重复性外周磁刺激联合上肢智能机器人对痉挛型偏瘫儿童上肢功能的效果OA

Objective To investigate the effect of repetitive peripheral magnetic stimulation(rPMS)combined with upper limb intel-ligent robotic training on muscle tension,motor function and cortical excitability in children with unilateral spas-tic cerebral palsy(USCP). Methods From March,2023 to December,2024,90 children with USCP admitted to Children's Hospital of Soochow University were selected and randomly divided into control group(n=30),rPMS group(n=30)and combined group(n=30).The control group received conventional occupational therapy.The rPMS group received rPMS intervention followed by conventional occupational therapy.The combined group received rPMS followed by up-per limb intelligent robot training,for four weeks.Before and after treatment,muscle tension of biceps brachii was assessed using the modified Ashworth Scale(MAS);upper limb motor function was evaluated using the Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and upper limb intelligent parameters;and cortical excit-ability was measured using transcranial magnetic stimulation(TMS),including resting motor threshold(RMT)and motor-evoked potential(MEP)amplitude of the affected hemisphere. Results After treatment,MAS grades improved in all groups(|Z|>3.523,P<0.001),and the improvement in the com-bined group was superior to that in the control group(P<0.05).Significant intra-group(F>65.21,P<0.001),inter-group(F>17.94,P<0.001)and interaction effects(F>5.36,P<0.01)were observed in FMA-UE scores,upper limb intelligent parameters and TMS parameters.Post Hoc analysis showed that the combined group dem-onstrated significantly greater improvements in FMA-UE scores,upper limb intelligent parameters,and TMS pa-rameters compared with both the control and rPMS groups(all P<0.01).Except for FMA-UE scores,the rPMS group showed significantly greater improvements than the control group in upper limb intelligent parameters(me-chanical feedback,trajectory,and range of motion)and TMS parameters(RMT and MEP amplitude)(P<0.05). Conclusion rPMS combined with upper limb intelligent robotic training can reduce upper limb muscle tension,improve motor function,and enhance cortical excitability in children with USCP.