Katusić Ana, Mejaski-Bosnjak Vlatka
Mali Dom, Zagreb Day Care Center for Rehabilitation, Croatia.
Coll Antropol. 2011 Jan;35 Suppl 1:57-63.
Afferent signals from the muscle's proprioceptors play important role in the control of muscle tone and in the facilitation of movements. Peripheral afferent pathway enables the restoration of connections with supraspinal structures and so includes mechanism of synaptic inhibition in the performance of normal movement. Different sensory stimuli, as vibrotactile stimulation, excite muscle's proprioceptors which then send sensorimotor information via spinal cord. In this way afferent signals promote cortical control and modulation of movements. The goal of this study is to evaluate the effects of vibrotactile stimulation on the spasticity and motor performance in children with cerebral injury. Subjects included in this study were 13 children who were developing the classification of spastic cerebral palsy. For all children perinatal brain damage was documented by medical reports and neonatal brain ultrasound scan. At the mean age of 3 years and 6 months subject underwent the assessment of motor development by Gross Motor Function Measurement (GMFM-88). Gross Motor Classification System (GMFCS) has been used to classify functions of lower extremities. Therapeutic intervention was conducted once a week during 3 months. All subjects were stimulated with vibrotactile stimuli of 40Hz in duration of 20 minutes in order to reduce spasticity. After the ending of the treatment subjects underwent second assessment of motor performance and the classification of lower extremities functions. The results have shown that there was a significant improvement in motor performance, what has been seen in the facilitation of rotations, better postural trunk stability and head control and in greater selectivity of movements. Further randomized, control trial investigations with bigger sample and included spasm scale are needed to gain better insight in the role of vibrotactile stimulation in the facilitation of normal movements.
来自肌肉本体感受器的传入信号在肌肉张力控制和运动促进方面发挥着重要作用。外周传入通路能够恢复与脊髓上结构的连接，因此在正常运动表现中包括突触抑制机制。不同的感觉刺激，如振动触觉刺激，会激发肌肉的本体感受器，然后这些感受器通过脊髓发送感觉运动信息。通过这种方式，传入信号促进了对运动的皮质控制和调节。本研究的目的是评估振动触觉刺激对脑损伤儿童痉挛和运动表现的影响。本研究纳入的受试者为13名正在进行痉挛型脑瘫分类的儿童。所有儿童的围产期脑损伤均由医学报告和新生儿脑超声扫描记录。受试者在平均年龄3岁6个月时接受了粗大运动功能测量（GMFM - 88）对运动发育的评估。采用粗大运动分类系统（GMFCS）对下肢功能进行分类。治疗干预在3个月内每周进行一次。为了减轻痉挛，所有受试者均接受了持续20分钟的40Hz振动触觉刺激。治疗结束后，受试者接受了运动表现的第二次评估以及下肢功能分类。结果表明，运动表现有显著改善，这体现在旋转动作的促进、更好的躯干姿势稳定性和头部控制以及更高的运动选择性上。需要进一步进行更大样本量且纳入痉挛量表的随机对照试验研究，以更深入了解振动触觉刺激在促进正常运动中的作用。
