间歇性θ刺激联合Bobath康复训练治疗脑卒中后上肢痉挛的疗效OA

Objective:To evaluate the efficacy of intermittent theta burst stimulation(iTBS)combined with Bobath training(BT)in patients with post-stroke upper limb spasticity(PS-ULS).Methods:A total of 153 patients with PS-ULS admitted to our hospital from January 2024 to June 2025 were enrolled and randomly assigned(using SPSS-generated random numbers)into three groups:the control group(n=51,receiving BT alone),the iTBS group(n=51,receiving iTBS alone),and the study group(n=51,receiving BT plus iTBS).We compared their clinical efficacy,spasticity severity,motor function,modified Barthel index(MBI),surface electromyography(sEMG)parameters,cerebral vascular hemodynamics(CVH),and incidence of adverse events.Results:The modi-fied Ashworth Scale(MAS)score of the study group was significantly better than that of the control and iTBS groups(P<0.05).After treatment,the scores of the Fugl-Meyer Assessment for Upper Limb(FMA-UE),MBI,the sEMG amplitude during maximal voluntary contraction(MVC)of the biceps brachii,and the mean blood flow velocity(Vm)were significantly increased compared to baseline in all three groups(all P<0.05),with the study group showing greater improvements than both the control and iTBS groups(all P<0.05).Conversely,the elbow joint flexion-extension recurrent excitation ratio(RER),resting sEMG amplitude of the biceps brachii,pulsatility index(PI),and resistance index(RI)were significantly decreased from baseline in all three groups(all P<0.05),with the study group demonstrating lower values than the control and iTBS groups(all P<0.05).No significant differences were observed in the overall incidence of adverse events among the three groups.Conclusion:The iTBS combined with BT effectively alleviates spasticity,enhances motor function,MBI,sEMG parameters,and cere-bral vascular hemodynamics in patients with PS-ULS,yielding significant clinical efficacy without increasing the risk of adverse events.