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重复经颅磁刺激联合减重步行训练治疗慢性不完全性脊髓损伤患者的临床疗效观察
  • ISSN号:0254-1424
  • 期刊名称:《中华物理医学与康复杂志》
  • 时间:0
  • 分类:R651.2[医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]华中科技大学同济医学院附属同济医院康复医学科,武汉430030, [2]武汉市妇女儿童保健医院检验部, [3]华中科技大学同济医学院附属同济医院影像科,武汉430030
  • 相关基金:国家自然科学基金项目(81071601)
中文摘要:

目的采用重复经颅磁刺激(rTMS)联合减重步行训练(BWSTT)治疗慢性不完全性脊髓损伤(SCI)的临床疗效观察。方法慢性不完全性SCI患者4例,先给予rTMS治疗后立即给予BWSTT训练。在治疗前、后以及治疗后第3周,分别进行临床功能评估。对其中2例患者进行H反射、功能性磁共振成像(fMRI)和静态平衡功能评估(BPM)。结果4例患者中有2例美国脊髓损伤协会(ASIA)运动及感觉评分、10m步行速度提高,步行费力程度减小,身体重心摆动路径和摆动面积均减小,改变持续到治疗后第3周。2例患者的电生理评估均显示H反射最大波幅降低,H/M最大波幅比下降。治疗后,2例患者的fMRI均显示M1区激活体积增大。结论高频rTMS联合BWSTT可能改善慢性不完全性SCI患者的运动功能,提高脊髓运动神经元的兴奋性并促进大脑皮质的重塑。

英文摘要:

Objective To investigate the clinical effects of repetitive transcranial magnetic stimulation (rTMS) combined with body-weight-supported treadmill training (BWSTT) on patients with incomplete spinal cord injury (SCI). Methods Four patients with chronic incomplete SCI participated in this study. They were first trea- ted with rTMS and then BWSTT training. They were assessed with clinical measures of function. Two of the four pa- tients were assessed in terms of their H reflex, and using functional magnetic resonance imaging (fMRI) and a balance performance monitor ( BPM ). Results In two of the four patients, American spinal injury association (ASIA) clinical measures of motor and sensory function improved, as did 10 m walking speed and their sense of effort. In static balance tests, the sway path and sway area of the two patients both decreased. These improvements lasted for 3 weeks after the intervention. The two patients' maximum H reflex amplitude and the H/M amplitude ratio decreased. The fMRI results showed progressive enlargement of the activation volume of the movement-related M1 region after treat- ment. Conclusion High-frequency rTMS combined with BWSTT may improve motor function, elevate excitability of spinal motor neurons and improve the plasticity of the cerebral cortex in chronic incomplete SCI patients.

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期刊信息
  • 《中华物理医学与康复杂志》
  • 北大核心期刊(2011版)
  • 主管单位:中国科学技术协会
  • 主办单位:中华医学会 华中科技大学同济医院
  • 主编:
  • 地址:武汉市解放大道1095号同济医院内
  • 邮编:430030
  • 邮箱:cjpmr@tjh.tjmu.edu.cn
  • 电话:027-83662874
  • 国际标准刊号:ISSN:0254-1424
  • 国内统一刊号:ISSN:42-1666/R
  • 邮发代号:38-391
  • 获奖情况:
  • 国内外数据库收录:
  • 美国化学文摘(网络版),波兰哥白尼索引,日本日本科学技术振兴机构数据库,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版)
  • 被引量:23125