Evaluation Of Therapeutic Effect Of Needle Knife Combined With RTMS On Upper Limb Motor Dysfunction In Ischemic Stroke Patients With Spastic Hemiplegia

Objective:To observe the therapeutic effect of needle knife combined with repetitive transcranial magnetic stimulation on upper limb motor function in patients with spastic hemiplegia after ischemic stroke.So as to provide a new idea for the rehabilitation of upper limb function in patients with spastic hemiplegia after ischemic stroke.Methods:According to the diagnostic criteria revised by the fourth National Conference on Cerebrovascular Diseases in 1995,45 patients aged 18-75 years with spastic hemiplegia after ischemic stroke who were hospitalized in the Department of Rehabilitation Medicine of the fourth affiliated Hospital of Nanchang University from January 2019 to July 2020 were randomly divided into group A(n = 15),group B(n = 15)and group C(n =15).Group A was treated with r TMS combined with Bobath exercise therapy,group B with needle knife combined with Bobath exercise therapy,group C with needle knife combined with r TMS and Bobath exercise therapy.The differences and comparability of general conditions(age,sex,course of disease,hemiplegic side)among the three groups were analyzed and compared,as well as the changes of upper limb Fugl-Meyer motor function scale(FMA-UE),hand function,modified Ashworth grade spasticity and motor threshold(MT)before and after one month treatment.Results:1.There was no significant difference in FMA-UE score,modified Ashworth grade,hand function score and motor threshold among the three groups before treatment.There was no significant difference in age,sex,course of disease and hemiplegic side among the three groups(P > 0.05).2.There were significant differences in FMA-UE scores between the three groups before treatment,between group B and group A,between group B and group B(P < 0.0l),and between group C and group B(P < 0.05 and P < 0.05.Contral to group B),FMA-UE score was significantly higher in group C than that in group A(P< 0.05),and there was significant difference in group B(P < 0.05)and group C(P <0.05).3.Compared with the modified Ashworth classification,there was no significant difference in group A(P > 0.05),),B group and group C(P < 0.05,0.05),but there was no significant difference in group B(P > 0.05),C),and there was significant difference in group C compared with group B(P < 0.05).4.The hand function scores of the three groups were significantly different from those before treatment,the hand function scores of group B and group C were significantly higher than those of group A(P < 0.05),),C group(P < 0.05)and group C(P < 0.05).The hand function scores of the three groups were significantly higher than those of group A(P < 0.05),group B(P < 0.05)and group C(P < 0.05).5.Compared with the results of motor threshold before treatment,there was no significant difference in bilateral MT in group B(P > 0.05).There was no significant difference in MT in healthy side between group);An and group C(P > 0.05).There was significant difference in MT between group),An and group C(P < 0.05).Conclusion:This study shows that needle knife combined with repetitive transcranial magnetic therapy((r TMS)and Bobath)can significantly improve the spasticity of upper limbs,promote the recovery of limb motor function and improve the fine movement of hand function in patients with spastic hemiplegia.This scheme is worthy of clinical promotion and provides a new choice for the rehabilitation of upper limb function in stroke patients with hemiplegia...