Repetitive peripheral magnetic stimulation combined with intensive physical therapy for gait disturbance after hemorrhagic stroke: an open-label case series
Repetitive peripheral magnetic stimulation combined with intensive physical therapy for gait disturbance after hemorrhagic stroke: an open-label case series
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DOI：
10.1097/mrr.0000000000000416
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发表时间：
2020-09-01
影响因子：
1.7
通讯作者：
Abo, Masahiro
中科院分区：
文献类型：
--
作者：
Kinoshita, Shoji;Ikeda, Kumi;Abo, Masahiro
在这项初步研究中，我们的目的是确定一个15天的协议，包括在医院重复外周磁刺激（rPMS）结合强化物理治疗的下肢轻偏瘫慢性中风患者的步态障碍的恢复的安全性和可行性。入选7例伴有下肢轻偏瘫和步态障碍的出血性卒中患者（年龄：50-78岁;卒中发作时间：7-107个月）。rPMS应用于具有抛物线线圈的麻痹下肢的肌肉。以20 Hz的频率施加一系列刺激3 s，然后是27 s的休息间隔。使用八十个此类刺激序列（总共4800个脉冲）进行rPMS治疗。rPMS治疗后，每天给予120分钟的物理治疗。每名患者连续15天接受这种联合治疗，在干预前后评估所有参与者的行走功能。所提出的治疗方案导致步行速度，步行能力和平衡能力的显着改善，但对耐力，步长和痉挛没有显着影响。未观察到rPMS相关的副作用。我们的方案组成的rPMS和强化物理治疗出现良好的耐受性和可行的治疗出血性中风患者的步态障碍。需要进一步的大规模研究来证实其功效。
In this pilot study, we aimed to determine the safety and feasibility of a 15-day protocol consisting of in-hospital repetitive peripheral magnetic stimulation (rPMS) combined with intensive physical therapy for the recovery of the gait disturbance in chronic stroke patients with lower limb hemiparesis. Seven hemorrhagic stroke patients with lower limb hemiparesis and gait disturbance (age: 50-78; time from onset of stroke: 7-107 months) were enrolled. rPMS was applied to the muscles of the paretic lower limb with a parabolic coil. A train of stimuli at a frequency of 20 Hz was applied for 3 s followed by a 27-s rest interval. Therapy with rPMS was performed with eighty such trains of stimuli (total 4800 pulses). Following rPMS therapy, 120 min of physical therapy was administrated daily. Each patient received this combination treatment over fifteen consecutive days, with the walking function of all participants assessed before and after the intervention. The proposed treatment protocol resulted in significant improvements in the walking speed, ambulation ability, and balance ability, but showed no significant effects on the endurance capacity, step length, and spasticity. No rPMS-related side effects were noted. Our protocol consisting of rPMS and intensive physical therapy appears well tolerated and feasible for therapy in hemorrhagic stroke patients with gait disturbance. Further large-scale studies are required to confirm its efficacy.