低频重复经颅磁刺激联合脑机接口康复机器人对脑卒中患者上肢运动功能障碍的影响

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中图分类号：R743.3 文献标志码：A DOI：10.11958/20251930

Abstract：ObjectiveTo explore the influence oflow-frequency repetitive transcranial magnetic stimulation （rTMS） combined with brain-computer interfacerehabilitationrobotinpatients with upper limb motor dysfunction after stroke. MethodsAtotalof126 patients withupperlimb motor dysfunction after stroke were divided into thecombined group（61 cases，low-frequencyTMScombinedwithbrain-computerinterfacerehabilitationrobotonthebasisofroutinerehabilitation treatment）andthe magneticstimulationgroup（65cases，low-frequencyrTMSonthebasisofroutinerehabilitationtreatment） according todiffrent treatment methods，and both groups werecontinuously treated for3 weeks.The upper limb motor function[upper-extremityFugl-Meyer scale （UFMA），actionresearcharm test （ARAT）]，handBrunnstrom staging，upper limb surfaceelectromyography indicators[root mean square （RMS）and integrated electromyography （iEMG）of biceps brachii，triceps brachi，deltoidanteriorbundleanddeltoidmiddlebundle]，cerebralarteryhemodynamics[systolicblod flowvelocity（Vs），resistanceindex（RI），meanbloodflowvelocity（Vm）]andratiooffractionalanisotropy（FA）ofcentral regionof brain lesionandFAof miror-imageregionof healthycerebral hemisphere （rFA）wereobserved beforeand after treatment inthetwo groups.ResultsCompared withthe magnetic stimulation group，the UFMA score，ARATscore，hand Brunnstrom staging，Vs，Vm and rFA were higher after treatment in the combined group P<0.05 ）. TheRMS and iEMG of biceps brachi，triceps brachii，deltoidanterior bundleand deltoidmiddle bundle were higher in thecombinedgroup compared with those of the magnetic stimulation group （ P<0.05 ），while the RI waslower （ P<0.05 ）. Conclusion Combined treatmentcan more efectively improve the upperlimb motor functionof patients，enhance handactivity ability， promotetherecoveryofupperlimb muscleand nerve function，andregulate thehemodynamics ofcerebralarteries.

Key Words：stroke;brain-computer interface robot; low-frequency repetitive transcranial magnetic stimulation;upper limb motor dysfunction; cerebral artery hemodynamics; surface electromyography

上肢运动功能障碍是脑卒中后遗症之一，尤其以手部运动功能障碍最为常见，包括上肢肌肉无力、肌肉痉挛、协调性下降无法完成精细动作以及关节活动受限等[1]。（剩余13163字）