动作观察疗法联合重复经颅磁刺激对脑卒中后下肢功能障碍的影响

目的:探讨动作观察疗法(AOT)联合重复经颅磁刺激(rTMS)对缺血性脑卒中患者下肢运动功能的影响。方法:选择72名缺血性脑卒中后下肢功能障碍的患者作为研究对象，随机分为A～D 4组各18例，4组都进行常规康复治疗，在此基础上再给与不同治疗措施。A组：AOT+rTMS,B组：AOT,C组：rTMS;D组：无其他治疗措施。每组均治疗8周。在治疗开始前、治疗4、8周后分别进行Fugl-Meyer下肢评分(FMA-LE)、10m步行测试(10MWT)、体感诱发电位(SEP)评估。结果:4组患者治疗4周、8周后的FMA-LE、10MWT、SEP潜伏期以及SEP波幅均存在交互效应(均P<0.05)。4组患者治疗4周、8周后的FMA-LE、10MWT以及SEP波幅均高于治疗前(均P<0.05);4组患者治疗8周后的FMA-LE,10MWT以及SEP波幅均较治疗4周后升高(均P<0.05);4组患者治疗4周及8周后SEP潜伏期均降低(均P<0.05);4组患者治疗8周后SEP潜伏期较治疗4周后均有降低(均P<0.05)。治疗4周、8周时，A组FMA-LE、10MWT和S...

Effect of motion observation therapy combined with repetitive transcranial magnetic stimulation on lower extremity function after stroke

Objective: To investigate the effect of action observation therapy (AOT) in combination with repetitive transcranial magnetic stimulation (rTMS) on lower limb motor function in patients with ischemic stroke. Method: From July 2019 to February 2021, 72 patients with lower limb dysfunction after ischemic stroke who met the inclusion and exclusion criteria were selected. All patients were randomly divided into 4 groups (group A: 18 cases given AOT+rTMS; group B: 18 cases given AOT; group C: 18 cases given rTMS; group D: 18 cases given routine treatment). AOT treatment lasted about 30~45 min each time, twice a day, 5 days a week, for 8 consecutive weeks. The rTMS treatment was performed on the lower extremity region of the affected side motor cortex with 1000 pulses of 5Hz rTMS, the intensity was 80% of MT of tibialis anterior muscle, and the duration was about 20 min, once a day, 5 days a week for 4 weeks. Fugl-meyer lower extremity score (FMA-LE), 10-meter walk test (10MWT) and somatosensory evoked potential (SEP) were assessed at baseline, 4 weeks and 8 weeks after tredment. Results: Repeated ANOVA showed that FMA-LE, 10MWT, SEP latency and SEP peak had the interaction effect of time and group(P<0.05). For intragroup comparison, compared with the baseline, peak FMA-LE, 10MWT, and SEP were increased in all 4 groups at 4 and 8 weeks post-intervention (P<0.05); compared with those at week 4, FMA-LE, 10MWT, and SEP peaks were increased in all 4 groups at week 8 (P<0.05). The SEP latency in the 4 groups decreased after 4 and 8 weeks of intervention (P<0.05). The SEP latency was decreased after 8 weeks of treatment in all 4 groups compared with those after 4 weeks of treatment (P<0.05). Whether the intervention was 4 weeks or the intervention was 8 weeks, FMA-LE, 10MWT, and SEP amplitude was higher and SEP latency was lower in the group A than those in the other 3 groups (P<0.05). However, there were no significant differences in FAM-LE, 10MWT, SEP latency, or amplitudes among groups B, C, and D at either 4-week intervention or 8-week intervention. Conclusion: AOT combined with rTMS, AOT alone and rTMS alone can improve lower limb motor function and nerve conduction function, but compared with AOT alone or rTMS treatment, AOT combined with rTMS treatment is more beneficial for the improvement of lower limb dysfunction after ischemic stroke.