虚拟现实技术联合重复经颅磁刺激对脑卒中偏瘫患者上肢运动功能的影响

摘要

目的:探讨虚拟现实技术联合重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对脑卒中偏瘫患者上肢运动功能的影响.方法:选择42例脑卒中后偏瘫患者,采用随机数字表法分为研究组和对照组,每组各21例.两组均给予常规康复治疗和虚拟现实治疗,研究组在此基础给予rTMS治疗.在治疗前和治疗4周后,评估两组上肢Brunnstrom分期、Fugl-Meyer运动功能评测上肢部分(simple Fugl-Meyer Assessment,FMA-UE)、改良Barthel指数(modified Barthel index,MBI)以及简易上肢功能评价(simple test for evaluating hand function,STEF).结果:治疗后,研究组上肢Brunnstrom分期得分为4.19±0.75,对照组为3.29±0.71;研究组FMA-UE评分为51.10±8.24,对照组为37.14±7.88;研究组MBI评分为63.10±6.01,对照组为49.76±7.49;研究组STEF评分为66.62±7.34,对照组为54.90±9.63,较治疗前均明显改善,差异均有统计学意义(P＜0.05).且治疗后研究组各项评分均显著优于对照组,差异亦均有统计学意义(P＜0.05).结论:在常规治疗的基础上虚拟现实技术联合rTMS能够更好地改善脑卒中偏瘫患者上肢运动功能,提高患者的日常生活质量,值得临床推广.%Objective:To investigate the effects of virtual reality alliance frequency combined with repetitive transcranial magnetic stimulation (rTMS) on the upper limb dysfunction after stroke.Methods:Forty-two patients suffering from upper limb dysfunction were randomly divided into a study group and a control group,21 patients in each group.Both groups were given routine rehabilitation and virtual reality therapy,the patients in the study group were augmented frequency rTMS.The scores of Brunnstrom staging,simple Fugl-Meyer Assessment (FMA),modified Barthel index (MBI) and simple test for evaluating hand function (STEF) before and 4 weeks after the treatment were used to evaluate the upper limb movement function recovery.Results:After treatment for 4 weeks,the score of the Brunnstrom staging was 4.19±0.75 in the study group,and 3.29±0.71 in the control group;the score of FMA was 51.10±8.24 in the study group,and 37.14±7.88 in the control group;the score of MBI was 63.10±6.01 in the study group,and 49.76±7.49 in the control group;the score of STEF was 66.62±7.34 in the study group,and 54.90±9.63 in the control group,the differences were all statistically significant when compared with before treatment (P＜0.05).The scores were significantly higher in the study group than those in the control group (P＜0.05).Conclusion:On the basis of conventional treatment,virtual reality technology combined with rTMS can improve the function of upper limb movement in patients with hemiplegia of cerebral apoplexy and the quality of daily life of patients,which is worthy of clinical promotion.