分级运动表象联合重复经颅磁刺激对脑卒中患者上肢功能的效果

doi:10.3969/j.issn.1006-9771.2023.05.004

Abstract

Abstract:

Objective To explore the effects of graded motor imagery (GMI) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb function and activities of daily living of stroke patients.

Methods From June, 2022 to February, 2023, 45 stroke patients from Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital were recruited and divided into control group (n = 15), GMI group (n = 15) and combined group (n = 15) randomly. All the groups received conventional rehabilitation, in addition, GMI group received GMI and the combined group received GMI and rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), modified Barthel Index (MBI) and Hong Kong version of Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) before and after treatment.

Results The scores of FMA-UE, ARAT and MBI, and grades of FTHUE-HK improved in all the groups after treatment (|t| > 9.681, P< 0.001), and all these indexes were the best in the combined group (F > 13.241, P< 0.001).

Conclusion GMI combined with rTMS can further improve the motor function of upper limbs and activities of daily living of stroke patients.

Key words: stroke, upper limb, motor function, transcranial magnetic stimulation, graded motor imagery

CLC Number:

R743.3

JIA Fan, ZHAO Ying, WANG Zhao, CHEN Jie, LU Sihan, ZHANG Ming. Effect of graded motor imagery combined with repetitive transcranial magnetic stimulation on upper limb function of stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 516-520.

Figures/Tables 5

References 36

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组别	n	性别(男/女)/n	年龄/岁	病程/d	性质(出血/梗死)/n	偏瘫侧别(左/右)/n
常规组	15	10/5	57.80±12.36	35.67±31.49	4/11	5/10
GMI组	15	7/8	63.13±8.54	34.80±27.35	2/13	7/8
联合组	15	10/5	59.47±6.30	28.80±23.87	2/13	8/7
χ²/F值		1.667	1.263	0.273	1.176	1.260
P值		0.435	0.293	0.763	0.697	0.651

组别	n	治疗前	治疗后	t值	P值
常规组	15	8.27±3.83	16.07±4.11	-10.301	< 0.001
GMI组	15	8.13±4.05	21.73±5.31^a	-15.699	< 0.001
联合组	15	8.36±3.83	27.80±8.24^a,b	-12.504	< 0.001
F值		0.076	13.692
P值		0.927	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	15	5.20±3.05	12.27±3.56	-9.812	< 0.001
GMI组	15	5.00±2.39	17.20±5.29^a	-11.597	< 0.001
联合组	15	5.33±2.72	22.20±6.57^a,b	-13.627	< 0.001
F值		0.057	13.241
P值		0.945	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	15	52.33±8.85	67.87±7.47	-14.187	< 0.001
GMI组	15	52.87±13.39	75.00±7.89^a	-9.681	< 0.001
联合组	15	55.40±12.99	82.87±7.26^a,b	-12.501	< 0.001
F值		0.283	14.818
P值		0.755	< 0.001

组别	n	治疗前							治疗后							Z值	P值
组别	n	1级	2级	3级	4级	5级	6级	7级	1级	2级	3级	4级	5级	6级	7级	Z值	P值
常规组	15	3	6	6	0	0	0	0	0	3	10	2	0	0	0	-3.317	0.001
GMI组	15	3	7	4	1	0	0	0	0	0	6	6	2	1	0^a	-3.542	< 0.001
联合组	15	2	7	5	1	0	0	0	0	0	2	3	7	3	0^a,b	-3.520	< 0.001
H值		0.234							20.466
P值		0.890							< 0.001

Effect of graded motor imagery combined with repetitive transcranial magnetic stimulation on upper limb function of stroke patients

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