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基于地面的高频低强度振动刺激在痉挛型脑瘫儿童中的部位特异性传递

Site-Specific Transmission of a Floor-Based, High-Frequency, Low-Magnitude Vibration Stimulus in Children With Spastic Cerebral Palsy.

作者信息

Singh Harshvardhan, Whitney Daniel G, Knight Christopher A, Miller Freeman, Manal Kurt, Kolm Paul, Modlesky Christopher M

机构信息

Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE.

Department of Orthopedics, Nemours AI duPont Hospital for Children, Wilmington, DE.

出版信息

Arch Phys Med Rehabil. 2016 Feb;97(2):218-23. doi: 10.1016/j.apmr.2015.08.434. Epub 2015 Sep 21.

Abstract

OBJECTIVE

To determine the degree to which a high-frequency, low-magnitude vibration signal emitted by a floor-based platform transmits to the distal tibia and distal femur of children with spastic cerebral palsy (CP) during standing.

DESIGN

Cross-sectional study.

SETTING

University research laboratory.

PARTICIPANTS

Children with spastic CP who could stand independently (n=18) and typically developing children (n=10) (age range, 4-12y) participated in the study (N=28).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The vibration signal at the high-frequency, low-magnitude vibration platform (approximately 33Hz and 0.3g), distal tibia, and distal femur was measured using accelerometers. The degree of plantar flexor spasticity was assessed using the Modified Ashworth Scale.

RESULTS

The high-frequency, low-magnitude vibration signal was greater (P<.001) at the distal tibia than at the platform in children with CP (.36±.06g vs .29±.05g) and controls (.40±.09g vs .24±.07g). Although the vibration signal was also higher at the distal femur (.35±.09g, P<.001) than at the platform in controls, it was lower in children with CP (.20±.07g, P<.001). The degree of spasticity was negatively related to the vibration signal transmitted to the distal tibia (Spearman ρ=-.547) and distal femur (Spearman ρ=-.566) in children with CP (both P<.05).

CONCLUSIONS

A high-frequency, low-magnitude vibration signal from a floor-based platform was amplified at the distal tibia, attenuated at the distal femur, and inversely related to the degree of muscle spasticity in children with spastic CP. Whether this transmission pattern affects the adaptation of the bones of children with CP to high-frequency, low-magnitude vibration requires further investigation.

摘要

目的

确定站立时,基于地面的平台发出的高频、低强度振动信号传递到痉挛型脑瘫(CP)患儿胫骨远端和股骨远端的程度。

设计

横断面研究。

地点

大学研究实验室。

参与者

能够独立站立的痉挛型CP患儿(n = 18)和发育正常的儿童(n = 10)(年龄范围4 - 12岁)参与了本研究(N = 28)。

干预措施

不适用。

主要观察指标

使用加速度计测量高频、低强度振动平台(约33Hz和0.3g)、胫骨远端和股骨远端的振动信号。使用改良Ashworth量表评估跖屈肌痉挛程度。

结果

CP患儿(.36±.06g对.29±.05g)和对照组(.40±.09g对.24±.07g)胫骨远端的高频、低强度振动信号大于平台处(P<.001)。虽然对照组股骨远端的振动信号(.35±.09g,P<.001)也高于平台处,但CP患儿的较低(.20±.07g,P<.001)。CP患儿的痉挛程度与传递到胫骨远端(Spearman ρ = -.547)和股骨远端(Spearman ρ = -.566)的振动信号呈负相关(均P<.05)。

结论

来自基于地面的平台的高频、低强度振动信号在胫骨远端被放大,在股骨远端被衰减,并且与痉挛型CP患儿的肌肉痉挛程度呈负相关。这种传递模式是否会影响CP患儿骨骼对高频、低强度振动的适应性,需要进一步研究。

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