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慢性卒中患者的全身振动强度:一项随机对照试验。

Whole-Body Vibration Intensities in Chronic Stroke: A Randomized Controlled Trial.

作者信息

Liao Lin-Rong, Ng Gabriel Y F, Jones Alice Y M, Huang Mei-Zhen, Pang Marco Y C

机构信息

1Department of Physiotherapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, CHINA; 2Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, CHINA; and 3School of Allied Health Sciences, Griffith University, Gold Coast, AUSTRALIA.

出版信息

Med Sci Sports Exerc. 2016 Jul;48(7):1227-38. doi: 10.1249/MSS.0000000000000909.

Abstract

PURPOSE

A single-blinded randomized controlled study was conducted to investigate the effects of different whole-body vibration (WBV) intensities on body functions/structures, activity, and participation in individuals with stroke.

METHODS

Eighty-four individuals with chronic stroke (mean age = 61.2 yr, SD = 9.2) with mild to moderate motor impairment (Chedoke-McMaster Stroke Assessment lower limb motor score: median = 9 out of 14, interquartile range = 7-11.8) were randomly assigned to a low-intensity WBV, high-intensity WBV, or control group. The former two groups performed various leg exercises while receiving low-intensity and high-intensity WBV, respectively. Controls performed the same exercises without WBV. All individuals received 30 training sessions over an average period of 75.5 d (SD = 5.2). Outcome measurements included knee muscle strength (isokinetic dynamometry), knee and ankle joint spasticity (Modified Ashworth Scale), balance (Mini Balance Evaluation Systems Test), mobility (Timed-Up-and-Go test), walking endurance (6-Minute Walk Test), balance self-efficacy (Activities-specific Balance Confidence scale), participation in daily activities (Frenchay Activity Index), perceived environmental barriers to societal participation (Craig Hospital Inventory of Environmental Factors), and quality of life (Short-Form 12 Health Survey). Assessments were performed at baseline and postintervention.

RESULTS

Intention-to-treat analysis revealed a significant time effect for muscle strength, Timed-Up-and-Go distance, and oxygen consumption rate achieved during the 6-Minute Walk Test, the Mini Balance Evaluation Systems Test, the Activities-specific Balance Confidence scale, and the Short-Form 12 Health Survey physical composite score domain (P < 0.05). However, the time-group interaction was not significant for any of the outcome measures (P > 0.05).

CONCLUSION

The addition of the 30-session WBV paradigm to the leg exercise protocol was no more effective in enhancing body functions/structures, activity, and participation than leg exercises alone in chronic stroke patients with mild to moderate motor impairments.

摘要

目的

开展一项单盲随机对照研究,以调查不同全身振动(WBV)强度对中风患者身体功能/结构、活动能力及参与度的影响。

方法

84例慢性中风患者(平均年龄 = 61.2岁,标准差 = 9.2),存在轻度至中度运动障碍(Chedoke - McMaster中风评估下肢运动评分:中位数为14分中的9分,四分位间距 = 7 - 11.8),被随机分配至低强度WBV组、高强度WBV组或对照组。前两组在分别接受低强度和高强度WBV的同时进行各种腿部锻炼。对照组在无WBV的情况下进行相同锻炼。所有个体在平均75.5天(标准差 = 5.2)的时间内接受30次训练。结果测量包括膝关节肌肉力量(等速测力法)、膝关节和踝关节痉挛(改良Ashworth量表)、平衡能力(简易平衡评估系统测试)、活动能力(计时起立行走测试)、步行耐力(6分钟步行测试)、平衡自我效能感(特定活动平衡信心量表)、日常活动参与度(Frenchay活动指数)、对社会参与的感知环境障碍(克雷格医院环境因素量表)以及生活质量(简明健康调查量表12项)。在基线和干预后进行评估。

结果

意向性分析显示,在6分钟步行测试、简易平衡评估系统测试、特定活动平衡信心量表以及简明健康调查量表身体综合评分领域中,肌肉力量、计时起立行走距离和耗氧率存在显著的时间效应(P < 0.05)。然而,对于任何一项结果测量指标,时间 - 组交互作用均不显著(P > 0.05)。

结论

在轻度至中度运动障碍的慢性中风患者中,在腿部锻炼方案中增加30节次的WBV模式,在增强身体功能/结构、活动能力及参与度方面并不比单纯的腿部锻炼更有效。

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