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评估聚焦振动器对健康人群肌腱和肌腹的不同电生理效应。

Evaluating the differential electrophysiological effects of the focal vibrator on the tendon and muscle belly in healthy people.

作者信息

Lee Gangpyo, Cho Yung, Beom Jaewon, Chun Changmook, Kim Choong Hyun, Oh Byung-Mo

机构信息

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea.

出版信息

Ann Rehabil Med. 2014 Aug;38(4):494-505. doi: 10.5535/arm.2014.38.4.494. Epub 2014 Aug 28.

Abstract

OBJECTIVE

To investigate the electrophysiological effects of focal vibration on the tendon and muscle belly in healthy people.

METHODS

The miniaturized focal vibrator consisted of an unbalanced mass rotating offset and wireless controller. The parameters of vibratory stimulation were adjusted on a flat rigid surface as 65 µm at 70 Hz. Two consecutive tests on the different vibration sites were conducted in 10 healthy volunteers (test 1, the Achilles tendon; test 2, the muscle belly on the medial head of the gastrocnemius). The Hoffman (H)-reflex was measured 7 times during each test. The minimal H-reflex latency, maximal amplitude of H-reflex (Hmax), and maximal amplitude of the M-response (Mmax) were acquired. The ratio of Hmax and Mmax (HMR) and the vibratory inhibition index (VII: the ratio of the Hmax after vibration and Hmax before vibration) were calculated. The changes in parameters according to the time and site of stimulation were analyzed using the generalized estimating equation methods.

RESULTS

All subjects completed the two tests without serious adverse effects. The minimal H-reflex latency did not show significant changes over time (Wald test: χ(2)=11.62, p=0.07), and between the two sites (χ(2)=0.42, p=0.52). The changes in Hmax (χ(2)=53.74, p<0.01), HMR (χ(2)=20.49, p<0.01), and VII (χ(2)=13.16, p=0.02) were significant over time with the adjustment of sites. These parameters were reduced at all time points compared to the baseline, but the decrements reverted instantly after the cessation of stimulation. When adjusted over time, a 1.99-mV decrease in the Hmax (χ(2)=4.02, p=0.04) and a 9.02% decrease in the VII (χ(2)=4.54, p=0.03) were observed when the muscle belly was vibrated compared to the tendon.

CONCLUSION

The differential electrophysiological effects of focal vibration were verified. The muscle belly may be the more effective site for reducing the H-reflex compared to the tendon. This study provides the neurophysiological basis for a selective and safe rehabilitation program for spasticity management with focal vibration.

摘要

目的

研究局部振动对健康人肌腱和肌腹的电生理效应。

方法

小型局部振动器由一个不平衡质量偏心旋转装置和无线控制器组成。在平坦刚性表面上,将振动刺激参数调整为70Hz时65μm。对10名健康志愿者在不同振动部位进行了两项连续测试(测试1,跟腱;测试2,腓肠肌内侧头肌腹)。每次测试期间测量7次霍夫曼(H)反射。获取最小H反射潜伏期、H反射最大波幅(Hmax)和M反应最大波幅(Mmax)。计算Hmax与Mmax的比值(HMR)以及振动抑制指数(VII:振动后Hmax与振动前Hmax的比值)。使用广义估计方程方法分析刺激时间和部位引起的参数变化。

结果

所有受试者均完成两项测试,无严重不良反应。最小H反射潜伏期随时间未显示出显著变化(Wald检验:χ(2)=11.62,p=0.07),且在两个部位之间也无显著变化(χ(2)=0.42,p=0.52)。调整部位后,Hmax(χ(2)=53.74,p<0.01)、HMR(χ(2)=20.49,p<0.01)和VII(χ(2)=13.16,p=0.02)随时间的变化具有显著性。与基线相比,这些参数在所有时间点均降低,但刺激停止后即刻恢复。随时间调整后,与肌腱相比,肌腹振动时Hmax降低1.99mV(χ(2)=4.02,p=0.04),VII降低9.02%(χ(2)=4.54,p=0.03)。

结论

验证了局部振动的不同电生理效应。与肌腱相比,肌腹可能是降低H反射更有效的部位。本研究为采用局部振动进行痉挛管理的选择性安全康复方案提供了神经生理学依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c3a/4163589/4975fcdb11a5/arm-38-494-g001.jpg

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