Ritzmann Ramona, Stark Christina, Krause Anne
Department of Sport Science, University of Freiburg, Freiburg, Germany.
Children's and Adolescent's Hospital, University of Cologne, Cologne, Germany.
Neuropsychiatr Dis Treat. 2018 Jun 18;14:1607-1625. doi: 10.2147/NDT.S152543. eCollection 2018.
The neurological disorder cerebral palsy (CP) is caused by unprogressive lesions of the immature brain and affects movement, posture, and the musculoskeletal system. Vibration therapy (VT) is increasingly used to reduce the signs and symptoms associated with this developmental disability. The purpose of this narrative review was systematically to appraise published research regarding acute and long-term effects of VT on functional, neuromuscular, and structural parameters. Systematic searches of three electronic databases identified 28 studies that fulfilled the inclusion criteria. Studies were analyzed to determine participant characteristics, VT-treatment protocols, effect on gross motor function (GMF), strength, gait, posture, mobility, spasticity, reflex excitability, muscle tone, mass, and bone strength within this population, and outcome measures used to evaluate effects. The results revealed that one acute session of VT reduces reflex excitability, spasticity, and coordination deficits. Subsequently, VT has a positive effect on the ability to move, manifested for GMF, strength, gait, and mobility in patients with CP. Effects persist up to 30 minutes after VT. Long-term effects of VT manifest as reduced muscle tone and spasticity occurring concomitantly with improved movement ability in regard to GMF, strength, gait, and mobility, as well as increased muscle mass and bone-mineral density. Posture control remained unaffected by VT. In conclusion, the acute and chronic application of VT as a nonpharmacological approach has the potential to ameliorate CP symptoms, achieving functional and structural adaptations associated with significant improvements in daily living. Even though further studies including adult populations validating the neuromuscular mechanisms underlying the aforementioned adaptations should be fostered, growing scientific evidence supports the effectiveness of VT in regard to supplementing conventional treatments (physiotherapy and drugs). Therefore, VT could reduce CP-associated physical disability and sensorimotor handicaps. Goals for patients and their caregivers referring to greater independence and improved safety may be achieved more easily and time efficiently.
神经疾病脑瘫(CP)由未成熟大脑的非进行性损伤引起,会影响运动、姿势和肌肉骨骼系统。振动疗法(VT)越来越多地用于减轻与这种发育障碍相关的体征和症状。本叙述性综述的目的是系统评估已发表的关于VT对功能、神经肌肉和结构参数的急性和长期影响的研究。对三个电子数据库进行系统检索,确定了28项符合纳入标准的研究。对这些研究进行分析,以确定参与者特征、VT治疗方案、对该人群的粗大运动功能(GMF)、力量、步态、姿势、活动能力、痉挛、反射兴奋性、肌张力、肌肉质量和骨强度的影响,以及用于评估效果的结局指标。结果显示,一次急性VT治疗可降低反射兴奋性、痉挛和协调缺陷。随后,VT对CP患者的运动能力有积极影响,表现为GMF、力量、步态和活动能力方面。VT后效果可持续30分钟。VT的长期影响表现为肌张力和痉挛降低,同时GMF、力量、步态和活动能力方面的运动能力改善,以及肌肉质量和骨矿物质密度增加。姿势控制不受VT影响。总之,作为一种非药物方法,急性和慢性应用VT有可能改善CP症状,实现与日常生活显著改善相关的功能和结构适应。尽管应鼓励开展进一步研究,包括纳入成年人群以验证上述适应背后的神经肌肉机制,但越来越多的科学证据支持VT在补充传统治疗(物理治疗和药物)方面的有效性。因此,VT可减少与CP相关的身体残疾和感觉运动障碍。患者及其护理人员关于更大独立性和更高安全性的目标可能更容易、更高效地实现。