小脑间歇性Theta脉冲刺激对卒中后下肢功能障碍患者步行功能的疗效

Effects of Cerebellar Intermittent Theta Rhythm Stimulation on Gait in Patients with Post-Stroke Lower Limb Dysfunction

摘要: 目的：本研究的目的是对小脑半球间歇性Theta脉冲刺激治疗卒中后下肢功能障碍患者步行功能的疗效进行探讨。方法：将24例符合纳入标准的卒中后步行功能障碍患者随机分配到试验组和对照组，每组12例。在传统康复治疗的基础上，试验组患者给予小脑半球间歇性Theta脉冲刺激(iTBS)，对照组患者给予假iTBS。两组治疗均持续3周。在治疗前和治疗3周后，均采用Berg平衡量表(Berg Balance Scale, BBS)、Fugl-Meyer评估量表下肢部分(Fugl-Meyer assessment scale for Lower Extremity, FMA-LE)评估患者脑卒中后下肢功能；采用鞋垫式步态分析仪评估患者治疗前后的步速。结果：治疗后，两组患者BBS、FMA-LE评分、步速数值均有显著增加(p < 0.05)，且试验组比对照组疗效更好(p < 0.05)。结论：小脑半球iTBS结合传统康复治疗可改善脑卒中后下肢功能障碍患者步行功能，且疗效较单纯给予传统康复治疗好。

Abstract: Objective: The purpose of this study was to investigate the effect of intermittent Theta pulse stimu-lation in cerebellar hemisphere on walking function in patients with lower limb dysfunction after stroke. Methods: 24 patients with post-stroke walking dysfunction who met the inclusion criteria were randomly assigned to the experimental group and the control group, with 12 patients in each group. On the basis of traditional rehabilitation treatment, the experimental group was given in-termittent Theta pulse stimulation of cerebellar hemisphere (iTBS), and the control group was giv-en false iTBS. Both groups were treated for 3 weeks. Berg Balance Scale (BBS) and Fugl-Meyer as-sessment scale for Lower Extremity (Fugl-Meyer Assessment Scale for Lower extremity) were used before and after 3 weeks of treatment. FMA-LE was used to evaluate lower limb function after stroke. Insole gait analyzer was used to evaluate the patients’ gait speed before and after treatment. Results: After treatment, BBS, FMA-LE and walking speed were significantly increased in two groups (p < 0.05), and the therapeutic effect of experimental group was better than that of control group (p < 0.05). Conclusion: Cerebellar iTBS combined with traditional rehabilitation therapy can improve the walking function of patients with lower limb dysfunction after stroke, and the efficacy is better than that of traditional rehabilitation therapy alone.