MOTOmed运动训练系统结合间歇性θ短阵脉冲刺激在老年脑卒中后偏瘫患者中的应用效果

Application effects of MOTOmed exercise training system combined with intermittent theta burst stimulation in older patients with post-stroke hemiplegia

中文关键词: 运动训练    间歇性θ短阵脉冲刺激    卒中    偏瘫    生活质量

英文关键词: exercise trainingintermittent theta burst stimulationstrokehemiplegiaquality of life

中文摘要:

      目的 探究老年脑卒中后偏瘫患者使用MOTOmed运动训练系统结合间歇性θ短阵脉冲刺激(iTBS)的治疗效果。方法 纳入2023年6月至2025年6月首都医科大学附属北京康复医院的住院老年脑卒中后偏瘫患者80例。通过随机数表分为对照组(MOTOmed运动训练系统，n=40)与研究组(MOTOmed运动训练系统+iTBS,n=40)，疗程1个月。比较2组治疗前后的脑源性神经营养因子(BDNF)、神经胶质细胞原纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)水平，Fugl-Meyer上肢功能评定量表(FMA-UE)、Fugl-Meyer下肢功能评定量表(FMA-LE)、Tinetti平衡与步态量表(POMA)、Berg平衡量表(BBS)、脑卒中专用生活质量量表(SS-QOL)评分，以及10m步行时间测试(10MWT)时间。结果 治疗后，2组BDNF水平均升高，NSE、GFAP水平均降低，FMA-UE、FMA-LE、POMA、BBS、SS-QOL评分均升高，10MWT均降低，差异有统计学意义(P <0.05)。与对照组相比，研究组治疗前后的BDNF、NSE、GFAP水平，FMA-UE、FMA-LE、POMA、BBS、SS-QOL评分及10MWT差值较大(均P <0.05)。结论 iTBS结合MOTOmed运动训练系统能一定程度促进老年脑卒中后偏瘫患者神经与运动功能恢复，提升生活质量。

英文摘要:

      Objective To investigate curative effects of the MOTOmed exercise training system combined with intermittent theta burst stimulation(iTBS)in older patients with post-stroke hemiplegia.Methods A total of 80 older inpatients with post-stroke hemiplegia admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University between June 2023 and June 2025 were enrolled.Using a random number table,they were divided into control group(MOTOmed exercise training system,n=40)and study group(MOTOmed exercise training system+iTBS,n=40).The treatment duration was 1 month for both groups.The following indicators were compared between the two groups before and after treatment:the levels of brain-derived neurotrophic factor(BDNF),glial fibrillary acidic protein(GFAP),and neuron-specific enolase(NSE);scores of the Fugl-Meyer assessment of upper extremity(FMA-UE),Fugl-Meyer assessment of lower extremity(FMA-LE),Tinetti performance-oriented mobility assessment(POMA),Berg balance scale(BBS),and stroke-specific quality of life scale(SS-QOL);and the 10-meter walking test(10MWT)time.Results After treatment,BDNF levels increased in both groups,while NSE and GFAP levels decreased.The scores for FMA-UE,FMA-LE,POMA,BBS,and SS-QOL all increased,and 10MWT time decreased in both groups,with statistically significant differences(P＜0.05).Compared with the control group,the study group showed greater pre-to-post-treatment difference in BDNF,NSE,and GFAP level;FMA-UE,FMA-LE,POMA,BBS,and SS-QOL scores;and 10MWT time(all P＜0.05).Conclusion iTBS combined with the MOTOmed exercise training system can promote the recovery of neurological and motor function,and improve quality of life to a certain extent in older patients with post-stroke hemiplegia.