 6 months with no beneficial results.

Intervention: Two paddle electrodes covering frontal and parietal area were implanted, followed by dual cortical stimulation with concurrent rehabilitative training in patient 1. After 6 months of stimulation, the patient could walk with a good posture. Two paddle electrodes were implanted to cover pre-motor and motor cortex in patient 2. After similar treatment, the motor function was markedly improved.

Conclusion: Dual cortex stimulation, which acts on more diffuse areas or functionally related areas, is beneficial to promote the motor recovery in chronic stroke patients with large infarcts.     

A longitudinal study of health-related quality of life of first stroke survivors' close relatives

BACKGROUND AND PURPOSE: Mental and social burdens of stroke patients' relatives have been investigated repeatedly, but there is little information about their quality of life (QoL). The purpose of the study was to describe the health-related QoL of stroke patients' relatives at 3 points in time after the stroke. METHOD: Sixty-four closest relatives of patients suffering from a disabling stroke were questioned at admission to inpatient rehabilitation as well as 6 months and 1 year after discharge with the SF36 (short form 36-item questionnaire) and about probable covariates. RESULTS: During inpatient rehabilitation relatives' perception of their physical role as well as of all mental health scales was significantly lower than the normative data. We found improvements in all scales except physical functioning between inpatient rehabilitation and 6 months after discharge. Deteriorations between 6 months and 1 year occurred in physical functioning, role physical, social functioning, role emotional and mental health. CONCLUSIONS: Changes in perceived health-related QoL indicate that relatives go through different stages while coping with the chronic illness of their family member during rehabilitation and in the first year after discharge. These findings may aid support and counseling.     

急性脑卒中老人接受神经营养药物联合早期康复治疗的转归

在1年的时间里,对入住浙江大学附属第一医院老年病科的60例老年急性脑卒中患者给予神经营养药物联合早期康复治疗,借助Hunt-Hess 量表、功能独立性评测、简易智力测定量表和日常生活能力量表,对患者入院时和出院时的肢体运动、认知功能和日常生活自理能力变化做出了评估。纳入的60位患者平均住院时间35 d。出院时有40例患者存在不同程度的认知功能损害,56例接受康复治疗评估的脑卒中患者中,25例（45%）在日常生活方面获得了自理能力,11例（20%）日常生活的部分时间里需要有人照顾,20例（36%）在基本生活上需要全天24 h有人照顾。     

A型肉毒毒素注射配合综合康复训练治疗痉挛型偏瘫型脑瘫患儿临床分析

目的探讨A型肉毒毒素治疗痉挛型偏瘫型脑瘫患儿的临床疗效。方法选择痉挛型偏瘫型脑瘫儿童40例,随机分为A型肉毒毒素治疗组20例和单纯康复治疗组（对照组）20例。治疗组将A型肉毒毒素注射到患儿腘伸肌群和小腿三头肌群,注射后第2天开始进行康复训练（共6个月）。所有患者治疗前及治疗后2周、1个月、3个月、6个月进行腘窝角和足背屈角角度的测量、改良的Ashworth量表、粗大运动功能分级量表进行评价。结果治疗组的腘伸肌群和小腿三头肌群肌张力和粗大运动功能评分均比注射前改善明显（P〈0.05）,治疗效果明显优于对照组（P〈0.01）。结论 A型肉毒素配合康复治疗可以有效降低患儿患侧的肌张力,有助于提高运动功能,缩短治疗时间。     

Positional sleep apnea in patients with ischemic stroke

BACKGROUND: In non-stroke patients, the severity of sleep apnea (SA) is known to be frequently related to the sleeping position, a condition called positional SA. In the present study, we investigated whether in acute stroke the occurrence of apneas was related to the positioning of patients, and whether a similar finding could be observed after rehabilitation. With the purpose of identifying patients potentially being in need of a SA treatment beyond rehabilitation, we furthermore looked for epidemiologic and clinical parameters being related to persistent SA 6 months after stroke. PATIENTS AND METHODS: Fifty-five acute stroke patients underwent cardiorespiratory polygraphy within 72 hours after onset of neurological symptoms and after 6 months. Apart from the total AHI (AHITOT), the AHI with the patient in supine position and the AHI with the patient in other positions were determined. In all patients, demographic data, NIH-stroke scale score and cumulative vascular risk factors were assessed. RESULTS: In the initial sleep study, 78% of patients had an AHI>or=10/h, of whom 65% fulfilled the criteria of positional SA. On follow-up, the incidence of SA declined to 49% with positional SA being present in 33%. Multivariate logistic regression analysis identified AHITOT on admission [OR=1.07 (1.002-1.13)] and cumulative vascular risk factors [OR=3.48 (1.34-9.05)] as independent predictors of persistent SA 6 months after stroke. CONCLUSION: According to our results, positional SA is a predominant feature in acute stroke and its incidence decreases significantly during the following months. These findings may have implications for SA treatment in patients with acute stroke.     

社区脑卒中患者处理能力及主要照顾者的照顾能力

背景 脑卒中是造成人类死亡和残疾的主要疾病之一,我国卫生部已把康复作为社区卫生服务六位一体功能之一,实施社区康复、家庭康复已势在必行。 目的 通过对社区脑卒中患者自理能力及主要照顾者照顾能力现状的调查,分析其相关影响因素,为制定系统化、标准化、个性化和家庭化的护理方案,完善我国社区康复培训模式,提高脑卒中患者生活质量提供依据。 设计,时间和单位 于2009年1月～2009年4月对上海某两个社区的研究对象进行描述性研究。 对象 上海某两个社区病程在6个月～2年的脑卒中患者60名。 方法 方便抽样法。描述性研究。应用SPSS11.5软件处理数据。 主要观察指标 对研究对象的一般资料、疾病情况、康复训练情况、自理能力及照顾者照顾能力情况进行调查评定。 结果 63.3%脑卒中患者自理能力水平中等,只有36.7%处于高等;照顾者的照顾水平5.0%处于低等,51.7%处于中等,仅43.3%处于高等;参加过社区康复训练的脑卒中患者人数为28名（46.7%）,从未参加过社区康复训练的人数为32名（53.3%）;患者的自理能力与年龄、病程、文化程度、收入、是否参加过康复训练等具有相关性。 结论 社区脑卒中患者自理能力及主要照顾者照顾能力不容乐观,参加康复训练的普及率不高,需加强康复训练的指导。     

Epilepsy After Stroke

A retrospective follow-up of 200 consecutive stroke patients [ischemic brain infarction (IBI) 157, intracerebral hemorrhage (ICH) 20, subarachnoid hemorrhage (SAH) 23] who were in need of ambulatory rehabilitation was conducted for a mean period of 40 months after stroke. Epilepsy developed in 33 (17%) patients. The occurrence of epilepsy was 14% in IBI, 15% in ICH, and 35% in SAH. Significantly more patients developed epilepsy in the SAH group than in the IBI group (8 of 23 vs. 22 of 157, p less than 0.05). Of the 33 patients, 15% had their first seizures within the first 2 weeks after stroke, and 55% developed epilepsy in 6 months. Forty-eight percent of the patients had generalized seizures. Antiepileptic drug (AED) treatment was started in 28 of 33 patients, of whom 17 still had seizures during follow-up. Epilepsy was an important consequence of stroke among patients who needed rehabilitation, especially in SAH patients. In most, this was due to arterial spasm leading to IBI.     

Survival after stroke and transient ischemic attacks during the 1970s and 1980s

Survival after stroke and transient ischemic attack was studied in S?derhamn, Sweden, during the periods 1975-1979 and 1983-1987; 640 patients with first-ever stroke and 97 with first-ever transient ischemic attack were registered and followed for 1-3 years. Approximately 90% of the patients were treated in the Department of Internal Medicine of S?derhamn Hospital. The protocols for physical rehabilitation and antithrombotic treatment changed between study periods. Between periods, 3-year survival after stroke increased by 16% (p less than 0.003). The 95% confidence intervals of the relative survival rates were 0.524-0.648, 0.435-0.567, and 0.337-0.475 at 1, 2, and 3 years, respectively, during the first period and 0.616-0.728, 0.600-0.732, and 0.576-0.748 during the second period. Fewer patients suffered fatal complications of stroke during the second period. The rate of stroke recurrence was approximately 10%/year during both study periods. Four patients suffered fatal hemorrhage during the first period, but no patient did so during the second period. Observed survival after transient ischemic attack did not differ from that expected in the first 2 years of follow-up during either study period. The risk for stroke after transient ischemic attack was approximately 5%/year during both periods. The higher survival rates after stroke during the second period seems to be the result of fewer fatal complications rather than of a reduced risk for recurrent stroke.     

Patients with severe stroke benefit most by interdisciplinary rehabilitation team approach

BACKGROUND: We evaluated the efficacy of a regular interdisciplinary stroke team approach on rehabilitation outcome. METHODS: We compared a stroke rehabilitation unit (SRU) with regular interdisciplinary stroke team conferences with general rehabilitation ward (GRW) without such conferences in the same rehabilitation hospital. One hundred and seventy-eight patients within 3 months after stroke were allocated to SRU or GRW, based on bed availability. Main outcome measures were the Functional Independence Measure, Stroke Impairment Assessment Set, length of hospital stay, discharge disposition and cost of hospitalization. RESULTS: The interval between stroke onset and admission to our hospital was significantly longer in the SRU (n = 91) group compared with the GRW group (n = 87, p < 0.05). Although comparable numbers of patients were discharged home (74.7% in the SRU vs. 71.3% in the GRW), significantly more patients (p < 0.0001) with severe disability were discharged home in the SRU group (47.4%) compared with the GRW group (0%). There were no significant differences in the increase in Functional Independence Measure score, Stroke Impairment Assessment Set score,length of hospital stay, or cost. CONCLUSION: Patients with severe stroke appeared to benefit most from regular interdisciplinary stroke team conferences in the SRU and had an improved discharge disposition.     

低频重复经颅磁刺激联合以任务为导向作业疗法对脑卒中患者上肢运动功能的康复作用

目的探讨低频重复经颅磁刺激联合以任务为导向作业疗法对脑卒中患者上肢运动功能的康复作用。方法共42例脑卒中后偏瘫患者随机接受常规康复训练和以任务为导向作业疗法(对照组,20例)以及在此基础上联合健侧运动皮质低频(1 Hz)重复经颅磁刺激(治疗组,22例),分别于治疗前、治疗4周时和治疗后3个月采用Fugl-Meyer上肢评价量表(FMA-UE)和Wolf运动功能测验(WMFT)评价上肢运动功能,记录并分析健侧运动皮质运动诱发电位潜伏期和中枢运动传导时间。结果与对照组相比,治疗组FMA-UE评分(P=0.006)和WMFT评分(P=0.024)均增加;两组不同时间点FMA-UE评分(P=0.000)和WMFT评分(P=0.000)差异有统计学意义,其中治疗4周时和治疗后3个月FMA-UE评分(均P=0.000)和WMFT评分(均P=0.000)均高于治疗前,治疗后3个月FMA-UE评分(均P=0.000)和WMFT评分(均P=0.000)亦高于治疗4周时。两组患者治疗前后健侧运动皮质运动诱发电位潜伏期(P=0.979)和中枢运动传导时间(P=0.807)差异无统计学意义,不同时间点(治疗前、治疗4周时和治疗后3个月)健侧运动皮质运动诱发电位潜伏期(P=0.085)和中枢运动传导时间(P=0.507)差异亦无统计学意义。结论脑卒中患者健侧运动皮质低频重复经颅磁刺激联合以任务为导向作业疗法可以有效改善脑卒中患者上肢运动功能,值得临床推广应用。