Effects of transcranial magnetic stimulation on the performance of the activities of daily living and attention function after stroke: a randomized controlled trial
Effects of transcranial magnetic stimulation on the performance of the activities of daily living and attention function after stroke: a randomized controlled trial
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经颅磁刺激对卒中后日常生活活动能力和注意力功能的影响：随机对照试验
DOI：
10.1177/0269215520946386
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发表时间：
2020-08-04
影响因子：
3
通讯作者：
Hu, Xiquan
中科院分区：
文献类型：
--
作者：
Liu, Yuanwen;Yin, Mingyu;Hu, Xiquan
目的：目的探讨经颅磁刺激（TMS）对脑卒中后日常生活活动能力（ADL）和注意功能的影响。设计：随机对照试验。单位：住院康复医院。受试者：我们将62例伴有注意力障碍的脑卒中患者随机分为两组，每组各有2例退出。TMS组（n = 29）和假手术组（n = 29），其平均（SD）为58.12（6.72）岁。右半球病变33例（56.9%），左半球病变25例（43.1%）。干预措施：TMS组患者接受10 Hz，700个脉冲的TMS，而假手术组患者接受假TMS治疗4周。所有参与者都接受了全面的认知训练。主要措施：在基线和4周治疗结束时，通过功能独立性测量（Functional Independence Measure，简称FAI）评估日常生活活动的表现。采用简易精神状态检查表（MMSE）筛查注意功能障碍，采用连线测验-A（TMT-A）、数字符号测验（DST）和数字广度测验（DS）评定注意功能。结果如下：我们的数据显示治疗后功能独立性测量的运动增益有显著差异（13.00 SD 1.69 vs 4.21 SD 2.96），对功能独立性测量的认知（4.69 SD 1.56 vs 1.52 SD 1.02），功能独立性测量总分（17.69 SD 2.36 vs 5.72 SD 3.12），简易精神状态检查（3.07 SD 1.36 vs 1.21 SD 0.62），连线测试-A所用时间（96.67 SD 25.18 vs 44.28 SD 19.45），连线测试-A中的错误数（2.72 SD 1.03 vs 0.86 SD 1.03），数字符号试验数字广度测验（1.69SD0.54vs0.90SD0.72）与假手术组比较，差异有统计学意义（P < 0.05）。结论：综上所述，我们证明TMS改善了中风患者的日常生活活动和注意力功能。
Objective: We aimed to interrogate the effects of transcranial magnetic stimulation (TMS) on the performance in activities of daily living (ADL) and attention function after stroke. Design: Randomized controlled trial. Setting: Inpatient rehabilitation hospital. Subjects: We randomized 62 stroke patients with attention dysfunction who were randomly assigned into two groups, and two dropped out from each group. The TMS group (n = 29) and a sham group (n = 29), whose mean (SD) was 58.12 (6.72) years. A total of 33 (56.9%) patients had right hemisphere lesion while the rest 25 (43.1%) patients had left hemisphere lesion. Interventions: Patients in the TMS group received 10 Hz, 700 pulses of TMS, while those in the sham group received sham TMS for four weeks. All the participants underwent comprehensive cognitive training. Main measures: At baseline, and end of the four-week treatment, the performance in the activities of daily living was assessed by Functional Independence Measure (FIM). On the other side, attention dysfunction was screened by Mini-Mental State Examination (MMSE), while the attention function was assessed by the Trail Making Test-A (TMT-A), Digit Symbol Test (DST) and Digital Span Test (DS). Results: Our data showed a significant difference in the post-treatment gains in motor of Functional Independence Measure (13.00 SD 1.69 vs 4.21 SD 2.96), cognition of Functional Independence Measure (4.69 SD 1.56 vs 1.52 SD 1.02), total of Functional Independence Measure (17.69 SD 2.36 vs 5.72 SD 3.12), Mini-Mental State Examination (3.07 SD 1.36 vs 1.21 SD 0.62), time taken in Trail Making Test-A (96.67 SD 25.18 vs 44.28 SD 19.45), errors number in Trail Making Test-A (2.72 SD 1.03 vs 0.86 SD 1.03), Digit Symbol Test (3.76 SD 1.09 vs 0.76 SD 0.87) or Digital Span Test (1.69 SD 0.54 vs 0.90 SD 0.72) between the TMS group and the sham group (P < 0.05). Conclusions: Taken together, we demonstrate that TMS improves the performance in the activities of daily living and attention function in patients with stroke.