镜像神经元康复策略联合经颅磁刺激对卒中后神经与功能康复的作用研究

doi:10.3969/j.issn.1006-6233.2024.06.025

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Abstract Objective: To study the effects of the Mirror Neuron System (MNS) rehabilitation strategy combined with Transcranial Magnetic Stimulation (TMS) on neurological and functional recovery post-stroke.Methods: A total of 198 patients with motor dysfunction following a stroke, treated at a military rehabilitation center from January 2019 to June 2023, were selected and randomly divided into three groups of 66 patients each. All three groups received conventional rehabilitation guidance; the TMS group received TMS treatment, the MNS group received MNS treatment, and the combined group received TMS+MNS treatment. Neurological function (NIHSS), upper and lower limb motor function (FMA), activities of daily living (ADL), balance ability (BBS), upper and lower limb muscle tone (MAS), step length difference between healthy and affected sides, percentage of weight-bearing time on the affected side, and language function were compared among the three groups before the intervention, after 2 weeks of intervention, and after 4 weeks of intervention.Results: After 2 and 4 weeks of intervention, the NIHSS scores of the combined group were lower than those of the TMS group and the MNS group, with statistically significant differences (P<0.05); there was no statistically significant difference between the TMS group and the MNS group (P>0.05). After 2 and 4 weeks of intervention, the FMA-upper limb and FMA-lower limb scores of the combined group were higher than those of the TMS group and the MNS group, and the MNS group scored higher than the TMS group, with statistically significant differences (P<0.05). After 2 and 4 weeks of intervention, the ADL scores and BBS scores of the combined group were higher than those of the TMS group and the MNS group, and the MNS group scored higher than the TMS group, with statistically significant differences (P<0.05). After 4 weeks of intervention, the proportion of patients with upper and lower limb MAS grades 0-1 in the combined group was higher than in the TMS group and the MNS group, and higher in the TMS group than in the MNS group, with statistically significant differences (P<0.05). After 2 and 4 weeks of intervention, the step length difference between the healthy and affected sides in the combined group was lower than that in the TMS group and the MNS group, and the percentage of weight-bearing time on the affected side was higher than that in the TMS group and the MNS group, with greater changes observed in the MNS group compared to the TMS group, with statistically significant differences (P<0.05). After 2 and 4 weeks of intervention, scores for reading comprehension, repetition, fluency, and naming in language function were higher in the combined group than in the TMS group and the MNS group, and higher in the TMS group than in the MNS group, with statistically significant differences (P<0.05).Conclusion: MNS combined with TMS can promote neurological and functional recovery post-stroke, and improve patients' activities of daily living, and each method has its advantages and complements the other. The combined treatment is significantly effective and worthy of clinical promotion.

Key words： Mirror neuron rehabilitation strategy Transcranial magnetic stimulation Stroke Neurological rehabilitation Balance ability Upper and lower limb motor function

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.06.025 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I6/1007

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