经皮耳迷走神经电刺激结合康复机器人训练对脑卒中患者上肢功能的效果

doi:10.3969/j.issn.1006-9771.2023.06.009

Abstract

Abstract:

Objective To investigate the effect of transcutaneous auricular vagus nerve stimulation (taVNS) combined with robot-assisted therapy on upper limb function of subacute stroke patients.
Methods From March, 2022 to March, 2023, 60 subacute stroke patients from Dushu Lake Hospital and the First People's Hospital of Kunshan were randomly divided into control group (n = 20), robot group (n = 20) and combined group (n = 20). All the groups received conventional treatments including medication, physical therapy and occupational therapy; the robot group received sham taVNS combined with hand robot-assisted therapy; while the combined group received taVNS combined with hand robot-assisted therapy, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and hand part, the root mean square (RMS) electromyography of the extensor carpi radialis and extensor digitorum muscles during contraction, and the latency and amplitude of transcranial magnetic stimulation motor-evoked potential (TMS-MEP) before and after treatment.
Results After treatment, the scores of FMA-UE and hand part, RMS of the extensor carpi radialis and extensor digitorum muscles, and latency and amplitude of TMS-MEP improved in all the groups (t > 2.099, P < 0.05); and they were the best in all indicators in the combined group (F > 9.106, P < 0.001).
Conclusion taVNS combined with robot-assisted therapy can promote central nervous system remodeling and further improve upper limb function in stroke patients.

Key words: stroke, transcutaneous auricular vagus nerve stimulation, robot-assisted therapy, upper limb, motor function

CLC Number:

R743.3

ZHENG Li, BAO Zhicheng, ZHANG Qi, REN Xuyan, SU Min. Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 691-696.

Figures/Tables 7

References 39

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组别	n	性别(男/女) /n	年龄/岁	病程/d	患侧(左/右)/n	性质(梗死/出血)/n
常规组	20	11/9	58.20±11.83	19.85±7.10	12/8	8/12
机器人组	20	10/10	59.50±12.10	21.00±7.50	9/11	10/10
联合组	20	12/8	60.10±13.07	20.85±7.64	11/9	11/9
χ²/F值		0.404	0.124	0.142	0.938	0.934
P值		0.817	0.884	0.868	0.626	0.627

组别	n	治疗前	治疗后	t值	P值
常规组	20	20.50±4.11	27.35±5.17	4.702	< 0.001
机器人组	20	21.25±4.09	33.40±6.07^a	8.987	< 0.001
联合组	20	21.55±4.21	41.25±7.08^a,b	10.126	< 0.001
F值		0.342	25.600
P值		0.712	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	1.50±0.51	5.50±3.05	5.946	< 0.001
机器人组	20	1.45±0.51	9.50±2.67^a	13.313	< 0.001
联合组	20	1.40±0.50	11.50±2.65^a,b	17.554	< 0.001
F值		0.193	23.910
P值		0.825	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	15.62±4.20	43.33±6.34	18.558	< 0.001
机器人组	20	16.11±4.72	52.56±7.12^a	16.463	< 0.001
联合组	20	15.83±4.11	63.62±7.38^a,b	27.256	< 0.001
F值		0.064	42.589
P值		0.938	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	13.92±3.91	35.53±6.12	16.410	< 0.001
机器人组	20	14.23±3.86	43.95±6.43^a	17.942	< 0.001
联合组	20	13.79±4.11	56.32±7.14^a,b	23.168	< 0.001
F值		0.064	50.575
P值		0.938	< 0.001

Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients

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组别	n	治疗前	治疗后	t值	P值
常规组	20	25.16±1.36	24.21±1.21	2.165	0.043
机器人组	20	24.91±1.23	23.32±1.14^a	6.421	< 0.001
联合组	20	25.25±1.32	22.43±0.99^a,b	6.822	< 0.001
F值		0.354	12.689
P值		0.703	< 0.001

组别	n	治疗前	治疗后	t值	P值
常规组	20	0.54±0.16	0.65±0.17	2.099	0.049
机器人组	20	0.55±0.13	0.81±0.21^a	4.206	< 0.001
联合组	20	0.57±0.17	0.95±0.27^a,b	6.096	< 0.001
F值		0.115	9.106
P值		0.891	< 0.001

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