Effects of combining rTMs and augmented reality gait adaptive training on walking function of patients with stroke based on three-dimensional gait analysis and sEMG: a randomized controlled trial.

IF 1.6 4区 医学 Q2 REHABILITATION Physiotherapy Theory and Practice Pub Date : 2024-07-15 DOI:10.1080/09593985.2024.2378905
Linjie Fang, Wanying Zhang, Jianing Wu, Hong Yu, Huihuang Zhang, Shishi Chen, Beisi Zheng, Manting Cao, Yujia Zhang, Lei Dai, Jianer Chen
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Abstract

Background: Augmented reality gait adaptive training (ARGAT) and repetitive transcranial magnetic stimulation (rTMS) have both demonstrated efficacy in improving lower limb motor function in survivors of stroke.

Purpose: To investigate the effects of combining rTMS and ARGAT on motor function in survivors of stroke.

Methods: The experimental group received a combination of rTMS and ARGAT, while the control group received ARGAT alone. The interventions comprised a total of 20 sessions, conducted over four weeks with five consecutive daily sessions. Outcome measures included three-dimensional gait analysis (3DGA), surface electromyography (sEMG), Fugl-Meyer assessment for the lower extremity (FMA-LE), and the Berg Balance Scale (BBS).

Results: Following the intervention, both groups showed significant improvements in walking speed, symmetry index, affected step length, affected stride length, FMA-LE, and BBS scores (p < .05). Furthermore, the experimental group demonstrated greater improvements in walking speed (F = 4.58, p = .040), cadence (F = 5.67, p = .023), affected step length (F = 5.79, p = .022), affected stride length (F = 4.84, p = .035), FMA-LE (Z = 2.43, p = .019), and BBS (F = 4.76, p = .036) compared to the control group. The experimental group demonstrated a significant improvement in the co-contraction index (CCI) of the knee joint (F = 14.88, p < .001), a change not observed in the control group (F = 2.16, p = .151). However, neither group showed significant alterations in CCI of the ankle joint (F = 1.58, p = .218), step width (F = 0.24, p = .630), unaffected step length (F = 0.22, p = .641), or unaffected stride length (F = 2.99, p = .093).

Conclusion: The combination of low-frequency rTMS and ARGAT demonstrated superior effects on motor function recovery compared to ARGAT alone in survivors of stroke.

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基于三维步态分析和sEMG的rTM与增强现实步态适应性训练相结合对脑卒中患者行走功能的影响:随机对照试验。
背景:增强现实步态适应训练(ARGAT)和重复经颅磁刺激(rTMS)对改善中风幸存者的下肢运动功能均有疗效。目的:研究经颅磁刺激和增强现实步态适应训练相结合对中风幸存者运动功能的影响:实验组接受经颅磁刺激和 ARGAT 的组合治疗,对照组仅接受 ARGAT 治疗。干预共包括 20 个疗程,为期四周,每天连续 5 个疗程。结果测量包括三维步态分析(3DGA)、表面肌电图(sEMG)、下肢福格-迈耶评估(FMA-LE)和伯格平衡量表(BBS):干预后,两组患者的行走速度、对称指数、受影响步长、受影响步幅、FMA-LE 和 BBS 评分均有明显改善(P < .05)。此外,与对照组相比,实验组在行走速度(F = 4.58,p = .040)、步速(F = 5.67,p = .023)、受影响步长(F = 5.79,p = .022)、受影响步幅(F = 4.84,p = .035)、FMA-LE(Z = 2.43,p = .019)和 BBS(F = 4.76,p = .036)方面均有较大改善。实验组的膝关节共收缩指数(CCI)有明显改善(F = 14.88,P = .151)。然而,两组在踝关节的 CCI(F = 1.58,p = .218)、步宽(F = 0.24,p = .630)、未受影响的步长(F = 0.22,p = .641)或未受影响的步长(F = 2.99,p = .093)方面均未出现明显变化:结论:与单独使用 ARGAT 相比,低频经颅磁刺激和 ARGAT 联合使用对中风幸存者的运动功能恢复具有更好的效果。
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来源期刊
CiteScore
3.40
自引率
10.00%
发文量
300
期刊介绍: The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.
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