朱冬燕,吉桧媛,王梁,等.低频重复经颅磁刺激联合软体手功能康复机器人对脑卒中患者上肢功能的影响[J].中华物理医学与康复杂志,2026,48(5):400-404
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| 低频重复经颅磁刺激联合软体手功能康复机器人对脑卒中患者上肢功能的影响 |
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| DOI：10.3760/cma.j.cn421666-20250518-00424 |
| 中文关键词: 重复经颅磁刺激 气电驱动软体康复机器人 脑卒中 上肢功能 手功能 |
| 英文关键词: Repetitive transcranial magnetic stimulation Rehabilitation robots Stroke Upper limb function Hand function |
| 基金项目:南通市社会民生科技计划项目(MSZ2025088)；南通大学临床医学专项科研基金项目(2025LY054)；中国高校产学研创新基金项目(2023HT042) |
| 作者 | 单位 | | 朱冬燕 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 吉桧媛 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 王梁 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 徐倩 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 曹月姣 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 张航 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 蒋佃旺 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 陈伟观 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 | | 卢红建 | 南通市第一人民医院康复医学科,南通大学南通临床学院,南通 226001 |
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| 中文摘要: |
| 目的 观察低频重复经颅磁刺激(rTMS)联合气电驱动软体手功能康复机器人对脑卒中患者上肢和手功能的影响。 方法 将78例脑卒中患者按随机数字表法分为rTMS组25例，机器人组27例，联合组26例。3组患者均接受常规康复训练，在此基础上rTMS组增加低频rTMS治疗，机器人组增加气电驱动软体手功能康复机器人训练，联合组增加低频rTMS和气电驱动软体手功能康复机器人联合治疗。低频rTMS治疗和气电驱动软体手功能康复机器人治疗均为每日1次，每次20 min，每周治疗6 d，连续治疗2周。治疗前和治疗2周后(治疗后)，采用Fugl-Meyer运动量表上肢部分(FMA-UE)和Wolf运动功能测试(WMFT)分别评估3组患者的上肢和手的运动功能，采用改良Barthel指数(MBI)评估其日常生活活动能力，并采用运动诱发电位(MEP)检测患者的潜伏期和中枢运动传导时间(CMCT)。 结果 治疗后，3组患者的FMA-UE、WMFT和MBI评分均显著优于组内治疗前(P＜0.05)，且联合组的FMA-UE、WMFT和MBI评分分别为(42.19±7.70)分、(48.46±6.96)分和(67.69±10.30)分，均显著优于rTMS组和机器人组(P＜0.05)。治疗后，3组患者的MEP潜伏期和CMCT均显著优于组内治疗前(P＜0.05)，且联合组的MEP潜伏期和CMCT分别为(22.14±1.18)ms和(9.71±1.28)ms，均显著优于rTMS组和机器人组(P＜0.05)。 结论 低频rTMS联合气电驱动软体手功能康复机器人不仅可以显著改善脑卒中患者的上肢和手功能及其日常生活活动能力，还可促进其神经传导通路恢复。 |
| 英文摘要: |
| Objective To document any effect on the upper limb and hand functioning of stroke survivors of combining low-frequency transcranial magnetic stimulation (rTMS) with hand function rehabilitation assisted by a pneumatic-electric-driven robot. Methods Seventy-eight stroke survivors were randomly divided into an rTMS group of 25, a robot group of 27 and a combination group of 26. In addition to conventional rehabilitation training, the rTMS group received low-frequency rTMS treatment, the robot group underwent hand function rehabilitation assisted by a soft pneumatic-electric-driven robot, while the combination group received both. Each treatment lasted 20 minutes daily, 6 days a week for 2 consecutive weeks. Before and after the treatment, the subjects′ upper limb functioning was evaluated using the Fugl-Meyer upper extremity (FMA-UE) instrument and the Wolf motor function test (WMFT). The subjects′ ability in the activities of daily living was assessed using the modified Barthel index (MBI). Latency and central motor conduction times (CMCTs) were measured using motor evoked potentials (MEPs). Results There was significant improvement in the average FMA-UE, WMFT and MBI scores of all three groups. In the combination group the averages were (42.19±7.70), (48.46±6.96) and (67.69±10.30), respectively, significantly superior to the other two groups′ averages. After the treatment, the MEP latency and CMCT averages of all three groups were also significantly better, with those of the combination group ［MEP: (22.14±1.18)ms, CMCT: (9.71±1.28)ms］ again significantly better than the other two groups′ averages. Conclusions Low-frequency rTMS combined with a pneumatic-electric soft hand function rehabilitation robot can significantly improve upper limb and hand function as well as ability in the activities of daily living for stroke survivors. |
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