Učinkovitost transkutane avrikularne električne stimulacije vagusnega živca na motorično funkcijo zgornjega uda pri bolnikih po možganski kapi – pregled literature : diplomsko delo

Brelih, Evita (author), Tomc Žargi, Tina (mentor), Mlakar, Nataša (comentor), Jakovljević, Miroljub (reviewer)

Uvod: Možganska kap je nenadno nastalo nevrološko nujno stanje, ki predstavlja enega izmed vodilnih vzrokov invalidnosti in smrti na svetovni ravni. Približno 80-85 % bolnikov se v akutni fazi sooča z motorično okvaro zgornjih udov, pri 60 % bolnikov pa okvara vztraja tudi v kronični fazi. Skupaj z rehabilitacijskim programom se vse pogosteje uporabljajo nevromodulacijske tehnike. Transkutana avrikularna stimulacija vagusnega živca predstavlja neinvazivno alternativo kirurško vstavljeni stimulaciji vagusnega živca, ki lahko doseže primerljive učinke na možgansko aktivnost. Namen: Na podlagi pregleda znanstvene in strokovne literature ugotoviti učinkovitost transkutane avrikularne električne stimulacije vagusnega živca na motorično funkcijo zgornjega uda pri bolnikih po možganski kapi. Metode dela: Literaturo smo iskali v podatkovnih bazah Pubmed in PEDro. Uporabljena je bila naslednja kombinacija ključnih besed v angleškem jeziku: »Transcutaneous vagus nerve stimulation AND stroke«. Rezultati: V pregled literature smo na podlagi vključitvenih in izključitvenih meril vključili pet raziskav, objavljenih po letu 2017. V dveh raziskavah so preučevali vpliv transkutane avrikularne stimulacije vagusnega živca v kombinaciji z robotsko rehabilitacijo zgornjega uda, kjer je tudi prišlo do statistično in klinično pomembnih rezultatov. V preostalih treh raziskavah so ugotavljali učinke transkutane avrikularne stimulacije vagusnega živca skupaj z različnimi oblikami vadbe za zgornji ud, v eni izmed raziskav pa so uporabili tudi vaje za nadzor drže, proprioceptivne vaje, nevromuskularno facilitacijo in vadbo hoje. V raziskave so bili vključeni preiskovanci po ishemični ali hemoragični možganski kapi z disfunkcijo zgornjega uda. V vseh raziskavah je prišlo do izboljšanja motoričnih funkcij zgornjega uda. Razprava in zaključek: Na podlagi pregleda literature smo ugotovili pomembno izboljšanje motoričnih funkcij v skupinah, kjer so preiskovanci prejeli transkutano avrikularno stimulacijo vagusnega živca skupaj z robotsko podprto vadbo oziroma vadbo za zgornji ud, v primerjavi s kontrolnimi skupinami, ki so prejele lažno stimulacijo. V prihodnosti bi bile potrebne nadaljnje raziskave z večjim vzorcem, enotnejšimi parametri, časovnim obdobjem in obliko vadbe.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, možganska kap, disfunkcija zgornjega uda, vagusni živec, transkutana električna stimulacija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [E. Brelih]
• Year: 2025
• Number of pages: 36 str.
• PID: 20.500.12556/RUL-169453
• UDC: 615.8
• COBISS.SI-ID: 237582339
• Publication date in RUL: 29.05.2025

Secondary language

• Language: English
• Title: Efficacy of transcutaneous auricular vagus nerve stimulation on upper limb motor function in post-stroke patients – literature review : diploma work

Abstract

Introduction: Stroke is a sudden-onset neurological emergency and one of the leading causes of disability and mortality worldwide. Approximately 80–85% of patients experience motor impairment of the upper limbs during the acute phase, with persistent impairments observed in 60% of patients in the chronic phase. Neuromodulation techniques are increasingly utilized as adjuncts to rehabilitation programs. Transcutaneous auricular vagus nerve stimulation provides a non-invasive alternative to surgically implanted vagus nerve stimulation, offering comparable effects on brain activity. Purpose: To determine the effectiveness of transcutaneous auricular vagus nerve stimulation on upper limb motor function in stroke patients, based on a review of published scientific literature. Methods: A literature search was conducted in the PubMed and PEDro databases using the following combination of keywords in English: "Transcutaneous vagus nerve stimulation AND stroke." Results: Based on the inclusion and exclusion criteria, five research papers published since 2017 were included in the review. Two studies investigated the effects of transcutaneous auricular vagus nerve stimulation combined with robotic upper limb rehabilitation, showing statistically and clinically significant results. The remaining three studies evaluated the effects of transcutaneous auricular vagus nerve stimulation combined with various forms of upper limb exercises, with one study also incorporating posture control exercises, proprioceptive training, neuromuscular facilitation, and gait training. Participants in these studies included individuals with upper limb dysfunction following ischemic or haemorrhagic stroke. All studies reported improvements in upper limb motor function. Discussion and Conclusion: The literature review indicates greater improvements in motor function among participants who received transcutaneous auricular vagus nerve stimulation combined with robotic training or upper limb exercises compared to control groups that received sham stimulation. Future studies with larger sample sizes, standardized parameters, consistent timeframes, and well-defined exercise modalities are needed to further validate these findings.

• Keywords: diploma theses, physiotherapy, stroke, upper limb dysfunction, vagus nerve, transcutaneus stimulation