EFFECTS OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION OF THE UNAFFECTED HEMISPHERE LEG MOTOR AREA IN PATIENTS WITH SUBACUTE STROKE AND SUBSTANTIAL LEG IMPAIRMENT: A PILOT STUDY
EFFECTS OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION OF THE UNAFFECTED HEMISPHERE LEG MOTOR AREA IN PATIENTS WITH SUBACUTE STROKE AND SUBSTANTIAL LEG IMPAIRMENT: A PILOT STUDY
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DOI：
10.2340/16501977-1943
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发表时间：
2015-04-01
影响因子：
3.5
通讯作者：
Liou, Tsan-Hon
中科院分区：
文献类型：
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作者：
Lin, Yen-Nung;Hu, Chaur-Jong;Liou, Tsan-Hon
目的：探讨反复经颅磁刺激（rTMS）对亚急性脑卒中后重度下肢损伤患者活动能力的影响。设计：双盲、分层、随机试验，包括假对照组。参与者：首次亚急性中风后发生单侧偏瘫并接受住院中风康复治疗的患者。方法：在本研究中使用的15天干预方案包括在未受影响半球的腿部运动区应用rTMS （1 Hz， 15分钟），然后进行45分钟的物理治疗。总的来说，32名参与者被随机分配接受真实的rTMS或假刺激。在干预前后立即进行临床评估，包括脑卒中患者体位评估量表（PASS）、性能导向活动能力评估平衡量表（POMA-b）、Fugl-Meyer评估、Barthel指数（BI）和Timed Up and Go测试。结果：随着时间的推移，两组的所有测试结果都有了显著的改善。在测试后评估中，与假rTMS组相比，真实rTMS组的患者在PASS、POMA和BI评分方面表现出更大的改善。此外，与假rTMS组相比，真实rTMS组在测试后评估中恢复活动能力的患者人数显著增加。结论：应用1hz rTMS可改善亚急性脑卒中后严重腿部损伤患者的活动能力。
Objective: To evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on mobility among patients with substantial leg impairment after subacute stroke.Design: Double-blinded, stratified, randomized trial involving a sham control group.Participants: Patients who developed unilateral hemiplegia after first-ever subacute stroke and underwent inpatient stroke rehabilitation.Methods: The 15-day intervention programme used in the present study included the application of rTMS (1 Hz, 15 min) over the leg motor area of the unaffected hemisphere, followed by 45 min physical therapy. Overall, 32 participants were randomly assigned to receive either real rTMS or sham stimulation. Clinical assessments, including the Postural Assessment Scale for Stroke Patients (PASS), balance subscale of the Performance Oriented Mobility Assessment (POMA-b), Fugl-Meyer Assessment, Barthel Index (BI), and Timed Up and Go test, were performed immediately before and after the intervention.Results: Both groups demonstrated significant improvements in all the test results over time. At the post-test assessment, the patients in the real rTMS group demonstrated greater improvements in the PASS, POMA, and BI scores than did the patients in the sham rTMS group. In addition, a significantly higher number of patients in the real rTMS group regained mobility at the post-test assessment compared with the corresponding number of patients in the sham rTMS group.Conclusion: Application of 1-Hz rTMS may improve mobility among patients with substantial leg impairment after subacute stroke.