Observation on the efficacy of Neurac technique combined with TMS of vestibular reflex in treatment of post-stroke hemiplegia

WU Dan; GUO Boyuan; HUANG Yan; JIA Nan; GAO Chang; LI Shuang; ZHANG Xiaoying

doi:10.3969/j.issn.1674-3806.2025.02.10

Abstract：Objective To observe the efficacy of neuromuscular activation(Neurac)technique combined with transcranial magnetic stimulation(TMS)of vestibular reflex in treatment of post-stroke hemiplegia.Methods A total of 123 patients with post-stroke hemiplegia who were admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from January 2022 to August 2023 were recruited.The patients were randomly divided into Neurac technique group(N group),TMS of vestibular reflex group(T group),and combined treatment group,with 41 cases in each group.All the patients received conventional rehabilitation training.On this basis,N group received treatment of Neurac technique,and T group received treatment of TMS of vestibular reflex,and the combined treatment group received a combined treatment of Neurac technique and TMS of vestibular reflex,and all the groups were treated continuously for 4 weeks.The trunk stability,walking function,surface electromyography indicators[root mean square(RMS)values of biceps brachii and triceps brachii],lower limb muscle strength,upper and lower limb motor ability[Fugl-Meyer Assessment(FMA)scale scores],body balance function[Postural Assessment Scale for Stroke(PASS)scores,Brunel Balance Scale(BB A)scores]and quality of life[Stroke-Specific Quality of Life Scale(SS-QOL)scores]were compared among the three groups before and after treatment.Results Before treatment,there were no statistically significant differences in the trunk stability indicators among the three groups(P＞0.05).After treatment,the swing length,swing area,and average speed of the body in the three groups were significantly reduced when the eyes were open and closed compared with those before treatment(P＜0.05),and the levels of the indicators in the combined treatment group were significantly lower than those in T group and N group(P＜0.05),and the levels of the indicators in T group were significantly lower than those in N group(P＜0.05).Before treatment,there were no statistically significant differences in RMS values of biceps brachii and triceps brachii at the state of elbow flexion and extension,lower limb muscle strength,FMA scores of upper and lower limbs,BBA scores,and PASS scores among the three groups(P＞0.05).After treatment,the RMS values of biceps brachii and triceps brachii at the state of elbow flexion and extension,FMA scores of upper and lower limbs,BBA scores,and PASS scores in the three groups were significantly elevated compared with those before treatment(P＜0.05),and the levels of the indicators in the combined treatment group were higher than those in N group and T group(P＜0.05).However,there were no significant differences between N group and T group(P＞0.05).After treatment,the lower limb muscle strength in the three groups improved significantly compared with that before treatment(P＜0.05),and the improvement in the combined treatment group was significantly better than that in N group and T group(P＜0.05).After treatment,the self-care ability,activity ability,physical ability,and social role dimension scores of SS-QOL in the combined treatment group were significantly higher than those in N group and T group(P＜0.05),but there were no statistically significant differences between N group and T group(P＞0.05).Conclusion Neurac technique combined with TMS of vestibular reflex can enhance the muscle strength of the upper and lower limbs of the patients,improve their physical stability and balance ability,enhance their walking ability in the treatment of post-stroke hemiplegia,and improve their quality of life.