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| 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 oriented training on community walking ability of post-stroke patients |
| 投稿时间：2023-11-08 修订日期：2023-11-08 |
| 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: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 |
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| 中文摘要: |
| 目的：探讨重复经颅磁刺激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例脑卒中患者采用数字表方法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。两组患者均接受常规康复训练，对照组在此基础上给予重复经颅磁刺激（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 天，连续治疗4周。任务导向性训练具体包括以下训练单元：① 患腿支撑相稳定性训练；②提高摆动相步长的训练；③平衡功能训练；④上下台阶训练；⑤步行能力训练；⑥马路中步行训练。两组患者均在治疗前后进行功能评估，包括：下肢Fugl-Meyer评分(FMA-LE)、10米最大步行速度（10MWT）、6分钟步行试验（6WMD）、起立-行走计时测试（TUG）、仪器平衡功能测试评估患者姿态稳定极限。结果：治疗后两组患者的FMA-LE、10MWT、6分钟步行距离、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无显著性差异（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: |
| Objective: To explore the effect of repetitive transcranial magnetic stimulation combined with task oriented training of lower limb motor function on community walking ability and balance function in post-stroke patients. Method: 80 post-stroke patients were randomly divided into the experimental group and the control group by using the number table method, with 40 cases in each group. Among them, 1 case was lost in the experimental group and 2 cases were lost in the control group. Both groups of patients received routine rehabilitation training, while the control group received repeated transcranial magnetic stimulation (rTMS) treatment in additional.，and the experimental group received rTMS combined with task oriented training. Interventions were implemented once per day, 5 days per week for 4 weeks. Both groups of patients underwent functional assessment before and after 4 weeks of interventions, including lower limb Fugl Meyer score (FMA-LE), maximum walking speed of 10 meters (10MWT), 6-minute walking test, time of standing walking test (TUG), and instrument balance function test to assess the patient's posture stability limit. Result: The FMA-LE, 10MWT, 6-minute walking distance, TUG, and postural stability limit index of both groups of patients increased statistically when compared before and after intervention (P<0.05), and the experimental group was better than the control group (P<0.05).
Conclusion: The combination of repetitive transcranial magnetic stimulation and task oriented lower limb motor function training has a significant improvement effect on community walking ability and balance function in post-stroke patients, and its efficacy is superior to single repetitive transcranial magnetic stimulation treatment. |
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