| Objective: To observe the effect of LF-rTMS on the gait of hemiplegia in stroke patients.Methods: 40 patients with stroke hemiplegia who were qualified and completed the study were selected randomly into two groups,namely experimental group and control group.All patients in the two groups were given routine sequential rehabilitation treatment,30 minutes a day,5 days a week and 6 weeks of continuous treatment.It mainly includes: exercise therapy,physical factor therapy,operation therapy and traditional rehabilitation treatment.The operator selected the frequency of 1Hz stimulation to treat the R TMS stimulation in the primary motor cortex(M1 area)of the healthy brain of the experimental group;The control group received the same pseudo rTMS stimulation,the treatment time was 20 minutes,5 days a week,6 weeks in a row.Before and after treatment,the gait parameters,clinical function scores and neuroelectrophysiology of the subjects were evaluated and tested by the same group of professionals.The gait parameters,the FMA score,MEP latency and central motor conduction time were recorded.There was no significant difference in the evaluation results of general data parameters before treatment(P > 0.05).The results were as follows:(1)after 6 weeks of treatment,the step length of experimental group and control group was increased compared with that before rTMS[(37.60)± 7.22 VS 29.85 ± 8.55,32.40 ± 6.00 VS 28.45 ± 7.56 cm],faster [(45.45 ±10.79 VS 29.10 ± 8.55,32.40 ± 5.87 VS 27.35 ± 7.16 cm/s],step width reduced [(12.26± 2.17 VS 15.59 ± 2.15,14.07 ± 1.84 VS 15.64 ± 2.10 cm],step frequency increased[(50.75)± 5.65 VS 39.45 ± 4.84,44.05 ± 3.44 VS 38.95 ± 3.47)step / minute].The difference of step length,pace speed,step width and step frequency in the experimental group was significant(P < 0.05)(2)The difference between the experimental group and the control group was significant(P < 0.05);The difference between the experimental group and the control group was statistically significant(P < 0.05)(3)The maximum hip flexion and extension angle of the two groups was higher than that before rTMS [(37.38 ± 3.81 VS 26.04 ± 4.14,33.86 ± 3.66 VS 26.16 ± The difference between the experimental group and the control group was statistically significant(P <0.05).The maximum knee flexion and extension angle of the two groups was higher than that before rTMS [(48.52)± 4.25 VS 34.40 ± 4.28,43.32 ± 4.18 VS 34.66 ± The difference between the experimental group and the control group was statistically significant(P ± 3.96 VS 17.46 ± 3.08,18.53 ± 2.51 VS 17.71 ± The difference between the experimental group and the control group was not significant(P > 0.05)(4)Compared with the pre treatment,FMA scores of lower extremity motor function in control group and experimental group increased [(31.25)± 5.63 VS 22.25 ± 5.55,25.30± 6.78 VS 23.50 ± The improvement of experimental group was significantly better than that of the control group(P < 0.05)(5)The latency of MEP in experimental group and control group was lower than that before rTMS treatment [(32.44)± 1.51 VS 34.42 ±1.16,34.06 ± 0.61 VS 34.15 ± After 6 weeks of treatment,the experimental group was better than the control group,and the difference was statistically significant(P < 0.05);CMCT in experimental group was significantly decreased,while that in control group was not significant [(19.90)± 0.42 VS 21.19 ± 0.78,21.38 ± 0.62 VS 21.41 ± The difference between the experimental group and the control group was statistically significant(P < 0.05).Conclusion: the stimulation of the healthy hemisphere by repeated transcranial magnetic stimulation can improve the walking speed,improve the stability and symmetry of the patients,improve the gait of hemiplegia in stroke patients,and promote the recovery of lower extremity motor function. |
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