反复外周磁刺激改善脑卒中后偏瘫患者上肢功能

IF 0.8 Q4 RHEUMATOLOGY Egyptian Rheumatology and Rehabilitation Pub Date : 2023-10-10 DOI:10.1186/s43166-023-00204-x
Shereen Ismail Fawaz, Shin-Ichi Izumi, Amr Saeed Zaki, Shaimaa Elmetwally Eldiasty, Amr Saadawy, Heba Gamal eldin Saber, May Farouk Gadallah, Hossam Salaheldin Labib
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引用次数: 0

摘要

脑卒中是世界范围内致残的主要原因之一,其手部和手臂无力,影响患者的日常活动和生活质量。近年来,重复性外周磁刺激(rPMS)通过深层本体感觉刺激和模拟自主运动丧失,增强脑卒中偏瘫后的神经可塑性和运动恢复。目的观察rPMS对脑血管损伤后偏瘫患者上肢功能改善的疗效,并比较亚急性和慢性偏瘫患者的治疗效果。结果康复后活动组的fugl - meyer -上肢量表(FM-UE)和功能独立测量量表(FIM)均较对照组有显著改善。在肩部外展肌、肱三头肌、腕伸肌和旋肌的活动范围(AROM)方面,与对照组相比,活动组也发现了显著差异。改良Ashworth量表在活跃组也有显著变化。根据卒中后持续时间将患者分为亚急性组(卒中后6周至6个月)和慢性组(卒中后6个月以上),亚急性组在FM-UE量表、腕伸肌和旋前肌的AROM均有显著改善,而慢性组无显著改善。超声测量显示对照组的横截面积明显减小。结论rPMS对脑卒中后运动恢复有潜在的促进作用,尤其是亚急性期。
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Repetitive peripheral magnetic stimulation for improving upper limb function in post-stroke hemiparesis
Abstract Background Stroke is one of the leading causes of disability worldwide, with hand and arm weakness, affecting the patients’ daily activities and quality of life. Recently, repetitive peripheral magnetic stimulation (rPMS) was found to enhance neuroplasticity and motor recovery post-stroke hemiparesis via its deep proprioceptive stimulation and simulation of lost voluntary movement. Objective To determine the therapeutic effect of rPMS on the functional improvement of upper limb in patients with hemiparesis following cerebrovascular insult and to compare the effect of therapy in subacute and chronic cases. Results Post-rehabilitation program both the Fugl-Meyer-Upper Extremity scale (FM-UE) and Functional Independence Measures (FIM) scale showed highly significant improvement in the active group, compared to controls. Regarding active range of motion (AROM) of the shoulder abductors, triceps, wrist extensors and supinators, significant differences were also found in the active group in comparison to controls. Modified Ashworth scale showed also significant change in the active group. When dividing our patients according to the duration post-stroke, into subacute group (6 weeks to 6 months post-stroke) and chronic group (more than 6-month post-stroke), the subacute group showed significant improvements in the FM-UE scale, and in the AROM of wrist extensors and supinators but not in the chronic group. Ultrasonographic measurements showed a significant decrease in cross sectional area of the control group. Conclusion rPMS is potentially effective in improving motor recovery post-stroke, especially in the subacute stage.
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