Effect of cTBS magnetic stimulation over contralateral premotor areas on post-stroke spastic gait in severe hemiplegia patients
10.3969/j.issn.1009-0126.2024.09.014
- VernacularTitle:连续θ爆发经颅磁刺激对侧运动前区对脑卒中重度偏瘫患者痉挛步态的影响
- Author:
Lijing NIE
1
;
Qian DENG
;
Huifang ZHANG
Author Information
1. 473000 南阳医学高等专科学校第一附属医院神经内科
- Keywords:
stroke;
hemiplegia;
transcranial magnetic stimulation;
gait disorders,neurologic
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(9):1044-1048
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the effects of continuous θ burst stimulation of contralateral premotor areas on post-stroke spasticity gait in patients with severe hemiplegia.Methods A pro-spective trial was conducted on 186 stroke patients with severe hemiplegia admitted to our depart-ment from January 2019 to January 2024.They were randomly into control group(93 cases,con-ventional rehabilitation training)and observation group(93 cases,continuous θ burst transcranial stimulation).In 4 weeks after treatment,gait parameters,Fugl-Meyer assessment of lower ex-tremity(FMA-LE)score,Berg balance scale(BSS)score,clinic spasticity index(CSI)score,lower limb sensation,spasticity improvement,and total effective rate were compared between the two groups.Results After treatment,both the 2 groups had significantly higher hip flexion,knee flex-ion,stride length,step frequency,step speed,FMA-LE score,BSS score,CSI score,and H wave latency,and lower two-point discrimination perception and H/M ratio when compared with the levels before treatment(P＜0.01).What's more,all above indicators were obviously better in the observation group than the control group(P＜0.01).The observation group had 1(1.1％),11(11.8％),48(51.6％),31(33.3％)and 2 cases(2.2％),respectively,of spasticity improvement grades 1,1+,2,3,and 4,and the control group had 0,7(7.5％),29(31.2％),44(47.3％),and 13 cases(14.0％),respectively,with statistical differences between the two group(P＜0.01).The total effective rate was notably higher in the observation group than the control group(96.8％vs 77.4％,x2=15.500,P＜0.01).Conclusion For severe hemiplegia patients,continuous θ burst stimulation can improve muscle spasm,restore gait,and better improve lower limb sensory and motor function.
