等速肌力训练联合rTMS治疗脑卒中后上肢功能障碍的康复效果及对血清BDNF、NGF水平的影响OA

Objective To investigate the effects of isokinetic muscle strength training combined with repet-itive transcranial magnetic stimulation(rTMS)on upper-limb motor function,muscle strength,neurophysio-logical parameters,activities of daily living,and serum brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)levels in patients with post-stroke upper-limb dysfunction.Methods A total of 82 pa-tients with post-stroke upper-limb dysfunction admitted to the hospital from January 2022 to May 2023 were enrolled.The patients were divided into control group and observation group using a random number table,with 41 cases in each group.The control group received conventional rehabilitation training combined with rT-MS,whereas the observation group additionally received upper-limb isokinetic muscle strength training.Up-per-limb motor function[Fugl-Meyer Assessment of the Upper Extremity(FMA-UE)score],isokinetic mus-cle strength parameters[peak torque(PT)and average power(AP)],electrophysiological parameters[mo-tor-evoked potential(MEP)latency and central motor conduction time(CMCT)],activities of daily living[Bar-thel Index(BI)score],and serum BDNF and NGF levels were compared between the two groups.Results After 4 weeks of treatment,the FMA-UE and BI scores,PT and AP during shoulder flexion and extension and elbow flexion and extension,and serum BDNF and NGF levels were higher in the observation group than those in the control group,whereas MEP latency and CMCT were shorter.All between-group differences were statistically significant(P<0.05).Conclusion Upper-limb isokinetic muscle strength training combined with rTMS ef-fectively improves upper-limb motor function,enhances muscle strength,and promotes neurological recovery in patients with post-stroke upper-limb dysfunction,indicating its potential for clinical application.