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全身振动疗法对慢性脑卒中患者骨转换、肌肉力量、运动功能和痉挛的影响:一项随机对照试验。

The effects of whole-body vibration therapy on bone turnover, muscle strength, motor function, and spasticity in chronic stroke: a randomized controlled trial.

机构信息

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong -

出版信息

Eur J Phys Rehabil Med. 2013 Aug;49(4):439-50. Epub 2013 Mar 13.

PMID:23486302
Abstract

BACKGROUND

Whole-body vibration (WBV) has been used in older adults to improve bone health and neuromuscular function, and may have potential applications for stroke patients.

AIM

To investigate the effects of WBV on bone turnover, leg muscle strength, motor function, and spasticity among chronic stroke patients.

DESIGN

Randomized controlled trial (RCT).

SETTING

Community.

POPULATION

Eighty-two chronic stroke patients.

METHODS

The experimental group underwent exercise training with WBV stimulation for a maximum of 15 minutes, 3 days per week for 8 weeks. The controls received the same exercises without WBV. Participants were evaluated for isokinetic knee muscle strength, serum levels of bone formation and resorption markers, spasticity and motor function of the paretic leg at baseline, immediately after the 8-week training period, and 1-month follow-up.

RESULTS

Intention-to-treat analysis revealed no significant changes in levels of bone turnover markers and motor function of the paretic leg over time in both groups. Muscle strength outcomes showed no significant group×time interaction, with similar significant improvements found in both groups. Spasticity of the paretic knee was significantly reduced in the experimental group (P=0.005), but not in controls (P=0.465). No serious adverse events were reported.

CONCLUSION

The WBV protocol used in this study did not induce additional effects on bone turnover, knee muscle strength and paretic leg motor function among chronic stroke patients. WBV may have potential to modulate spasticity, but this requires further investigation.

CLINICAL REHABILITATION IMPACT

More study on WBV is required before it can be recommended as an adjunct treatment in rehabilitation of chronic stroke patients.

摘要

背景

全身振动(WBV)已被用于老年人以改善骨骼健康和神经肌肉功能,并且可能对中风患者具有潜在的应用价值。

目的

研究全身振动(WBV)对慢性中风患者的骨转换、腿部肌肉力量、运动功能和痉挛的影响。

设计

随机对照试验(RCT)。

地点

社区。

人群

82 例慢性中风患者。

方法

实验组接受最大 15 分钟、每周 3 天、共 8 周的 WBV 刺激运动训练。对照组接受相同的运动训练,但没有 WBV。在基线、8 周训练期结束后和 1 个月随访时,评估参与者的等速膝关节肌肉力量、血清骨形成和吸收标志物水平、患侧腿部痉挛和运动功能。

结果

意向性治疗分析显示,两组患者的骨转换标志物水平和患侧腿部运动功能均无随时间的变化。肌肉力量结果显示组间无显著的时间交互作用,两组均有显著的改善。实验组患侧膝关节痉挛显著降低(P=0.005),但对照组无显著变化(P=0.465)。未报告严重不良事件。

结论

本研究中使用的 WBV 方案并未在慢性中风患者中引起骨转换、膝关节肌肉力量和患侧腿部运动功能的额外作用。WBV 可能有调节痉挛的潜力,但这需要进一步研究。

临床康复影响

在推荐 WBV 作为慢性中风患者康复的辅助治疗方法之前,还需要更多的研究。

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