| Objective: To investigate the effect of action observation therapy (AOT) in combination with repetitive transcranial magnetic stimulation (rTMS) on lower limb motor function in patients with ischemic stroke. Method: From July 2019 to February 2021, 72 patients with lower limb dysfunction after ischemic stroke who met the inclusion and exclusion criteria were selected. All patients were randomly divided into 4 groups (group A: 18 cases given AOT+rTMS; group B: 18 cases given AOT; group C: 18 cases given rTMS; group D: 18 cases given routine treatment). AOT treatment lasted about 30~45 min each time, twice a day, 5 days a week, for 8 consecutive weeks. The rTMS treatment was performed on the lower extremity region of the affected side motor cortex with 1000 pulses of 5Hz rTMS, the intensity was 80% of MT of tibialis anterior muscle, and the duration was about 20 min, once a day, 5 days a week for 4 weeks. Fugl-meyer lower extremity score (FMA-LE), 10-meter walk test (10MWT) and somatosensory evoked potential (SEP) were assessed at baseline, 4 weeks and 8 weeks after tredment. Results: Repeated ANOVA showed that FMA-LE, 10MWT, SEP latency and SEP peak had the interaction effect of time and group(P<0.05). For intragroup comparison, compared with the baseline, peak FMA-LE, 10MWT, and SEP were increased in all 4 groups at 4 and 8 weeks post-intervention (P<0.05); compared with those at week 4, FMA-LE, 10MWT, and SEP peaks were increased in all 4 groups at week 8 (P<0.05). The SEP latency in the 4 groups decreased after 4 and 8 weeks of intervention (P<0.05). The SEP latency was decreased after 8 weeks of treatment in all 4 groups compared with those after 4 weeks of treatment (P<0.05). Whether the intervention was 4 weeks or the intervention was 8 weeks, FMA-LE, 10MWT, and SEP amplitude was higher and SEP latency was lower in the group A than those in the other 3 groups (P<0.05). However, there were no significant differences in FAM-LE, 10MWT, SEP latency, or amplitudes among groups B, C, and D at either 4-week intervention or 8-week intervention. Conclusion: AOT combined with rTMS, AOT alone and rTMS alone can improve lower limb motor function and nerve conduction function, but compared with AOT alone or rTMS treatment, AOT combined with rTMS treatment is more beneficial for the improvement of lower limb dysfunction after ischemic stroke. |
