| ObjectiveBased on the brain-limb coordinated regulation model,to explore the clinical effects and mechanism of TaiChi Tuina combined with low frequency repetitive transcranial magnetic stimulation(LF-rTMS)in the treatment of upper limb motor dysfunction after ischemic stroke.It is expected to provide a new optimized joint intervention program for the rehabilitation of upper limb motor dysfunction after ischemic stroke.MethodWe selected stroke patients who were hospitalized in the Tuina Department/Rehabilitation Medicine Department of Hubei Provincial Hospital of Traditional Chinese Medicine from September 2020 to February 2021.All patients met the TCM and Western medicine diagnostic criterias for stroke,48 subjects meeting the diagnostic and inclusion criterias were randomly divided into a control group and a treatment group with 24 cases each,all subjects received conventional basic treatment.The control group received LF-rTMS treatment,the treatment group received TaiChi Tuina treatment on the basis of the control group.Both groups received treatment 6 times a week,with 24 interventions for 4 weeks.The TCM symptom scores,Fugl-Meyer upper limb motor function score(FMA-UE),modified version of daily living ability score(MBI),grip strength,cortical latency(CL),and amplitude(AMP)changes were compared between the two groups before and after treatment.Results1.Basic information analysis of included cases The study included 48 cases,6 of whom dropped out.A total of 42 cases were finally completed,including 21 cases in the control group and 21 cases in the treatment group.In the control group,there were 13 males and 8 females,with an average age of(57.16±2.61)years and an average duration of(2.46± 1.68)months.There were 15 cases of left limb paralysis and 6 cases of right limb paralysis.The average NHISS score was(7.13±1.62)points;in the treatment group,there were 16 males and 5 females,with an average age of(58.35±3.07)years,an average course of(3.25± 1.56)months,11 cases of left limb paralysis,and 10 cases of right limb paralysis,with an average NHISS The score is(6.84±12.08)points.After statistical analysis,the two groups of research subjects were not statistically significant in general conditions such as age,gender,course of disease,hemiplegia,and NIHSS score(P>0.05),indicating that the two groups of subjects are comparable.2.Analysis of statistical results of outcome indicators after treatment(1)Comparison of TCM symptom scores before and after treatmentBefore treatment,the comparison of the TCM symptom scores(18.37±4.73,19.00±4.71)between the control group and the treatment group showed no significant difference(P>0.05)and was comparable;after 4 weeks of treatment,the TCM symptom scores of the two groups were higher than those before treatment Improvement(13.83±4.65,10.77±4.29),and the treatment group was better than the control group,the difference was statistically significant(P<0.05).(2)Comparison of FMA-UE scores before and after treatmentBefore treatment,the FMA-UE scores(15.60±6.08,16.13±6.49)of the control group and the treatment group were not statistically significant(P>0.05),and they were comparable;After 4 weeks of treatment,the FMA-UE scores of the two groups were compared,there was improvement before treatment(24.00±8.23,31.42±7.14),and the treatment group was better than the control group,the difference was statistically significant(P<0.05).(3)Comparison of MBI score before and after treatmentBefore treatment,the MBI scores of the control group and the treatment group(30.51 ± 13.65,29.56± 13.84)were not statistically significant(P>0.05),and they were comparable;After 4 weeks of treatment,the MBI scores of the two groups were improved compared to before treatment(41.31±15.54,52.03±13.24),and the treatment group was better than the control group,the difference was statistically significant(P<0.05).(4)Comparison of grip strength before and after treatmentBefore treatment,there was no significant difference between the control group and the treatment group in grip strength(4.25±3.51,4.63±3.82)(P>0.05),which was comparable;After 4 weeks of treatment,the grip strength values of the two groups were improved compared to before treatment(5.51±3.02,7.63±3.56),and the treatment group was better than the control group,the difference was statistically significant(P<0.05).(5)Comparison of CL values before and after treatment Before treatment,the CL values of the control group and the treatment group(23.91 ±3.05,25.71 ±2.76)were not statistically significant(P>.05)and were comparable;After 4 weeks of treatment,the CL values of the two groups were improved compared to before treatment(22.20±2.39,23.96±2.85),and the treatment group is better than the control group,the difference is statistically significant(P<0.05).(6)Comparison of AMP value before and after treatment Before treatment,comparing the AMP values(63.43±19.61,61.33±16.71)of the control group and the treatment group,the difference was not statistically significant(P>0.05),which was comparable;After 4 weeks of treatment,the AMP values of the two groups were improved compared to before treatment(74.60± 15.84,86.15 ± 17.36),and the treatment group was better than the control group,the difference was statistically significant(P<0.05).Conclusion1.On the basis of conventional basic treatment,LF-rTMS treatment alone and TaiChi Tuina combined with LF-rTMS treatment can improve the TCM symptom scores,FMA-UE score,MBI score,grip strength,CL and AMP of ischemic stroke patients to varying degrees,and restore stroke The recovery of upper limb motor function and the improvement of daily life ability of patients in early stage have certain positive significance.2.The therapeutic effect of TaiChi Tuina combined with LF-rTMS is better than that of LF-rTMS alone,suggesting that the two have a synergistic effect.The combined rehabilitation program is worthy of clinical promotion. |
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