Sijie Liang, Weining Wang, Fengyun Yu, Li Pan, Dongyan Xu, Ruiping Hu, Shan Tian, Jie Xiang, Yulian Zhu
{"title":"重复性外周磁刺激结合经颅磁刺激在中风后上肢偏瘫康复中的应用：一项试点研究。","authors":"Sijie Liang, Weining Wang, Fengyun Yu, Li Pan, Dongyan Xu, Ruiping Hu, Shan Tian, Jie Xiang, Yulian Zhu","doi":"10.2340/jrm.v56.19449","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation on upper extremity function in subacute stroke patients.</p><p><strong>Design: </strong>Pilot study.</p><p><strong>Subjects: </strong>Subacute stroke patients.</p><p><strong>Methods: </strong>Included patients were randomized into 3 groups: a central-associated peripheral stimulation (CPS) group, a central-stimulation-only (CS) group, and a control (C) group. The CPS group underwent a new paired associative stimulation (combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation), the CS group underwent repetitive transcranial magnetic stimulation, and the C group underwent sham stimulation. All 3 groups received physiotherapy after the stimulation or sham stimulation. The treatment comprised 20 once-daily sessions. Primary outcome was the Fugl-Meyer Assessment Upper Extremity (FMA-UE) score, and secondary outcomes were the Barthel Index and Comprehensive Functional Assessment scores, and neurophysiological assessments were mainly short-interval intracortical inhibition. A 3-group (CPS, CS, C) × 2-time (before, after intervention) repeated measures analysis of variance was conducted to determine whether changes in scores were significantly different between the 3 groups.</p><p><strong>Results: </strong>A total of 45 patients were included in the analysis. Between-group comparisons on the FMA-UE demonstrated a significant improvement (group × time interaction, F2,42 = 4.86; p = 0.013; C vs CS, p = 0.020; C vs CPS, p = 0.016; CS vs CPS, p = 0.955). Correlation analysis did not find any substantial positive correlation between changes in FMA-UE and short-interval intracortical inhibition variables (C, r = -0.196, p = 0.483; CS, r = -0.169, p = 0.546; CPS, r = -0.424, p = 0.115).</p><p><strong>Conclusion: </strong>This study suggests that the real-stimulus (CS and CPS) groups had better outcomes than the control (C) group. In addition, the CPS group showed a better trend in clinical and neurophysiological assessments compared with the CS group.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847975/pdf/","citationCount":"0","resultStr":"{\"title\":\"Repetitive peripheral magnetic stimulation combined with transcranial magnetic stimulation in rehabilitation of upper extremity hemiparesis following stroke: a pilot study.\",\"authors\":\"Sijie Liang, Weining Wang, Fengyun Yu, Li Pan, Dongyan Xu, Ruiping Hu, Shan Tian, Jie Xiang, Yulian Zhu\",\"doi\":\"10.2340/jrm.v56.19449\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the effect of combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation on upper extremity function in subacute stroke patients.</p><p><strong>Design: </strong>Pilot study.</p><p><strong>Subjects: </strong>Subacute stroke patients.</p><p><strong>Methods: </strong>Included patients were randomized into 3 groups: a central-associated peripheral stimulation (CPS) group, a central-stimulation-only (CS) group, and a control (C) group. The CPS group underwent a new paired associative stimulation (combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation), the CS group underwent repetitive transcranial magnetic stimulation, and the C group underwent sham stimulation. All 3 groups received physiotherapy after the stimulation or sham stimulation. The treatment comprised 20 once-daily sessions. Primary outcome was the Fugl-Meyer Assessment Upper Extremity (FMA-UE) score, and secondary outcomes were the Barthel Index and Comprehensive Functional Assessment scores, and neurophysiological assessments were mainly short-interval intracortical inhibition. A 3-group (CPS, CS, C) × 2-time (before, after intervention) repeated measures analysis of variance was conducted to determine whether changes in scores were significantly different between the 3 groups.</p><p><strong>Results: </strong>A total of 45 patients were included in the analysis. Between-group comparisons on the FMA-UE demonstrated a significant improvement (group × time interaction, F2,42 = 4.86; p = 0.013; C vs CS, p = 0.020; C vs CPS, p = 0.016; CS vs CPS, p = 0.955). Correlation analysis did not find any substantial positive correlation between changes in FMA-UE and short-interval intracortical inhibition variables (C, r = -0.196, p = 0.483; CS, r = -0.169, p = 0.546; CPS, r = -0.424, p = 0.115).</p><p><strong>Conclusion: </strong>This study suggests that the real-stimulus (CS and CPS) groups had better outcomes than the control (C) group. In addition, the CPS group showed a better trend in clinical and neurophysiological assessments compared with the CS group.</p>\",\"PeriodicalId\":54768,\"journal\":{\"name\":\"Journal of Rehabilitation Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847975/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Rehabilitation Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2340/jrm.v56.19449\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/jrm.v56.19449","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
摘要
目的：研究重复外周磁刺激和经颅磁刺激对亚急性中风患者上肢功能的影响：研究重复外周磁刺激和经颅磁刺激对亚急性脑卒中患者上肢功能的影响：受试者：亚急性中风患者亚急性脑卒中患者：方法：将纳入的患者随机分为 3 组：中枢相关外周刺激（CPS）组、纯中枢刺激（CS）组和对照（C）组。CPS 组接受新的配对联想刺激（重复外周磁刺激和经颅磁刺激相结合），CS 组接受重复经颅磁刺激，C 组接受假刺激。三组患者在接受刺激或假刺激后都接受了物理治疗。治疗包括 20 个疗程，每天一次。主要结果为 Fugl-Meyer 上肢评估（FMA-UE）评分，次要结果为 Barthel 指数和综合功能评估评分，神经电生理评估主要为短时皮层内抑制。研究人员进行了3组（CPS、CS、C）×2次（干预前、干预后）重复测量方差分析，以确定3组之间的评分变化是否存在显著差异：结果：共有 45 名患者参与了分析。FMA-UE的组间比较显示出显著的改善（组与时间的交互作用，F2,42 = 4.86; p = 0.013; C vs CS, p = 0.020; C vs CPS, p = 0.016; CS vs CPS, p = 0.955）。相关分析未发现 FMA-UE 的变化与短时皮层内抑制变量之间存在任何实质性的正相关（C，r = -0.196，p = 0.483；CS，r = -0.169，p = 0.546；CPS，r = -0.424，p = 0.115）：本研究表明，真实刺激（CS 和 CPS）组比对照（C）组效果更好。此外，与 CS 组相比，CPS 组在临床和神经生理学评估方面表现出更好的趋势。
Repetitive peripheral magnetic stimulation combined with transcranial magnetic stimulation in rehabilitation of upper extremity hemiparesis following stroke: a pilot study.
Objective: To investigate the effect of combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation on upper extremity function in subacute stroke patients.
Design: Pilot study.
Subjects: Subacute stroke patients.
Methods: Included patients were randomized into 3 groups: a central-associated peripheral stimulation (CPS) group, a central-stimulation-only (CS) group, and a control (C) group. The CPS group underwent a new paired associative stimulation (combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation), the CS group underwent repetitive transcranial magnetic stimulation, and the C group underwent sham stimulation. All 3 groups received physiotherapy after the stimulation or sham stimulation. The treatment comprised 20 once-daily sessions. Primary outcome was the Fugl-Meyer Assessment Upper Extremity (FMA-UE) score, and secondary outcomes were the Barthel Index and Comprehensive Functional Assessment scores, and neurophysiological assessments were mainly short-interval intracortical inhibition. A 3-group (CPS, CS, C) × 2-time (before, after intervention) repeated measures analysis of variance was conducted to determine whether changes in scores were significantly different between the 3 groups.
Results: A total of 45 patients were included in the analysis. Between-group comparisons on the FMA-UE demonstrated a significant improvement (group × time interaction, F2,42 = 4.86; p = 0.013; C vs CS, p = 0.020; C vs CPS, p = 0.016; CS vs CPS, p = 0.955). Correlation analysis did not find any substantial positive correlation between changes in FMA-UE and short-interval intracortical inhibition variables (C, r = -0.196, p = 0.483; CS, r = -0.169, p = 0.546; CPS, r = -0.424, p = 0.115).
Conclusion: This study suggests that the real-stimulus (CS and CPS) groups had better outcomes than the control (C) group. In addition, the CPS group showed a better trend in clinical and neurophysiological assessments compared with the CS group.
期刊介绍：
Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year.
Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics, including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
