| Stroke is a sudden,localized or holistic brain dysfunction caused by a cerebrovascular disease,or a lethal clinical syndrome that lasts over 24 hours.Stroke usually causes in limb dysfunctions,where the recovery of upper limbs and hands lags relatively behind that of lower limbs,which has a great influence on daily living activities of the patients.Transcranial Magnetic Stimulation(TMS)is a rehabilitation that enhances or decreases cortical excitability and regulates post-stroke cortical excitability balance,thus promoting the healing of post-stroke limb dysfunction through long-term enhancement or sample effect.This study observes the effects of magnetic stimulation on the recovery of upper limb dysfunction as well as the changes of cortical excitability of stroke patients under different stimulation modes,and it aims to explore different medical efficacies of corresponding stimulation modes on the recovery of upper limb function as well as the safety of magnetic stimulation.Objective The paper aims to observe the effect of intermittent Theta Burst Stimulation(i TBS)and 1Hz low-frequency repetitive Transcranial Magnetic Stimulation(r TMS)on recovering the motor function of upper limb and cortical excitability changes of stroke patients.Methods 37 hemiplegia patients in the recovery after stroke were selected and randomly divided into three groups(13 in the i TBS group,11 in the 1Hz r TMS group,and 13 in the control group)using random number table method.All patients received routine rehabilitation therapy for 10 days,including routine neurological medication,exercise therapy,physical therapy and occupational therapy.Based on this,1Hz group received 1Hz r TMS on the contralateral cerebral area of M1,i TBS group was treated with i TBS on the lateral cerebral area of M1,and the control group did not receive magnetic stimulation.We conduct examination of motion-evoked electric potential on the affected side with full wireless Trigno Mobile GPS surface electromyography tester made by Delsys at 10 days before and after the beginning of the healing treatment.Meanwhile we apply upper limb Fugl-Meyer(U-FMA)to evaluate motion functions of upper limb,arm action assessment(ARAT)to evaluate arm functions,and Modified Barthel Index(MBI)to evaluate daily living ability.Finally we collect data and conduct statistical analysis accordingly with statistical software SPSS17.0.Result After treatment,the scoring of FMA and MBI of all the three groups are significantly higher than those before the treatment,What’s more,the ARPT score,MEP peak of 1Hz group as well as i TBS group are greatly enhanced,and the MBI score is enhanced than that of control group(P<0.05);the FMA and ARPT score of i TBS group are much higher than those of the control group(P<0.05);MEP latency on the affected side of patients in 1Hz group is obviously shorter than that of control group(P<0.05).There are no significant differences found in the latency and peak values of FMA,ARPT,MBI and MEP latency and peak between the two groups of 1Hz and i TBS(P > 0.05).The pre-treatment scores of FMA of group 1Hz,i TBS and the control group are 11.00(5.00,46.00),29.00(16.00,43.00),20.00(11.00,43.00)respectively,and the post-treatment scores of FMA are 23.00(10.00,55.00),45.00(23.00,54.00),26.00(14.00,57.00)respectively.The pre-treatment scores of ARPT of group 1Hz,i TBS and the control group are 12.00(0.00,28.00),14.00(0.00,17.00),37.00(7.00,43.00)respectively,and the post-treatment scores of ARPT are 14.00(2.00,39.00),26.00(6.00,34.00),40.00(5.00,49.00)respectively.The pre-treatment scores of MBI of group 1Hz,i TBS and the control group are 55.00(40.00,65.00),55.00(42.50,55.00),60.00(55.00,67.50)respectively,and the post-treatment scores of MBI are 60.00(55.00,85.00),60.00(60.00,70.00),65.00(60.00,70.00)respectively.The pre-treatment MEP latency of group 1Hz,i TBS and the control group are 25.71(24.39,26.36),25.49(23.48,26.61),23.80(22.94,25.04)respectively,and the post-treatment scores of MEP latency are 23.76(23.36,24.53),23.45(22.24,25.13),23.81(22.54,24.38)respectively.The pre-treatment MEP peak of group 1Hz,i TBS and the control group are 145.82(95.42,180.34),112.83(69.36,156.25),197.15(110.72,480.47)respectively,and the post-treatment scores of MEP latency are 271.67(255.16,366.44),246.05(167.15,401.61),274.62(116.37,467.41)respectively.Conclusion 1.The study shows that i TBS and 1Hz repetitive transcranial magnetic stimulation group have benefits on the recovery of daily activities of stroke patients.Among them,i TBS has a more significant effect on the recovery of their hand function;2.i TBS group and 1Hz group can enhance the excitability of ipsilateral cerebral area of M1;3.Parameters gotten from two modes of treatment are safe;4.No significant differences have been found during the treatment of i TBS and 1Hz groups. |
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