经颅磁刺激同步踏车训练在胸腰段脊髓损伤治疗中的应用

The effect of repetitive transcranial magnetic stimulation synchronizing treadmill training on thoracolumbar spinal cord injury

中文关键词:  脊髓损伤  胸腰段  经颅磁刺激  踏车训练  康复

英文关键词:Spinal cord injury  Thoracolumbar  Repetitive transcranial magnetic stimulation  Treadmill training  Rehabilitation

中文摘要:

  【摘要】 目的：探讨经颅磁刺激同步踏车训练对胸腰段脊髓损伤患者功能恢复的影响。方法：30例不完全性T10～T12脊髓损伤患者，ASIA脊髓神经功能分级均为C级，病程3～4个月，随机分为训练组和对照组。两组均接受常规康复治疗（包括物理治疗、作业治疗、理疗和梯度气压助动等），训练组比对照组仅增加经颅磁刺激同步踏车训练1个项目。治疗时间6周，比较两组治疗前后ASIA运动评分、ASIA感觉评分、脊髓损伤步行指数Ⅱ（WISCIⅡ）和功能独立性评定（FIM）情况。结果：两组患者治疗前各临床评价指标间比较均无显著性差异（P>0.05）。治疗6周后，训练组ASIA运动评分、WISCIⅡ、FIM评分较治疗前均有提高，差异有显著性（P<0.05）；对照组FIM评分较治疗前提高，差异有显著性（P<0.05），余评价指标与治疗前比较差异无显著性（P>0.05）。治疗后两组间比较，经颅磁刺激同步踏车训练组ASIA运动评分、WISCIⅡ均高于对照组，差异有显著性（P<0.05），ASIA感觉评分、FIM评分两组间差异无显著性（P>0.05）。结论：经颅磁刺激同步踏车训练对不完全性胸腰段脊髓损伤患者运动功能恢复有一定程度的促进作用。

英文摘要:

  【Abstract】 Objective：To investigate the effect of repetitive transcranial magnetic stimulation（rTMS） synchronizing treadmill training on neurofunction recovery of patients with incomplete thoracolumbar spinal cord injury（SCI）.Method：Thirty patients with T10-12 incomplete spinal cord injury（ASIA C） were recruited and randomly divided into rTMS group and control group.Routine rehabilitation exercises were performed in both groups，while additional rTMS was used in experimental group.Patients were assessed with ASIA motor score，ASIA sensory score，walking index for spinal cord injuryⅡ（WISCIⅡ） and functional independence measure（FIM） score before treatment and after 6 weeks.Result：There was no difference between two groups with regard to the clinical assessment（P>0.05） before treatment.After 6 weeks，ASIA motor score，WISCIⅡ and FIM score were noted improvement in rTMS group，which showed significant difference（P<0.05）.While in control group，only FIM score increased significantly（P<0.05）.Compared with control group，ASIA motor score and WISCIⅡ improved in rTMS group，which showed significant difference（P<0.05）.Conclusion：Repetitive transcranial magnetic stimulation synchronizing treadmill training can improve the motor function after incomplete thoracolumbar spinal cord injury.