| Objective: To observe the impact of spine nerves muscle stimulation combined with repetitive transcranial magnetic stimulation (rTMS) on post-stroke sleep disorders (SD) and psychological status. Methods: From May 2023 to March 2024, 90 patients with post-stroke SD admitted to our hospital were selected and randomly divided into three groups: manual therapy group, rTMS group, and combined group, with 30 patients in each group. However, 2 patients dropped out from the manual therapy group, 1 from the rTMS group, and 1 from the combined group, leaving 28, 29, and 29 patients in each group respectively. All groups received conventional treatment. Additionally, the manual therapy group received spine nerves muscle stimulation for 30 min/day, 6 days/week for 4 weeks; the rTMS group received rTMS for 20 min/day, 6 days/week for 4 weeks; and the combined group received both rTMS and spine nerves muscle stimulation for 50 min/day, 6 days/week for 4 weeks. The Pittsburgh sleep quality index (PSQI), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and polysomnography parameters (arousal index, sleep efficiency, sleep latency, and total sleep time) were evaluated and compared before and after treatment in all groups. Results: Before treatment, there were no statistically significant differences in the aforementioned outcomes among the three groups. After 4 weeks of treatment, the PSQI, HAMD, HAMA scores, arousal index, and sleep latency decreased in all groups compared to baseline (P<0.05), while sleep efficiency and total sleep time increased (P<0.05). The PSQI, HAMD, HAMA scores, arousal index, and sleep latency were lower in the combined group than in the manual therapy and rTMS groups (P<0.05). Additionally, the sleep efficiency and total sleep time parameters were higher in the combined group than in the manual therapy and rTMS groups (P<0.05). There were no statistically significant differences in PSQI, HAMD, HAMA scores, or polysomnography parameters between the rTMS group and the manual therapy group. Conclusion: Compared with spine nerves muscle stimulation or rTMS alone, the combined use of spine nerves muscle stimulation and rTMS can more effectively improve post-stroke SD and alleviate depression and anxiety in stroke patients. |
