Application Of RTMS Combined With Upper Limb Robot Training In Rehabilitation Of Patients With Upper Limb Motor Dysfunction After Stroke

Objective: A large number of clinical trials at home and abroad have confirmed that Repetitive Transcranial Magnetic Stimulation(rTMS)and upper limb robot training can improve the upper limb motor function of patients with hemiplegia after stroke.This study mainly explored whether rTMS and upper limb robot training could improve upper limb motor dysfunction after stroke,compared the therapeutic effects of the two,and studied whether the combined treatment effect of the two schemes was superior to the single use of one.Methods:In this study,45 stroke patients who met the inclusion criteria and exclusion criteria were randomly divided into rTMS group,upper limb robot group and combined treatment group by random number table method.RTMS was performed on bilateral Motor cortex(M1)and conventional rehabilitation therapy.The upper limb robot group received upper limb robot training and routine rehabilitation training;The combined group received bilateral rTMS in M1 area,upper limb robot training and routine rehabilitation training.The Fugl-Meyer Assessnent Scale(FMA)and Functional Rating Scale(FIM)of upper extremity,FIM and改良Barthel指数Index were evaluated before and after treatment,respectively,and the changes of the above related indexes before and after treatment were compared.Results:Before treatment,there was no statistical difference in the general information and the scores of various rating scales among the three groups.At the end of the treatment cycle,the FMA,FIM,FIM and改良Barthel指数scores in each group were significantly higher than those before treatment(P<0.05).There were no statistically significant differences in FMA upper limb scores,FIM and改良Barthel指数before and after treatment among the three treatment methods(P>0.05).The difference of FIM upper limb scores in the combination group and rTMS group was different before and after treatment,and the combination group was better than the rTMS group(P<0.05).Conclusion: All the three treatments can improve the upper extremity motor function,functional activities and daily living ability of patients.The improvement of upper extremity functional activities in patients treated with rTMS combined with upper extremity robot is better than that treated with rTMS alone.