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局部肌肉振动治疗与假治疗对慢性卒中后患者上肢的短期影响:一项随机对照试验

Short-term effect of local muscle vibration treatment versus sham therapy on upper limb in chronic post-stroke patients: a randomized controlled trial.

作者信息

Costantino Cosimo, Galuppo Laura, Romiti Davide

机构信息

Unit of Rehabilitation Medicine, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy -

Unit of Rehabilitation Medicine, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy.

出版信息

Eur J Phys Rehabil Med. 2017 Feb;53(1):32-40. doi: 10.23736/S1973-9087.16.04211-8. Epub 2016 Sep 6.

Abstract

BACKGROUND

In recent years, local muscle vibration received considerable attention as a useful method for muscle stimulation in clinical therapy. Some studies described specific vibration training protocol, and few of them were conducted on post-stroke patients. Therefore there is a general uncertainty regarding the vibrations protocol.

AIM

The aim of this study was to evaluate the effects of local muscle high frequency mechano-acoustic vibratory treatment on grip muscle strength, muscle tonus, disability and pain in post-stroke individuals with upper limb spasticity.

DESIGN

Single-blind randomized controlled trial.

SETTING

Outpatient rehabilitation center.

POPULATION

Thirty-two chronic poststroke patients with upper-limb spasticity: 21 males, 11 females, mean age 61.59 years ±15.50, time passed from stroke 37.78±17.72 months.

METHODS

The protocol treatment consisted of the application of local muscle vibration, set to a frequency of 300 Hz, for 30 minutes 3 times per week, for 12 sessions, applied to the skin covering the venter of triceps brachii and extensor carpi radialis longus and brevis muscles during voluntary isometric contraction. All participants were randomized in two groups: group A treated with vibration protocol; group B with sham therapy. All participants were evaluated before and after 4-week treatment with Hand Grip Strength Test, Modified Ashworth Scale, QuickDASH score, FIM scale, Fugl-Meyer Assessment, Jebsen-Taylor Hand Function Test and Verbal Numerical Rating Scale of pain. Outcomes between groups was compared using a repeated-measures ANOVA.

RESULTS

Over 4 weeks, the values recorded in group A when compared to group B demonstrated statistically significant improvement in grip muscle strength, pain and quality of life and decrease of spasticity; P-values were <0.05 in all tested parameters.

CONCLUSIONS

Rehabilitation treatment with local muscle high frequency (300 Hz) vibration for 30 minutes, 3 times a week for 4 weeks, could significantly improve muscle strength and decrease muscle tonus, disability and pain in upper limb of hemiplegic post-stroke patients.

CLINICAL REHABILITATION IMPACT

Local muscle vibration treatment might be an additional and safe tool in the management of chronic poststroke patients, granted its high therapeutic efficiency, limited cost and short and repeatable protocol of use.

摘要

背景

近年来,局部肌肉振动作为临床治疗中一种有用的肌肉刺激方法受到了广泛关注。一些研究描述了特定的振动训练方案,但其中很少有针对中风后患者进行的。因此,关于振动方案存在普遍的不确定性。

目的

本研究旨在评估局部肌肉高频机械声学振动治疗对中风后上肢痉挛患者握力、肌肉张力、残疾程度和疼痛的影响。

设计

单盲随机对照试验。

地点

门诊康复中心。

研究对象

32例慢性中风后上肢痉挛患者,其中男性21例,女性11例,平均年龄61.59岁±15.50岁,中风后时间为37.78±17.72个月。

方法

方案治疗包括在自愿等长收缩期间,将局部肌肉振动频率设置为300Hz,每周3次,每次30分钟,共12次,施加于覆盖肱三头肌腹侧以及桡侧腕长伸肌和桡侧腕短伸肌的皮肤。所有参与者随机分为两组:A组采用振动方案治疗;B组采用假治疗。所有参与者在4周治疗前后均通过握力测试、改良Ashworth量表、QuickDASH评分、FIM量表、Fugl-Meyer评估、Jebsen-Taylor手功能测试和疼痛数字评分量表进行评估。组间结果采用重复测量方差分析进行比较。

结果

在4周内,与B组相比,A组记录的值在握力、疼痛和生活质量方面有统计学意义的改善,痉挛程度降低;所有测试参数的P值均<0.05。

结论

局部肌肉高频(300Hz)振动,每周3次,每次30分钟,持续4周的康复治疗可显著提高偏瘫中风后患者上肢的肌肉力量,降低肌肉张力、残疾程度和疼痛。

临床康复意义

局部肌肉振动治疗可能是慢性中风后患者管理中的一种额外且安全的工具,因为其治疗效率高、成本有限且使用方案简短且可重复。

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