振动强度、运动及运动功能障碍对脑卒中患者全身振动诱发的腿部肌肉活动的影响

Effects of Vibration Intensity, Exercise, and Motor Impairment on Leg Muscle Activity Induced by Whole-Body Vibration in People With Stroke.

作者信息

Liao Lin-Rong, Ng Gabriel Y F, Jones Alice Y M, Chung Raymond C K, Pang Marco Y C

机构信息

L-R. Liao, MPT, Department of Physiotherapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China, and Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China.

G.Y.F. Ng, PhD, Department of Rehabilitation Sciences, Hong Kong Polytechnic University.

出版信息

Phys Ther. 2015 Dec;95(12):1617-27. doi: 10.2522/ptj.20140507. Epub 2015 May 28.

DOI:10.2522/ptj.20140507

PMID:26023219

Abstract

BACKGROUND

Whole-body vibration (WBV) has increasingly been used as an adjunct treatment in neurological rehabilitation. However, how muscle activation level changes during exposure to different WBV protocols in individuals after stroke remains understudied.

OBJECTIVE

The purpose of this study was to examine the influence of WBV intensity on the magnitude of biceps femoris (BF) and tibialis anterior (TA) muscle activity and its interaction with exercise and with severity of motor impairment and spasticity among individuals with chronic stroke.

METHODS

Each of the 36 individuals with chronic stroke (mean age=57.3 years, SD=10.7) performed 8 different static exercises under 3 WBV conditions: (1) no WBV, (2) low-intensity WBV (frequency=20 Hz, amplitude=0.60 mm, peak acceleration=0.96g), and (3) high-intensity WBV (30 Hz, 0.44 mm, 1.61g). The levels of bilateral TA and BF muscle activity were recorded using surface electromyography (EMG).

RESULTS

The main effect of intensity was significant. Exposure to the low-intensity and high-intensity protocols led to a significantly greater increase in normalized BF and TA muscle electromyographic magnitude in both legs compared with no WBV. The intensity × exercise interaction also was significant, suggesting that the WBV-induced increase in EMG activity was exercise dependent. The EMG responses to WBV were similar between the paretic and nonparetic legs and were not associated with level of lower extremity motor impairment and spasticity.

LIMITATIONS

Leg muscle activity was measured during static exercises only.

CONCLUSIONS

Adding WBV during exercise significantly increased EMG activity in the TA and BF muscles. The EMG responses to WBV in the paretic and nonparetic legs were similar and were not related to degree of motor impairment and spasticity. The findings are useful for guiding the design of WBV training protocols for people with stroke.

摘要

背景

全身振动（WBV）越来越多地被用作神经康复的辅助治疗方法。然而，中风个体在接受不同WBV方案时肌肉激活水平如何变化仍未得到充分研究。

目的

本研究旨在探讨WBV强度对慢性中风个体股二头肌（BF）和胫骨前肌（TA）肌肉活动幅度的影响，以及其与运动、运动功能障碍严重程度和痉挛之间的相互作用。

方法

36名慢性中风个体（平均年龄 = 57.3岁，标准差 = 10.7）在3种WBV条件下进行8种不同的静态运动：（1）无WBV，（2）低强度WBV（频率 = 20Hz，振幅 = 0.60mm，峰值加速度 = 0.96g），（3）高强度WBV（30Hz，0.44mm，1.61g）。使用表面肌电图（EMG）记录双侧TA和BF肌肉活动水平。