文章摘要
许菁, ，张伟, ，李奎, ，吕佳豪 ，郑婵娟, ，夏文广,,.重复经颅磁刺激联合任务导向性训练对脑卒中患者社区步行能力的影响[J].神经损伤功能重建,2024,(3):136-140
重复经颅磁刺激联合任务导向性训练对脑卒中患者社区步行能力的影响
Effects of Repetitive Transcranial Magnetic Stimulation Combined with Task-OrientedTraining on Community Walking Ability of Post-Stroke Patients
  
DOI：
中文关键词: 脑卒中  重复经颅磁刺激  任务导向性训练  社区步行能力  平衡功能
英文关键词: stroke  repetitive transcranial magnetic stimulation  task-oriented training  community walking ability  balance function
基金项目:湖北省第二届医学 领军人才工程培养 对象暨湖北名医工 作 室 负 责 人 项 目 ( 鄂 卫 通 [2019]47 号)；湖北省卫生健 康委科研中医面上 项目（基于头针联 合 rTMS 的扶正祛 邪益智治疗中风后 不同程度认知功能 障碍恢复的影响， No. ZY2021M101）
作者单位
许菁1,2 ，张伟1,2 ，李奎1,2 ，吕佳豪1 ，郑婵娟1,2 ，夏文广1,2,3 1. 湖北省中西医结 合医院康复医学中 心 2. 湖北省脑卒中后 中西医结合康复临 床研究中心 3. 湖北省康复医院 
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中文摘要:
      目的：探讨重复经颅磁刺激（repetitive transcranial magnetic stimulation, rTMS）联合任务导向性下肢运 动功能训练对脑卒中患者社区步行能力及平衡功能的影响。方法：将80例脑卒中患者随机分为实验组与对 照组，每组40例，其中实验组脱落1例，对照组脱落2例。2组患者均接受常规康复训练，对照组在此基础上 给予 rTMS治疗，实验组给予rTMS联合任务导向性下肢运动功能训练，每天治疗1次，每周5 d，连续治疗4 周。2组患者均在治疗前后进行功能评估，包括下肢Fugl-Meyer评分（Fugl-Meyer Assessment of lower extremity，FMA-LE）、10 米最大步行速度（10 meter walk test，10MWT）、6 min 步行试验（6 minute walk distance， 6MWD）、起立-行走计时测试（time up and go test，TUG）、仪器平衡功能测试评估患者姿态稳定极限。结果：治 疗后2组患者的FMA-LE、10MWT、6 min步行距离、TUG、极限位移时的移动速度、最大位移、终点位移均较治 疗前改善（P＜0.05），但对照组患者治疗前后极限位移时的反应时间及方向控制差异无统计学意义（P＞0.05）， 治疗后实验组的观察指标改善程度均优于对照组（P＜0.05）。结论：rTMS联合任务导向性下肢运动功能训练 对于脑卒中患者社区步行能力及平衡功能有明显改善作用，其疗效优于单一rTMS治疗。
英文摘要:
      To explore effect of repetitive transcranial magnetic stimulation (rTMS) combined with task-oriented training of lower limb motor function on the community walking ability and balance function in post-stroke patients. Methods: Eighty post-stroke patients were randomly divided into the experimental group and the control group, with 40 cases in each group. One case was lost in the experimental group and two cases were lost in the control group. Both groups of patients received routine rehabilitation training. The control group received rTMS treatment, while the experimental group received rTMS combined with task-oriented training of lower limb motor function. Interventions were implemented once daily, 5 days per week for 4 weeks. Functional assessments, including the Fugl-Meyer Assessment of Lower Extremity (FMA-LE), 10-meter walking test (10MWT), 6-minute walk distance (6MWD), timed up and go test (TUG), and instrumented balance function testing were conducted before and after interventions to assess the patients' postural stability limits. Results: After treatment, both groups presented improvements in FMA-LE, 10MWT, 6MWD, TUG, movement speed at limit displacement, maximum displacement, and endpoint displacement (P<0.05). However, the differences in reaction time and directional control at limit displacement were not statistically significant in the control group before and after intervention (P>0.05). Moreover, after treatment, the experimental group exhibited superior improvements in the observational indexes compared to the control group (P<0.05). Conclusion: The combination of rTMS and task-oriented training of lower limb motor function significantly improves community walking ability and balance function in post-stroke patients, with its efficacy superior to that of single rTMS treatment.
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