| Objective: To evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with cerebral circulation therapy instrument on systemic motor function, surface electromyography (SEMG) and cerebral hemodynamics in children with spastic cerebral palsy. Methods: Children with cerebral palsy in our hospital from July 2020 to April 2022 were randomly divided into control group, rTMS group and combined group. The control group was treated with routine therapy and sham rTMS stimulation. The rTMS group was stimulated with real rTMS on the basis of the control group. The combined group was treated with cerebral circulation therapeutic instrument on the basis of rTMS group. The gross motor function measure (GMFM), fine motor function measure scale (FMFM), gross motor quotient (GMQ), fine motor quotient (FMQ), blood flow velocity (Vm), vascular resistance index (RI), root mean square (RMS) of surface electromyography of adductor and gastrocnemius, laboratory index ［high mobility group protein 1 (HMGB1), brain derived neurotrophic factor (BDNF), nerve growth factor (NGF)］ and clinical efficacy were observed before and 12 weeks after intervention. Results: After 12 weeks of intervention, except for one item of FMFM in the control group, GMFM, GMQ, FMFM and FMQ in the three gro-ups were higher than those before the intervention (P<0.05). After the intervention, the scores in 4 items in the rTMS group were significantly higher than those in the control group (P<0.05). In the combined group, GMFM, GMQ and FMQ were significantly higher than those in the rest two groups (P<0.05).However, FMFM in the combined group was only higher than that in the control group, and there was no significant difference between the combined group and the rTMS group (P>0.05). In three groups, Vm was significantly higher, and RI, adductor RMS and gastrocnemius RMS were significantly lower after the intervention than those before intervention (P<0.05). After intervention, Vm was significantly higher, and RI, adductor RMS and gastrocnemius RMS were significantly lower in the rTMS group than those in the control group (P<0.05). Vm was significantly higher, and adductor RMS and gastrocnemius RMS were significantly lower in the combined group than those in the rest two groups (P<0.05). RI in combined group was significantly lower than that in the control group, and there was no significant difference from rTMS group. HMGB1 was significantly lower, and BDNF and NGF were significantly higher in three groups after intervention than those before intervention (P<0.05). BDNF and NGF in the rTMS group were significantly higher than those in the control group after intervention (P<0.05). There was no significant difference in HMGB1 between the control group and the rest two groups. BDNF and NGF were significantly higher and HMGB1 was significantly lower in the combined group than those in the rest two groups (P<0.05). The clinical efficacy of the combined group was more satisfactory than that of the rest two groups (P<0.05). Conclusion: The cerebral circulation therapeutic apparatus combined with rTMS can relieve spasticity and motor dysfunction, reduce muscle tension, increase intracranial blood flow velocity, and improve laboratory indicators in children with spastic cerebral palsy, which is worthy of further promotion and application. |
