实用医学杂志2024，Vol.40Issue(13)：1797-1802,6.DOI:10.3969/j.issn.1006-5725.2024.13.006
健侧小脑间歇性θ短阵脉冲刺激康复治疗对脑卒中患者下肢步行功能的影响
Effect of contralesional cerebellar iTBS combined with routine rehabilitation on lower limb walking func-tion in stroke patients
摘要
Abstract
Objective To investigate the effect of iTBS stimulation on walking function in patients with stroke.Methods Fifty patients with post-stroke walking dysfunction who met the inclusion criteria were selected for 3-week rehabilitation treatment,and were randomly divided into iTBS group(n=25)and sham group(n=25).The iTBS group was treated with conventional rehabilitation therapy combined with iTBS stimulation of contral-esional cerebellum,and the sham group was treated with conventional rehabilitation therapy plus iTBS stimulation of contralesional cerebellum.Relevant indicators were analyzed before treatment and at 21 days of treatment.Lower limb motor function scores of the two groups were compared before and after treatment.Fugl-Meyer motor function lower limb activity score,Berg Balance Scale score,Brunnstrom stage(lower limb),hamstring/quadriceps(H/Q)on the affected side,Modified Barthel index(MBI),gait analysis parameters,and TMS-MEP were used to evaluate the effectiveness of cerebellar iTBS in the rehabilitation of walking dysfunction after stroke.Results After 21 days of treatment,the improvements of Brunnstrom stage,Holden grade,Berg score,FMA score,6-minute walking dis-tance,NIHSS score and MBI score in iTBS group were significantly better than those in sham group(P<0.05).Af-ter treatment,the H/Q in iTBS group was significantly higher thanbefore(P<0.05),but there was no significant difference between the two groups(P>0.05).Stride speed,stride frequency,stride width,single support phase on the affected side and GDI score in iTBS group were significantly improved compared with sham group(P<0.05),and there was no significant difference in stride length between the two groups after treatment(P>0.05).The amplitude of MEP in the affected cerebral cortex of iTBS group was lower after treatment than before(P<0.05).Conclusion Contralesional cerebellar iTBS combined with routine rehabilitation could improve lower limb walk-ing function and daily living ability of stroke patients.关键词
脑卒中/间歇θ短阵脉冲刺激/三维步态分析/步行功能Key words
stroke/intermittent theta-burst stimulation/three-dimensional gait analysis/walking function分类
医药卫生引用本文复制引用
邓罗义,陈彦,曾妮,黄璞,张兴,胡康杰,郑鹏,吴霜..健侧小脑间歇性θ短阵脉冲刺激康复治疗对脑卒中患者下肢步行功能的影响[J].实用医学杂志,2024,40(13):1797-1802,6.基金项目
国家自然科学基金委员会地区项目(编号:82060419,82260452) （编号:82060419,82260452）
贵州省卫生健康委科学技术基金项目(编号:gzwkj2023-014) （编号:gzwkj2023-014）
贵州省科技计划项目(编号:黔科合基础-ZK[2022]重点045) （编号:黔科合基础-ZK[2022]重点045）
