中国康复2026，Vol.41Issue(6)：342-347,6.DOI:10.3870/zgkf.2026.06.004
间歇性θ刺激联合Bobath康复训练治疗脑卒中后上肢痉挛的疗效
The curative effect of intermittent theta burst stimulation combined with Bobath training in treating post-stroke upper limb spasticity
摘要
Abstract
Objective:To evaluate the efficacy of intermittent theta burst stimulation(iTBS)combined with Bobath training(BT)in patients with post-stroke upper limb spasticity(PS-ULS).Methods:A total of 153 patients with PS-ULS admitted to our hospital from January 2024 to June 2025 were enrolled and randomly assigned(using SPSS-generated random numbers)into three groups:the control group(n=51,receiving BT alone),the iTBS group(n=51,receiving iTBS alone),and the study group(n=51,receiving BT plus iTBS).We compared their clinical efficacy,spasticity severity,motor function,modified Barthel index(MBI),surface electromyography(sEMG)parameters,cerebral vascular hemodynamics(CVH),and incidence of adverse events.Results:The modi-fied Ashworth Scale(MAS)score of the study group was significantly better than that of the control and iTBS groups(P<0.05).After treatment,the scores of the Fugl-Meyer Assessment for Upper Limb(FMA-UE),MBI,the sEMG amplitude during maximal voluntary contraction(MVC)of the biceps brachii,and the mean blood flow velocity(Vm)were significantly increased compared to baseline in all three groups(all P<0.05),with the study group showing greater improvements than both the control and iTBS groups(all P<0.05).Conversely,the elbow joint flexion-extension recurrent excitation ratio(RER),resting sEMG amplitude of the biceps brachii,pulsatility index(PI),and resistance index(RI)were significantly decreased from baseline in all three groups(all P<0.05),with the study group demonstrating lower values than the control and iTBS groups(all P<0.05).No significant differences were observed in the overall incidence of adverse events among the three groups.Conclusion:The iTBS combined with BT effectively alleviates spasticity,enhances motor function,MBI,sEMG parameters,and cere-bral vascular hemodynamics in patients with PS-ULS,yielding significant clinical efficacy without increasing the risk of adverse events.关键词
间歇性θ刺激/Bobath康复训练/脑卒中/上肢痉挛Key words
intermittent theta burst stimulation/Bobath training/stroke/upper limb spasticity分类
医药卫生引用本文复制引用
段园园,刘莉宁,侯天朋,于俊峰,赵晓利..间歇性θ刺激联合Bobath康复训练治疗脑卒中后上肢痉挛的疗效[J].中国康复,2026,41(6):342-347,6.基金项目
河北省中医药管理局科研计划项目(2024532) （2024532）
