| 段园园,刘莉宁,侯天朋,于俊峰,赵晓利.间歇性θ刺激联合Bobath康复训练治疗脑卒中后上肢痉挛的疗效[J].中国康复,2026,41(6):342-347 |
| 间歇性θ刺激联合Bobath康复训练治疗脑卒中后上肢痉挛的疗效 |
| The curative effect of intermittent theta burst stimulation combined with Bobath training in treating post-stroke upper limb spasticity |
| |
| DOI：10.3870/zgkf.2026.06.004 |
| 中文关键词: 间歇性θ刺激 Bobath康复训练 脑卒中 上肢痉挛 |
| 英文关键词: intermittent theta burst stimulation Bobath training stroke upper limb spasticity |
| 基金项目: |
|
| 摘要点击次数: 42 |
| 全文下载次数: 23 |
| 中文摘要: |
| 目的：观察间歇性θ刺激（iTBS）联合Bobath康复训练（BT）治疗脑卒中后上肢痉挛（PS-ULS）的疗效。方法：选择2024年1月至2025年6月本院收治的153例PS-ULS患者，随机分为BT组（n=51，行BT治疗）、iTBS组（n=51，行iTBS治疗）和研究组（n=51，行iTBS+BT治疗）。比较临床疗效、痉挛程度、运动功能、改良巴氏指数（MBI）、表面肌电图（sEMG）、脑血流动力学（CVH）、不良事件。结果：治疗4周后，研究组MAS评级优于BT组和iTBS组（P＜0.05）；治疗后，3组的简式Fugl-Meyer评分量表（FMA）-上肢、MBI、肱二头肌最大自主收缩（MVC）时sEMG振幅、平均血流速度（Vm）均高于治疗前（P＜0.05），且研究组高于BT组和iTBS组（P＜0.05）；3组的肘关节屈伸协同收缩率（RER）、肱二头肌静息时sEMG振幅、搏动指数（PI）、阻力指数（RI）均低于治疗前（P＜0.05），且研究组低于BT组和iTBS组（P＜0.05）；BT组和iTBS组各项指标比较差异无统计学意义。3组不良事件总发生率比较差异无统计学意义。结论：iTBS联合BT可缓解PS-ULS患者痉挛，改善运动功能、神经肌肉控制和脑部血流，提高生活质量，临床疗效显著且未增加不良事件发生。 |
| 英文摘要: |
| Objective: To evaluate the efficacy of intermittent theta burst stimulation (iTBS) combined with Bobath training (BT) in patients with post-stroke upper limb spasticity (PS-ULS). Methods: A total of 153 patients with PS-ULS admitted to our hospital from January 2024 to June 2025 were enrolled and randomly assigned (using SPSS-generated random numbers) into three groups: the control group (n=51, receiving BT alone), the iTBS group (n=51, receiving iTBS alone), and the study group (n=51, receiving BT plus iTBS). We compared their clinical efficacy, spasticity severity, motor function, modified Barthel index (MBI), surface electromyography (sEMG) parameters, cerebral vascular hemodynamics (CVH), and incidence of adverse events. Results: The modified Ashworth Scale (MAS) score of the study group was significantly better than that of the control and iTBS groups (P<0.05). After treatment, the scores of the Fugl-Meyer Assessment for Upper Limb (FMA-UE), MBI, the sEMG amplitude during maximal voluntary contraction (MVC) of the biceps brachii, and the mean blood flow velocity (Vm) were significantly increased compared to baseline in all three groups (all P<0.05), with the study group showing greater improvements than both the control and iTBS groups (all P<0.05). Conversely, the elbow joint flexion-extension recurrent excitation ratio (RER), resting sEMG amplitude of the biceps brachii, pulsatility index (PI), and resistance index (RI) were significantly decreased from baseline in all three groups (all P<0.05), with the study group demonstrating lower values than the control and iTBS groups (all P<0.05). No significant differences were observed in the overall incidence of adverse events among the three groups. Conclusion: The iTBS combined with BT effectively alleviates spasticity, enhances motor function, MBI, sEMG parameters, and cere-bral vascular hemodynamics in patients with PS-ULS, yielding significant clinical efficacy without increasing the risk of adverse events. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|
