Bihemispheric repetitive transcranial magnetic stimulation combined with intensive occupational therapy for upper limb hemiparesis after stroke: a preliminary study
Bihemispheric repetitive transcranial magnetic stimulation combined with intensive occupational therapy for upper limb hemiparesis after stroke: a preliminary study
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双半球重复经颅磁刺激联合强化作业治疗脑卒中后上肢偏瘫的初步研究
DOI：
10.1097/mrr.0b013e3283624907
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发表时间：
2013
影响因子：
1.7
通讯作者：
Abo M
中科院分区：
文献类型：
--
作者：
Yamada N;Kakuda W;Kondo T;Shimizu M;Mitani S;Abo M
我们研究了双半球重复经颅磁刺激（rTMS）和强化作业疗法（OT）联合治疗脑卒中后上肢轻偏瘫患者的安全性、可行性和有效性。研究参与者为8例卒中后上肢轻偏瘫患者（干预时年龄：62.8±4.9岁，卒中后时间：84.3±87.2个月，平均值±标准差）。在15天的住院期间，每位患者接受了10次40分钟的双半球rTMS和240分钟的强化OT（120分钟的一对一训练和120分钟的自我训练）。双半球rTMS的一个会话包括应用1和10 Hz rTMS（每个半球2000个刺激）。在入院当天和出院时进行Fugl-Meyer评估、Wolf运动功能测试和改良Ashworth量表。所有患者均完成治疗，无任何不良反应。患侧上肢运动功能在Fugl-Meyer评定和Wolf运动功能测试的基础上明显改善（P< 0.05）。患侧手肘、腕、指屈肌的改良Ashworth量表评分显著降低（P< 0.05）。双侧rTMS联合强化OT治疗脑卒中偏瘫患者安全可行，可改善患者偏瘫上肢运动功能。这一发现为脑卒中后轻偏瘫患者的治疗提供了新的途径。
We investigated the safety, feasibility, and efficacy of the combination of bihemispheric repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis in poststroke patients. The study participants were eight poststroke patients with upper limb hemiparesis (age at intervention: 62.8±4.9 years, time after stroke: 84.3±87.2 months, mean±SD). During 15 days of hospitalization, each patient received 10 sessions of 40-min bihemispheric rTMS and 240-min intensive OT (120-min one-to-one training and 120-min self-training). One session of bihemispheric rTMS comprised the application of both 1 and 10 Hz rTMS (2000 stimuli for each hemisphere). The Fugl-Meyer Assessment, Wolf Motor Function Test, and the Modified Ashworth Scale were administered on the day of admission and at discharge. All patients completed the treatment without any adverse effects. Motor function of the affected upper limb improved significantly, on the basis of changes in Fugl-Meyer Assessment and Wolf Motor Function Test (P< 0.05, each). A significant decrease in the Modified Ashworth Scale score was noted in the elbow, wrist, and finger flexors of the affected upper limb (P< 0.05, each). The combination of bihemispheric rTMS and intensive OT was safe and feasible therapy for poststroke hemiparetic patients, and improved motor function of the hemiparetic upper limb in poststroke patients. The findings provide a new avenue for the treatment of patients with poststroke hemiparesis.