| Cerebrovascular accidents have become one of the most important causes of harm to the health of people.Due to the high mortality and disability of stroke,more and more people are participating in the research of stroke.There are many legacy complications,such as motor dysfunction,speech dysfunction,swallowing dysfunction,cognitive dysfunction,depression,and shoulder-hand syndrome.Among them,motor dysfunction has the highest incidence and has the widest impact,up to 80 % Of surviving stroke patients have motor deficits that seriously affect the quality of their daily lives.Improving motor function through various forms of rehabilitation interventions is of great importance for improving the activities of daily living(ADL)of stroke patients and for their early return to family and society.Repetitive transcranial magnetic stimulation(rTMS)is a new neurological examination and treatment technology.It is characterized by painlessness and non-invasiveness,and is increasingly used in the field of stroke rehabilitation.Objective:To observe the effects of rTMS with different frequencies(0.5Hz and 10Hz)on motor function recovery in patients with ischemic stroke.Methods:Using random number table method,ninety patients with ischemic stroke and hemiplegia were divided into high frequency group,low frequency group and sham stimulation group,thirty cases in each group.All three groups were given conventional rehabilitation interventions.On the basis of this,patients in the high-frequency group were given 10 Hz high-frequency rTMS treatment for the affected motor cortex M1 area,and patients in the low-frequency group were given 0.5 Hz low-frequency rTMS treatment for the healthy motor cortex M1 area.In the pseudo-stimulation group,pseudo-magnetic stimulation was given to the affected motor cortex M1 area.Before the treatment and after 3 weeks of treatment,the motor evoked potential(MEP)cortical incubation period and central motor conduction time(CMCT)of the three groups of patients were recorded.At the same time,the motor function assessment scale:Fugl-Meyer Assessment(FMA)and Berg Balance Scale(BBS),and daily activity ability scale-modified Barthel index(MBI)were employed,and the patients' motor function recovery was evaluated.Result:1.Before and after comparison of MEP cortex latency: Before treatment,there was no significant difference in MEP latency(24.42 ± 1.46 s,25.26 ± 1.05 s,24.90 ± 1.60s)in the high-frequency group,low-frequency group,and sham stimulation group(P> 0.05);After three weeks of treatment,the MEP latency of the three groups was significantly shorter than before treatment(23.42 ± 1.51 s,22.71 ± 1.02 s,24.15 ± 1.48s),and the shortening degree of the high-frequency group and the low-frequency group was higher than that of the sham group.In the stimulation group,the difference was statistically significant(P <0.05).The MEP cortex latency was significantly shorter in the low-frequency group and the difference was statistically significant(P <0.05).2.Before and after CMCT: Before treatment,there was no significant difference in CMCT(11.86 ± 0.86 s,11.88 ± 0.69 s,12.16 ± 0.92s)between the high-frequency group,the low-frequency group and the sham stimulation group(P> 0.05);After three weeks of treatment,the CMCT of the three groups of patients was significantly shorter than before treatment(11.08 ± 0.84 s,10.65 ± 0.75 s,11.57 ± 0.75s),and the shortening degree of the high-frequency group and the low-frequency group was higher than that of the sham stimulation group.The difference was There was statistical significance(P <0.05).The CMCT in the low frequency group was significantly shortened in the higher frequency group,and the differences were statistically significant(P <0.05).3.Before and after comparison of FMA scale scores: before treatment,the FMA scores of upper limbs(23.27 ± 6.13,22.20 ± 6.18,22.50 ± 7.49),and lower limb FMA(11.73 ± 3.35,11.60)± 3.21,11.70 ± 3.32)The difference was not statistically significant(P> 0.05);after three weeks of treatment,the FMA scores of the three groups of patients were significantly higher than before treatment,and FMA of the upper limbs(36.43 ± 7.14,36.80 ± 5.65,30.33 ± 6.20),lower limb FMA(18.00 ± 3.38,18.70 ± 4.78,15.93 ± 3.24),and the degree of improvement between the high-frequency group and the low-frequency group was higher than that of the false stimulation group,the difference was statistically significant(P <0.05).There was no significant difference between the high-frequency groups(P> 0.05).4.Before and after comparison of BBS scale scores: Before treatment,there were no significant differences in BBS scores(18.20 ± 15.37,16.80 ± 12.73,16.77 ± 11.99)between the high-frequency group,the low-frequency group,and the sham stimulation group(P> 0.05).;After three weeks of treatment,the BBS scores of the three groups of patients were significantly higher than before treatment(32.43 ± 14.50,33.73 ± 12.88,25.27 ± 12.16),and the degree of improvement in the high-frequency group and the low-frequency group was higher than that in the sham stimulation group,with a difference.Statistical significance(P <0.05).There was no significant difference between the low-frequency group and the high-frequency group after treatment(P> 0.05).5.Before and after comparison of MBI scale scores: Before treatment,the MBI scores of patients in the high frequency group,low frequency group and sham stimulation group(39.47 ± 19.19,42.37 ± 18.43,42.37 ± 23.62)had no significant difference(P> 0.05);After three weeks of treatment,the MBI scores of the three groups were significantly higher than before treatment(64.13 ± 17.34,66.33 ± 18.73,53.83 ± 22.06),and the increase in the high-frequency group and the low-frequency group was higher than that of the sham stimulation group,with a difference.Statistical significance(P <0.05).There was no significant difference between the low-frequency group and the high-frequency group after treatment(P> 0.05).Conclusion:1.This study shows that low frequency rTMS on the healthy side and high frequency rTMS on the affected side can significantly improve patient's motor function for patients with ischemic stroke,compared with conventional rehabilitation therapy alone.2.This study shows that stimulation of the healthy side M1 area with 0.5 Hz low-frequency rTMS on the lesion side cortical excitability is better than high-frequency rTMS stimulation on the lesion side M1 area. |
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