| Objective：To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with virtual reality (VR) in patients with hemiplegia after stroke. Methods：A total of 108 patients with hemiplegia after stroke from January 2022 to June 2023 were randomly divided into 3 groups with 36 cases in each group. All patients were given conventional comprehensive treatment, and the rTMS group was given low-frequency rTMS, the VR group was given VR technology training, and the combined group was given low-frequency rTMS combined with VR technology training. The intervention duration was 4 weeks. The changes in body pressure center sway index, limit of stability (LOS), upper and lower limb motor function (FMA), and activities of daily living (BI), body composition, cerebral blood flow (CBF), neurocognitive function(NIHSS MoCA RBMT) were compared among the three groups before and after intervention. Results：After 4 weeks of intervention, the swing length, swing area, and average speed of the three groups during eye opening and closing were all reduced as compared with those before intervention, and those in the combined group were lower than in the VR group and rTMS group, while those in the VR group were lower than in the rTMS group (P<0.05). After 4 weeks of intervention, the LOS results of the three groups were all increased as compared with before intervention, and those in the combined group were higher than in the VR group and rTMS group, while those in the VR group were higher than the rTMS group (P<0.05). After 4 weeks of intervention, the upper and lower limb function and daily activity ability of the three groups were all increased as compared with those before intervention, and those in the combined group were higher than in the VR group and rTMS group, while those in the VR group were higher than in the rTMS group (P<0.05). After 4 weeks of intervention, the edema index of the three groups was all decreased as compared with before intervention, and that in the combined group and VR group was lower than in the rTMS group (P<0.05), while the upper limb muscle strength and skeletal muscle index of the three groups were all increased as compared with before intervention, and those in the combined group and VR group were greater than in the rTMS group (P<0.05). After 4 weeks of intervention, the CBF values of the three groups were all increased as compared with before intervention, and those in the combined group were higher than in the rTMS group and VR group, while those in the rTMS group were higher than in the VR group (P<0.05). After 4 weeks of intervention, the NIHSS scores of the three groups were all decreased as compared with before intervention, and those in the combined group were lower than in the VR group and rTMS group, while those in the rTMS group were lower than in the VR group. The MoCA and RBMT scores after 4 weeks of intervention were both increased as compared with before intervention, and those in the combined group were higher than in the VR group and rTMS group, while those in the rTMS group was higher than in the VR group (P<0.05). Conclusion：rTMS combined with VR technology training can improve motor function, limb stability, neurocognitive function and cerebral blood flow of stroke patients with hemiplegia, and improve their self-care ability. |
