中国老年保健医学2025，Vol.23Issue(2)：12-17,6.DOI:10.3969/j.issn.1672-2671.2025.02.002
经颅磁刺激联合任务导向性训练对OCSP亚型上肢运动功能的影响
Effect of transcranial magnetic stimulation combined with task-oriented training on upper limb FMA score of OCSP sub-types
摘要
Abstract
Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with task-oriented training on the score of the upper limb part of the simplified Fugl-Meyer motor assessment(FMA)in hemiplegia patients with different OCSP subtypes.Methods Select 96 cases of patients with cerebral infarction who were hospitalized in the re-habilitation department of our hospital from January 2022 to December 2023.Divide them into four groups according to the OCSP clinical classification standard:TACI group with 17 cases,PACI group with 31 cases,POCI group with 33 cases,and LACI group with 15 cases.All four groups received low-frequency rTMS combined with task-oriented training.Simplified Fugl-Meyer Motor Function Assessment Scale(FMA)upper limb part scores were evaluated before and after treatment.The changes in upper limb FMA scores of each subtype were analyzed to assess clinical efficacy.A change value of upper limb FMA score greater than 4.6 is considered signif-icant therapeutic effect,while less than 4.6 is considered insignificant.Patient course of disease,age,NIHSS scores,and resting motor threshold(RMT)of the affected side were compared to analyze factors affecting the therapeutic effect.Results Compared with before treatment,the upper limb FMA scores of all four groups increased after treatment,and the upper limb FMA score of the POCI group was higher than that of the TACI group(P＜0.05).Based on the minimal clinically important difference(MCID)of FMA in the as-sessment of motor function in stroke patients,the change in upper limb FMA score of the TACI group[2(0.5,5.5)was less than 4.6 points(P＜0.05),while the change in upper limb FMA score of the POCI group(6.45±4.72)was greater than 4.6 points(P＜0.05).Analysis of factors influencing treatment outcomes showed that the POCI group had the highest significant rate of efficacy;NIHSS score was a factor influencing the outcomes of patients with anterior circulation infarction(TACI group+PACI group),while disease course and affected side RMT were factors influencing the outcomes of patients with posterior circulation infarction(P＜0.05).Conclusion Low-frequency rTMS combined with task-oriented training is effective for upper limb motor function recovery in patients with the OCSP subtype of hemiplegia,with the most significant role in POCI.Disease course and the RMT of the affected side are factors influencing the clinical efficacy of POCI,while the NIHSS score is a factor influencing the clinical efficacy of anterior cir-culation infarction.关键词
脑梗死/OCSP亚型/rTMS/任务导向性训练/Fugl-Meyer运动功能评定量表Key words
cerebral infarction/OCSP subtypes/rTMS/task-oriented training/Fugl-Meyer motor function assessment scale引用本文复制引用
雷茵,顾琳,严琳,徐涵,张帆琪..经颅磁刺激联合任务导向性训练对OCSP亚型上肢运动功能的影响[J].中国老年保健医学,2025,23(2):12-17,6.基金项目
上海市黄浦区卫生健康委员会卫生行业临床研究专项青年项目(编号:HLQ202009) （编号:HLQ202009）
