低频重复经颅磁刺激联合Bobath疗法对脑卒中偏瘫患者神经功能、运动功能及平衡能力的影响

摘要 目的：观察Bobath疗法联合低频重复经颅磁刺激对脑卒中偏瘫患者运动功能、神经功能、平衡能力的影响。方法：研究对象为我院2020年05月-2022年05月期间收治的脑卒中偏瘫患者148例。按照随机数字表法分为对照组（Bobath疗法，74例）和研究组（低频重复经颅磁刺激联合Bobath疗法，74例）。观察两组平衡能力Berg平衡量表（BBS）]、神经功能美国国立卫生研究院卒中量表（NIHSS）]、日常生活自理能力改良Barthel指数（mBI）]、运动功能Fugl-Meyer上肢运动功能评定量表（FMA-UE）、Fugl-Meyer下肢运动功能评定量表（FMA-LE）]、凝血功能凝血酶原时间（PT）、纤维蛋白原（FIB）、D- 二聚体（D-D）、活化部分凝血活酶时间（APTT）]的变化情况。结果：两组治疗20 d后NIHSS评分下降， mBI评分升高，且研究组变化程度大于对照组（P<0.05）。两组治疗20 d后FMA-UE、FMA-LE评分升高，且研究组高于对照组（P<0.05）。两组治疗20 d后BBS评分升高，且研究组高于对照组（P<0.05）。两组治疗20 d后FIB、APTT、D-D、PT均下降，且研究组低于对照组（P<0.05）。结论：低频重复经颅磁刺激联合Bobath疗法用于脑卒中偏瘫患者，可改善其凝血功能，恢复神经功能，进而改善运动功能，提高其日常生活活动能力。

Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Bobath Therapy on Neurological Function, Motor Function and Balance Ability in Stroke Patients with Hemiplegia

ABSTRACT Objective: To observe the effects of Bobath therapy combined with low-frequency repetitive transcranial magnetic stimulation on motor function, neurological function and balance ability in stroke patients with hemiplegia. Methods: The study subjects were 148 stroke patients with hemiplegia who were admitted to our hospital from May 2020 to May 2022. According to the method of random number table, they were divided into control group (Bobath therapy, 74 cases) and study group (low-frequency repetitive transcranial magnetic stimulation combined with Bobath therapy, 74 cases). The balance ability Berg Balance Scale (BBS)], neurological function National Institutes of Health Stroke Scale (NIHSS)], daily living self-care ability modified Barthel Index (MBI)], motor function Fugl-Meyer upper limb motor function assessment scale (FMA-UE), Fugl-Meyer lower limb motor function assessment scale (FMA-LE)], coagulation function prothrombin time (PT), fibrinogen (FIB), D-Dimer (D-D), activated partial thromboplastin time (APTT)] changes were observed in the two groups. Results: 20d after treatment, NIHSS score decreased and MBI score increased in both groups, and the degree of change in the study group was greater than that in the control group (P<0.05). The scores of FMA-UE and FMA-LE in the two groups at 20 d after treatment increased, and the study group was higher than the control group (P<0.05). The BBS score of the two groups at 20 d after treatment increased, and the study group was higher than the control group (P<0.05). FIB, APTT, D-D and PT of the two groups at 20 d after treatment decreased, and the study group was lower than the control group (P<0.05). Conclusion: Low-frequency repetitive transcranial magnetic stimulation combined with Bobath therapy for stroke patients with hemiplegia can improve their coagulation function, recover their neurological function, and then improve their balance and motor function, and improve their daily living ability.