重复经颅磁刺激治疗脑卒中后患者肢体运动功能障碍的系统评价

被引:16
作者
王娟 [1 ]
朱芬 [1 ]
王朴 [2 ]
廖维靖 [1 ]
郭毅 [3 ]
李华钢 [4 ]
机构
[1] 武汉大学中南医院康复医学科
[2] 四川大学华西医院康复医学科
[3] 武汉大学公共卫生学院流行病学教研室
[4] 武汉大学中南医院神经内科
关键词
重复经颅磁刺激; 脑卒中; 运动功能; 系统评价; Meta分析; 随机对照试验;
D O I
暂无
中图分类号
R743.3 [急性脑血管疾病(中风)];
学科分类号
100204 [神经病学];
摘要
目的系统评价重复经颅磁刺激对脑卒中患者肢体运动功能障碍的疗效。方法计算机检索Cochrane图书馆、MEDLINE、EMbase、CBM、CNKI和WanFang Data中关于重复经颅磁刺激改善脑卒中后患者肢体运动功能障碍的随机对照试验(RCT),同时追溯纳入文献的参考文献。检索时限均为从建库至2012年1月。由两名研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.0.2软件进行Meta分析,并使用GRADE系统评价证据质量。结果共纳入11个RCT,376例患者。3个低质量RCT的Meta分析结果显示,与常规康复治疗相比,2~4周重复经颅磁刺激对脑卒中患者肢体运动功能障碍的疗效更好,其差异有统计学意义[WMD=11.02,95%CI(2.56,19.47)],其余8个研究仅作相应的描述性分析。结论重复经颅磁刺激对脑卒中患者的肢体运动功能障碍的治疗效果尚不能确定。因此,在临床上应用重复经颅磁刺激治疗脑卒中患者运动功能障碍时仍需谨慎。
引用
收藏
页码:1478 / 1488
页数:11
相关论文
共 27 条
[1]
Transcranial magnetic stimulation in mild to severe hemiparesis early after stroke: a proof of principle and novel approach to improve motor function [J].
Conforto, Adriana B. ;
Anjos, Sarah M. ;
Saposnik, Gustavo ;
Mello, Eduardo A. ;
Nagaya, Erina M. ;
Santos, Waldyr, Jr. ;
Ferreiro, Karina N. ;
Melo, Eduardo S. ;
Reis, Felipe I. ;
Scaff, Milberto ;
Cohen, Leonardo G. .
JOURNAL OF NEUROLOGY, 2012, 259 (07) :1399-1405
[2]
Repetitive transcranial magnetic stimulation at 1Hz and 5Hz produces sustained improvement in motor function and disability after ischaemic stroke [J].
Emara, T. H. ;
Moustafa, R. R. ;
ElNahas, N. M. ;
ElGanzoury, A. M. ;
Abdo, T. A. ;
Mohamed, S. A. ;
ElEtribi, M. A. .
EUROPEAN JOURNAL OF NEUROLOGY, 2010, 17 (09) :1203-1209
[3]
Role of 1 and 3 Hz repetitive transcranial magnetic stimulation on motor function recovery after acute ischaemic stroke [J].
Khedr, E. M. ;
Abdel-Fadeil, M. R. ;
Farghali, A. ;
Qaid, M. .
EUROPEAN JOURNAL OF NEUROLOGY, 2009, 16 (12) :1323-1330
[4]
Repetitive Transcranial Magnetic Stimulation as an Adjunct to Constraint-Induced Therapy: An Exploratory Randomized Controlled Trial.[J].Matthew P. Malcolm;William J. Triggs;Kathye E. Light;Leslie J. Gonzalez Rothi;Sam Wu;Kimberly Reid;Stephen E. Nadeau.American Journal of Physical Medicine & Rehabilitation.2007, 9
[5]
Direct demonstration that repetitive transcranial magnetic stimulation can enhance corticospinal excitability in stroke [J].
Di Lazzaro, Vincenzo ;
Dileone, Michele ;
Profice, Paolo ;
Pilato, Fabio ;
Cioni, Beatrice ;
Meglio, Mario ;
Capone, Fioravante ;
Tonali, Pietro A. ;
Rothwell, John C. .
STROKE, 2006, 37 (11) :2850-2853
[6]
A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients [J].
Fregni, Felipe ;
Boggio, Paulo S. ;
Valle, Angela C. ;
Rocha, Renata R. ;
Duarte, Julia ;
Ferreira, Merarl J. L. ;
Wagner, Tim ;
Fecteau, Shirley ;
Rigonatti, Sergio P. ;
Riberto, Marcelo ;
Freedman, Steven D. ;
Pascual-Leone, Alvaro .
STROKE, 2006, 37 (08) :2115-2122
[7]
A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition [J].
Fitzgerald, Paul B. ;
Fountain, Sarah ;
Daskalakis, Zafiris J. .
CLINICAL NEUROPHYSIOLOGY, 2006, 117 (12) :2584-2596
[8]
Repetitive Transcranial magnetic stimulation of contralesional primary motor cortex improves hand function after stroke [J].
Takeuchi, N ;
Chuma, T ;
Matsuo, Y ;
Watanabe, I ;
Ikoma, K .
STROKE, 2005, 36 (12) :2681-2686
[9]
Reliability and validity of the upper-extremity motor activity Log-14 for measuring real-world arm use [J].
Uswatte, G ;
Taub, E ;
Morris, D ;
Vignolo, M ;
McCulloch, K .
STROKE, 2005, 36 (11) :2493-2496
[10]
Management of adult stroke rehabilitation care - A clinical practice guideline [J].
Duncan, PW ;
Zorowitz, R ;
Bates, B ;
Choi, JY ;
Glasberg, JJ ;
Graham, GD ;
Katz, RC ;
Lamberty, K ;
Reker, D .
STROKE, 2005, 36 (09) :E100-E143