Supplementing transcranial magnetic stimulation with action observation therapy better improves the upper limb motor functioning of children with hemiplegic spastic cerebral palsy
10.3760/cma.j.cn421666-20240114-00045
- VernacularTitle:重复经颅磁刺激联合动作观察疗法对痉挛型偏瘫脑瘫患儿上肢运动功能的影响
- Author:
Chunhua WANG
1
;
Leying ZHU
;
Taolin FAN
;
Yumei TANG
Author Information
1. 湘雅博爱康复医院儿童康复治疗部，长沙 410151
- Keywords:
Transcranial magnetic stimulation;
Action observation therapy;
Cerebral palsy;
Hemiplegic spasticity;
Upper limb functioning
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2024;46(11):988-992
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the utility of combining repeated transcranial magnetic stimulation (rTMS) with action observation therapy (AOT) in improving the upper limb motor functioning of children with hemiplegic spastic cerebral palsy (HSCP).Methods:A total of 66 children with HSCP were randomly divided into a sham stimulation group, an rTMS group and a combination group, each of 22. In addition to routine rehabilitation, the sham stimulation and rTMS groups received the relevant treatment or sham treatment, while the combination group also received action observation therapy (AOT). The treatment was administered daily, five times a week for 12 weeks. Before and after the treatment, everyone′s upper limb muscle tone was evaluated using the modified Ashworth Scale (MAS), and fine motor function, grasping and hand coordination were quantified using the fine component of the Peabody Motor Development Scale (PDMS-FM) and the Carroll upper limb function test (UEFT).Results:After the treatment, significant improvement was documented in the average MAS scores of the bicipital arm and wrist flexors of all three groups, and also in their average PDMS-FM scores, fine motor quotient (FMQ) scores and UEFT scores. After 12 weeks the combination group significantly out-scored the other two groups in terms of their average biceps and wrist flexor MAS scores, PDMS-FM grasping area and visual-motor integration area scores, FMQ score and UEFT score. There was no significant difference between the other two groups in any of the outcome measurements, on average.Conclusions:Supplementing rTMS and routine rehabilitation with AOT more effectively improves the upper limb muscle tension, upper limb functioning and fine finger manipulation of children with hemiplegic spastic cerebral palsy.
