Effects Of Repetitive Transcranial Magnetic Stimulation On Muscle Coordination In Stroke Patients With Hemiplegia

Research backgroundStroke is a neurological deficit syndrome or an acute cerebrovascular disease caused by local cerebral blood circulation disorders.As a multiple and common disease of nervous system disease,stroke is currently one of the three leading causes of death.There were more than half of the patients with stroke left with severe disability,which brings huge burdens to family and society.Motor dysfunction is one of the most important clinical manifestations of patients with stroke,which seriously affects the quality of life.Therefore,the rehabilitation of motor function is still the hotspot and difficult point of research in this field.It is found that repetitive transcranial magnetic stimulation can improve motor function in patients with stroke.The decline of muscle coordination ability is an important reason for the recovery of motor function in stroke patients with hemiplegia,while RTMS,one of the main methods to promote motor function,improves muscle motor function mainly by increasing muscle strength and improving muscle tension.At present,there is no report about the influence of rTMS on the muscle coordination of stroke patients with hemiplegia.Therefore,the purpose of this study was to observe the effect of rTMS on muscle coordination in stroke patients with hemiplegia,and to verify whether rTMS could improve the motor function of stroke patients.Objective: Through observing the effects of repetitive transcranial magnetic stimulation on muscle coordination of stroke patients with hemiplegia,investigate the effects of rTMS on muscle function in stroke patients with hemiplegia,in order to provide experimental basis for the clinical application of rTMS to promote the rehabilitation of motor function.Methods: 60 stroke patients with hemiplegia(cerebral infarction and cerebral hemorrhage)were randomly divided into the treatment group and the control group,each with 30 cases.The treatment group was given rTMS,while the control group was given sham rTMS.Patients of two groups were given conventional drugs(including neurotrophic medications,improving microcirculation drugs,etc)and rehabilitation therapy.The patients in the treatment group were given rTMS on the basis of the above treatment.The rTMS was given 6 times a week,1 time a day,for 4 weeks.Before and after 4 weeks' treatments,each patient was evaluated by surface electromyography,Fugl-Meyer motor function assessment,balance ability and Modified Barthel index.The results were analyzed by statistical methods,comparing therapeutic effects between two groups and before and after treatment.Results:(1)?Triceps co-contraction rate of two groups was statistically significant difference before and after treatment when elbow extension makes maximum isometric contraction(P<0.01);Comparing two groups after treatment,there was statistically significant difference(P<0.01).Biceps brachii co-contraction rate of two groups was statistically significant difference before and after treatment when elbow flexion makes maximum isometric contraction(P<0.05);Comparing two groups after treatment,there was no statistically significant difference(P>0.05).(2)Quadriceps femoris co-contraction rate of two groups was statistically significant difference before and after treatment when Knee extension makes maximum isometric contraction(P<0.05);Comparing two groups after treatment,there was no statistically significant difference(P>0.05).Musculi biceps femoris co-contraction ratio of two groups was statistically significant difference before and after treatment when Knee flexion makes maximum isometric contraction(P<0.01);Comparing two groups after treatment,there was statistically significant(P<0.05).(2)Comparing the improved constituent ratio of Fugl-Meyer motor function scores btween two groups,the difference was statistically significant(P < 0.05).(3)Comparing the difference of the balance ability index,LFS index and speed chart before and after treatment between two groups,the difference was statistically significant(P < 0.01).(4)Comparing the improved constituent ratio of Daily living ability between two groups,the difference was statistically significant(P < 0.05).Conclusion: Repetitive transcranial magnetic stimulation can improve the coordination between active muscles and antagonistic muscles in stroke patients with hemiplegia,promote the rehabilitation of limb motor function and balance function,and improve the ability of daily living.