| 赵润,马将,李红,毛俐俐.经颅直流电刺激联合等速训练的时序性康复对脑卒中患者膝关节的影响[J].中国康复,2026,41(6):348-352 |
| 经颅直流电刺激联合等速训练的时序性康复对脑卒中患者膝关节的影响 |
| Effects of sequential rehabilitation with transcranial direct current stimulation combined with isokinetic training on the knee joint in stroke patients |
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| DOI：10.3870/zgkf.2026.06.005 |
| 中文关键词: 脑卒中 经颅直流电刺激 等速肌力训练 运动启动 时序性康复 膝关节 |
| 英文关键词: stroke transcranial direct current stimulation isokinetic muscle strength training motor initiation time-sequenced rehabilitation knee joint |
| 基金项目:河北省2023年度医学科学研究课题（20231590） |
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| 中文摘要: |
| 目的：探讨基于运动启动理论的时序性康复方案即tDCS联合等速肌力训练对脑卒中患者膝关节肌力、耐力及下肢运动功能的改善效果，并验证中枢干预后效应时间窗内进行外周治疗的科学性。方法：采用随机对照试验设计，纳入脑卒中后下肢运动功能障碍患者，随机分为观察组和对照组。观察组在阳极tDCS（经颅直流电刺激）（2mA，20min，刺激患侧M1区）后效应（60min）内进行等速肌力训练，对照组则在tDCS刺激后60min后进行相同等速肌力训练。主要结局指标包括Fugl-Meyer下肢运动功能评分（FMA-LE）和Holden步行功能评定量表（FAC），次要指标为60°/s角速度下屈膝肌及伸膝肌的峰值力矩（PT）、总功（TW）。结果：治疗后，2组患者的PT、TW、FMA-LE及FAC评分均显著提高（P<0.05），观察组改善幅度显著优于对照组（P＜0.05）。结论：在tDCS后效应时间窗内实施等速肌力训练可更有效增强脑卒中患者膝关节周围肌肉肌力及耐力，并促进下肢运动功能恢复。 |
| 英文摘要: |
| Objective: To explore the improvement effects of the sequential rehabilitation program based on the motor priming theory, namely transcranial direct current stimulation (tDCS) combined with isokinetic strength training, on knee joint muscle strength, muscle endurance, and lower limb motor function in stroke patients, and to verify the scientificity of conducting peripheral treatment within the post-central intervention effect time window. Methods: A randomized controlled trial design was adopted, and patients with lower limb motor dysfunction after stroke were enrolled and randomly divided into the experimental group and the control group. The experimental group underwent isokinetic muscle strength training within 60 min after stimulation of the M1 area on the affected side with anode tDCS (2 mA, 20 min), while the control group underwent the same isokinetic muscle strength training 60 min after tDCS stimulation. The primary outcome measures included the Fugl-Meyer assessment of lower extremity motor function (FMA-LE) and the Holden functional ambulation category (FAC), and the secondary measures were peak torque (PT) and total work (TW) of knee flexor and extensor muscles at an angular velocity of 60°/s.Results: After treatment, both groups showed significant improvements in PT, TW, FMA-LE, and FAC scores (P<0.05), with the experimental group showing significantly greater improvement than the control group (P<0.05). All differences were statistically significant. Conclusion: Implementing isokinetic muscle strength training within the effect time window after tDCS can more effectively enhance muscle strength and endurance around the knee joint in stroke patients, and promote the recovery of lower limb motor function. |
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