Abstract:

Objective　To explore the effect of mirror visual feedback (MVF) combined with high frequency repetitive transcranial magnetic stimulation (rTMS) on motor function recovery in patients with early hemiplegia due to cerebral infarction. Methods　One hundred and four patients with early hemiplegia due to cerebral infarction treated at Department of Neurology, Honghui Hospital Affiliated to Xi'an Jiaotong University from November 2021 to October 2024 were selected as the study objects by the convenience sampling method, and were divided into a control group and an observation group by the random number table method, with 52 cases in each group. There were 20 women and 32 men in the control group; they were (63.17±8.64) years old; their disease course was (28.39±5.82) d; there 33 cases on the left side and 19 cases on the right side. There were 28 women and 24 men in the observation group; they were (61.89±8.16) years old; their disease course was (26.82±5.08) d; their were 29 cases on the left side and 23 cases on the right side. Both groups received routine rehabilitation treatment. The control group received rTMS, while the observation group received rTMS and MVF. The clinical efficacies, cerebral blood flow velocities [mean velocity (V_m) and peak velocity (V_s)], central motor conduction times (CMCT), middle evoked potential (MEP) latencies, motor function [Fugl Meyer Motor Function Assessment (FMA)], balance function [Berg Balance Scale (BBS)], and daily living ability [Modified Barthel Index (MBI)] were compared between two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate of the observation group was higher than that of the control group [96.15% (50/52) vs. 82.69% (43/52)], with a statistical difference between the two groups (P<0.05). After the intervention, the V_m and V_s in the observation group were higher than those in the control group [(93.16±16.05) cm/s vs. (86.34±12.71) cm/s and (158.57±19.62) cm/s vs. (134.66±20.34) cm/s]; the CMCT and MEP latency in the observation group were lower than those in the control group [(8.84±1.30) ms vs. (12.02±3.53) ms and (21.68±1.62) ms vs. (24.61±2.09) ms; the scores of FMA, BBS, and MBI in the observation group were higher than those in the control group (61.07±6.32 vs. 53.95±6.18, 30.34±5.31 vs. 22.47±4.26, and 49.84±8.39 vs. 36.42±6.34); there were statistical differences in the above indicators between the two groups (all P<0.05). Conclusion　MVF combined with rTMS for patients with early hemiplegia due to cerebral infarction can improve their cerebral blood flow and cortical excitability, and accelerate their recovery of motor, balance, and daily living abilities.

Key words:

Cerebral infarction, Early hemiplegia, Mirror visual feedback training, Repetitive transcranial magnetic stimulation, Motor function

摘要：

目的　探讨镜像视觉反馈训练（mirror visual feedback，MVF）联合高频重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）对脑梗死早期偏瘫患者运动功能的影响。方法　采取便利抽样法，选取2021年11月至2024年10月在西安交通大学附属红会医院神经内科就诊的脑梗死早期偏瘫患者104例为研究对象，随机数字表法将患者分为对照组与观察组，各52例。对照组中，女20例，男32例，年龄（63.17±8.64）岁，病程（28.39±5.82）d，左侧33例、右侧19例。观察组中，女28例，男24例，年龄（61.89±8.16）岁，病程（26.82±5.08）d，左侧29例、右侧23例。两组患者均接受常规康复治疗，对照组在常规康复基础上进行rTMS，观察组在对照组的基础上联合MVF。比较两组患者临床疗效、脑血流速度［平均速度（V_m）、峰值速度（V_s）］、中枢运动传导时间（CMCT）、运动诱发电位（MEP）潜伏期、运动功能［Fugl-Meyer运动功能量表（FMA）］、平衡功能［Berg平衡量表（BBS）］及日常生活能力［改良Barthel指数（MBI）］。采用χ²检验、t检验进行统计分析。结果　观察组总有效率为96.15%（50/52），对照组为82.69%（43/52），差异有统计学意义（P<0.05）。干预后，观察组V_m为（93.16±16.05）cm/s、V_s为（158.57±19.62）cm/s，均高于对照组［（86.34±12.71）cm/s、（134.66±20.34）cm/s］；观察组CMCT为（8.84±1.30）ms、MEP潜伏期为（21.68±1.62）ms，均低于对照组［（12.02±3.53）ms、（24.61±2.09）ms］；观察组FMA为（61.07±6.32）分、BBS为（30.34±5.31）分、MBI为（49.84±8.39）分，均高于对照组［（53.95±6.18）分、（22.47±4.26）分、（36.42±6.34）分］；上述指标两组比较，差异均有统计学意义（均P<0.05）。结论　MVF联合rTMS有助于改善脑梗死早期偏瘫患者的脑血流，提高大脑皮层兴奋性，加快患者运动、平衡功能及日常生活能力的恢复进程。

关键词:

脑梗死, 早期偏瘫, 镜像视觉反馈训练, 高频重复经颅磁刺激, 运动功能