Clinical Study On The Effect Of Repetitive Transcranial Magnetic Stimulation On Gait And Balance Function In Patients With Vascular Parkinson’s Syndrome

Objective: A randomized controlled trial of repetitive transcranial magnetic stimulation in the treatment of gait and balance disorders in patients with vascular Parkinson’s syndrome(vascular parkinsonism,VP)was designed and carried out to observe the efficacy of repetitive transcranial magnetic stimulation in the recovery of gait and balance function in patients with vascular Parkinson’s syndrome(vascular parkinsonism,VP),so as to provide a new idea for the rehabilitation of vascular Parkinson’s syndrome patients with gait and balance dysfunction.Methods: 48 VP patients with gait and balance disorders were selected and randomly divided into control group and experimental group,each group 24 cases.Patients in both groups were given routine rehabilitation training on the basis of routine clinical drug therapy,the time of routine rehabilitation training in the two groups was 6 days a week,2 times per day,20 minutes at one time,according to individual differences,the treatment time did not fluctuate more than 5 minutes a day;and the treatment lasted for 2 weeks;On the basis of routine rehabilitation training,the experimental group was given 10 Hz rTMS acting on bilateral primary motor cortex,and the control group was given 10 Hz rTMS pseudo-stimulation acting on bilateral motor cortex,The treatment time is 6 days a week,2times a day,20 minutes each time,lasting for 2 weeks.Patients in both groups were assessed for balance and gait function before and after 2 weeks of treatment,mainly including Uniform Parkinson’s Disease Assessment Scale(UPDRSⅢ),Tinetti Balance and Gait analysis scale(Tinetti),Berg balance scale(BBS),step frequency,step size,step size variability.Results:1.The results show that There was no significant statistical difference in age,sex,body mass index,course of disease,levodopa dose,number of patients with hypertension and diabetes,number of smoking cases,serum total cholesterol,serum triglyceride,serum high density cholesterol,serum low density cholesterol and plasma homocysteine between the two groups before rehabilitation training(P > 0.05).2.There was no significant difference in UPDRSⅢ score,Tinetti score,BBS score,step frequency,step length and step length variability between the two groups before treatment(P > 0.05).3.After 2 weeks of rehabilitation treatment,the UPDRSⅢ score,Tinetti score,BBS score,step length and step length variability in the experimental group were all improved.The difference before and after treatment in the experimental group was statistically significant(P< 0.05).but the step frequency was not significantly improved,and there was no significant difference in the group before and after treatment(P > 0.05).The UPDRSⅢ score,Tinetti score,BBS score and step frequency in the control group were not significantly improved,and there was no significant difference before and after treatment in the control group(P <0.05).The evaluation of step length and step length variability in the control group was improved,and there was significant difference before and after treatment in the control group(P < 0.05).4.The difference of balance and gait function between the two groups before and after treatment showed that the improvement of d UPDRSⅢ,dTinetti,d BBS,d-step length and d-step length variability in the test group was better than that in the control group,and the difference was statistically significant(P < 0.05).There was no significant difference in d-step frequency between the two groups(P > 0.05).Conclusion:1.Routine rehabilitation training can partially improve the gait function of patients with vascular Parkinson’s syndrome.2.10 Hz rTMS with bilateral primary motor cortex as the target combined with conventional rehabilitation training can effectively improve the gait and balance function of patients with vascular Parkinson’s syndrome,and the effect is more significant than that of conventional rehabilitation training.